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This meta-analysis examined studies reporting on randomized controlled trials of the use of cognitive-behavioral approaches to intervention for children with autism spectrum disorder. Ten studies involving 402 children were located. The majority of the participants (mean age of 10.5 years) were high functioning, and all full-scale IQ scores reported for the individual participants were at or above 70. All interventions were administered by therapists in clinical settings, and most targeted anxiety and related issues. There was considerable variation in the intervention components used, the total training hours spent, and the modalities and time span over which the interventions were delivered. A large and statistically significant effect size was obtained from the meta-analysis, and extreme care is required in its interpretation because of substantial heterogeneity. There were some concerns about the use of child and parent reports as outcome measures and the quality of some studies. Further research is needed to investigate the feasibility of cognitive-behavioral approaches for low-functioning children with ASD by teachers in school settings.

Background Interventions using cognitive-behavioural approaches have been suggested to be effective for children with autism spectrum disorder (ASD). In the current review, the authors attempt to clarify how these cognitive-behavioural approach interventions may deliver their intended effects by examining the relationships between their aims, content/skills addressed, and outcome measures. Method A total of 39 studies reporting on cognitive-behavioural approaches for children with ASD were located through a database search, examined, and relevant data were subsequently extracted. Result There was a notable lack of correspondence between the intervention aims, content/skills taught, and the outcome variables measured. Mastery of intermediate knowledge and skills, which were presumed to indirectly facilitate desired behaviour change, was not typically assessed.Conclusion It is very difficult to determine the contribution of components to the effectiveness of multiple-component approach interventions. More cost-effective cognitive-behavioural approach interventions may be possible with research focusing on examining the effectiveness of individual components, in particular with single-subject experimental design research.

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