Cognitive Behavioral Therapy for Early Adolescents With Autism Spectrum Disorders and Clinical Anxiety: A Randomized, Controlled Trial

Wood, Jeffrey J.; Ehrenreich–May, Jill; Alessandri, Michael; Fujii, Cori; Renno, Patricia; Laugeson, Elizabeth A.; Piacentini, John; Nadai, Alessandro S. De; Arnold, Elysse B.; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

doi:10.1016/j.beth.2014.01.002

Cited by 191 publications

(145 citation statements)

References 51 publications

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“…Study designs included controlled trials and RCTs (Chalfant et al 2007;Fuji et al 2013;McNally Keehn et al 2013;Reaven et al 2012a;Reaven et al 2009;Sofronoff et al 2005;Storch et al 2013;Sung et al 2011;Wood et al 2009a;Wood et al 2015). The majority of participants were male (n = 353 or 83.5 %; 70 females), which broadly equates to the ratio of males to females diagnosed with ASD (4:1; Baron-Cohen et al 2001).…”

Section: Outcome Of Interventions Anxiety Disordersmentioning

confidence: 99%

“…The majority of participants were male (n = 353 or 83.5 %; 70 females), which broadly equates to the ratio of males to females diagnosed with ASD (4:1; Baron-Cohen et al 2001). Ages ranged from 7 to 16 years with the majority of studies recruiting older children and just one study recruiting adolescents (Wood et al 2015). All participants were high functioning with average or above IQ.…”

Section: Outcome Of Interventions Anxiety Disordersmentioning

confidence: 99%

“…Three studies employed manuals specifically developed for young people with autism (Facing your Fears; Reaven et al 2009;Reaven et al 2012a) or an unstandardized programme (Sofronoff et al 2005); two studies (Storch et al 2013;Wood et al 2015) employed Behavioural Interventions for Anxiety in Children with Autism (BIACA; Wood and Drahota 2005). • Improving social resources CBT Component All studies described between three and six components of CBT.…”

Section: Participant Selection and Comparability To Controlsmentioning

confidence: 99%

“…Relaxation activities were delivered in a more directive way than would be expected for CBT with a typically developing population. Cognitive restructuring was typically delivered in a creative way through the use of acronyms such as KICK-Knowing I'm nervous, Icky thoughts, Calming thoughts, Keep practicing (Wood et al 2015); through guided discovery pretending to be scientists (Sofronoff et al 2005); or through the use of lists of unhelpful and helpful thoughts from which alternative thinking strategies could be chosen rather than generated. Similarly, problem solving was introduced through acronyms such as STARStop, Think, Act, Reflect (Sung et al 2011)-or social stories and most exposure was completed as home practices.…”

Section: Participant Selection and Comparability To Controlsmentioning

confidence: 99%

“…Relapse prevention plans were not reported, with the exception of two studies (Chalfant et al 2007;Sofronoff et al 2005). It is of interest to note that it was the studies employing five or six components of CBT (Chalfant et al 2007;McNally Keehn et al 2013;Sofronoff et al 2005;Sung et al 2011;Wood et al 2015) which found significant reductions in child reports of anxiety or an increased use of coping strategies.…”

Section: Participant Selection and Comparability To Controlsmentioning

confidence: 99%

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A Systematic Review of Effective Modifications to Cognitive Behavioural Therapy for Young People with Autism Spectrum Disorders

Walters

Loades

Russell

2016

Rev J Autism Dev Disord

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The present review evaluated studies which effectively employed cognitive behavioural therapy (CBT) to alleviate symptoms of common mental health problems in young people with autism spectrum disorder (ASD). It assessed the modifications applied to CBT and compliance with recent guidelines from the National Institute of Health Care Excellence (NICE). Systematic searches of electronic databases, reference lists, and journals identified 12 studies meeting predetermined inclusion criteria. Results indicated that modified CBT yielded reductions in anxiety, obsessivecompulsive disorder (OCD), and depression. There was a lack of gold standard research into the effects of CBT for disorders other than anxiety. A greater number of modifications than recommended by NICE were consistently employed, including disorder-specific modifications. Implications for clinical intervention and future research are discussed.

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Section: Outcome Of Interventions Anxiety Disordersmentioning

confidence: 99%

Section: Outcome Of Interventions Anxiety Disordersmentioning

confidence: 99%

Section: Participant Selection and Comparability To Controlsmentioning

confidence: 99%

Section: Participant Selection and Comparability To Controlsmentioning

confidence: 99%

Section: Participant Selection and Comparability To Controlsmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review of Effective Modifications to Cognitive Behavioural Therapy for Young People with Autism Spectrum Disorders

Walters

Loades

Russell

2016

Rev J Autism Dev Disord

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Effectiveness of Training Therapists to Deliver An Individualized Mental Health Intervention for Children With ASD in Publicly Funded Mental Health Services

et al. 2019

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IMPORTANCE Publicly funded mental health services play an important role in addressing co-occurring mental health problems in children with autism spectrum disorder (ASD); however, therapists report lacking training to effectively serve this complex population. OBJECTIVE To test the effectiveness of training community therapists in An Individualized Mental Health Intervention for ASD (AIM HI) on challenging behaviors across 18 months among children with ASD and identify moderators and mediators of any intervention effects. DESIGN, SETTING, AND PARTICIPANTS Cluster randomized trial conducted in 29 publicly funded outpatient and school-based mental health programs in southern California from 2012 to 2017. Programs were randomized to receive immediate AIM HI training or provide usual care followed by receipt of AIM HI training. Therapist participants were recruited from enrolled programs, and child participants were recruited from participant therapists' caseloads. Data were analyzed from 202 children with ASD who were aged 5 to 13 years. INTERVENTIONS The AIM HI protocol is a package of parent-mediated and child-focused strategies aimed to reduce challenging behaviors in children with ASD who are 5 to 13 years old. It was designed for delivery in publicly funded mental health services based on a systematic assessment of therapist training needs and child clinical needs. The therapist training and consultation process takes approximately 6 months and includes an introductory workshop, 11 structured consultation meetings as the therapist delivers AIM HI with a current client, and case-specific performance feedback from trainers. MAIN OUTCOMES AND MEASURES Child participants were assessed for challenging behaviors using the Eyberg Child Behavior Inventory (ECBI) and Social Skills Improvement System (SSIS) Competing Problem Behaviors scales based on parent report at baseline and at 6-month intervals for 18 months. Outcomes were analyzed using intent-to-treat models. RESULTS In total, 202 children with ASD (mean [SD] age, 9.1 [2.4] years; 170 [84.2%] male; 121 [59.9%] Latinx) were eligible, enrolled, and included in the analyses. Statistically significant group by time interactions for the ECBI Intensity (B = −0.38; P = .02) and ECBI Problem (B = −1.00; P = .005) scales were observed, with significantly larger decreases in ECBI Intensity scores in the AIM HI group (B = −1.36; P < .001) relative to the usual care group (B = −0.98; P < .001) and a significantly larger decrease in ECBI Problem scores in the AIM HI group (B = −1.22; P < .001) relative to the usual care group (B = −0.20; P = .29). Therapist fidelity moderated these intervention effects. CONCLUSIONS AND RELEVANCE The present findings support the effectiveness of training therapists to deliver the AIM HI model to children with ASD receiving publicly funded mental health services.

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Cognitive Behavioral Treatments for Anxiety in Children With Autism Spectrum Disorder

et al. 2020

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IMPORTANCE Anxiety is common among youth with autism spectrum disorder (ASD), often interfering with adaptive functioning. Psychological therapies are commonly used to treat school-aged youth with ASD; their efficacy has not been established.OBJECTIVE To compare the relative efficacy of 2 cognitive behavioral therapy (CBT) programs and treatment as usual (TAU) to assess treatment outcomes on maladaptive and interfering anxiety in children with ASD. The secondary objectives were to assess treatment outcomes on positive response, ASD symptom severity, and anxiety-associated adaptive functioning. DESIGN, SETTING, AND PARTICIPANTSThis randomized clinical trial began recruitment in April 2014 at 3 universities in US cities. A volunteer sample of children (7-13 years) with ASD and maladaptive and interfering anxiety was randomized to standard-of-practice CBT, CBT adapted for ASD, or TAU. Independent evaluators were blinded to groupings. Data were collected through January 2017 and analyzed from December 2018 to February 2019. INTERVENTIONSThe main features of standard-of-practice CBT were affect recognition, reappraisal, modeling/rehearsal, in vivo exposure tasks, and reinforcement. The CBT intervention adapted for ASD was similar but also addressed social communication and self-regulation challenges with perspective-taking training and behavior-analytic techniques. MAIN OUTCOMES AND MEASURESThe primary outcome measure per a priori hypotheses was the Pediatric Anxiety Rating Scale. Secondary outcomes included treatment response on the Clinical Global Impressions-Improvement scale and checklist measures. RESULTSOf 214 children initially enrolled, 167 were randomized, 145 completed treatment, and 22 discontinued participation. Those who were not randomized failed to meet eligibility criteria (eg, confirmed ASD). There was no significant difference in discontinuation rates across conditions. Randomized children had a mean (SD) age of 9.9 (1.8) years; 34 were female (20.5%). The CBT program adapted for ASD outperformed standard-of-practice CBT (mean [SD] Pediatric Anxiety Rating Scale score, 2.13 [0.91] [95% CI, 1.91-2.36] vs 2.43 [0.70] [95% CI, 2.25-2.62]; P = .04) and TAU (2.93 [0.59] [95% CI,]; P < .001). The CBT adapted for ASD also outperformed standard-of-practice CBT and TAU on parent-reported scales of internalizing symptoms (estimated group mean differences: adapted vs standard-of-practice CBT, −0.

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Cognitive Behavioral Therapy for Early Adolescents With Autism Spectrum Disorders and Clinical Anxiety: A Randomized, Controlled Trial

Cited by 191 publications

References 51 publications

A Systematic Review of Effective Modifications to Cognitive Behavioural Therapy for Young People with Autism Spectrum Disorders

A Systematic Review of Effective Modifications to Cognitive Behavioural Therapy for Young People with Autism Spectrum Disorders

Effectiveness of Training Therapists to Deliver An Individualized Mental Health Intervention for Children With ASD in Publicly Funded Mental Health Services

Cognitive Behavioral Treatments for Anxiety in Children With Autism Spectrum Disorder

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