Therapies for Children With Autism Spectrum Disorders

Schedule for Affective Disorders and Schizophrenia or on the Screen for Child Anxiety and
Related Emotional Disorders.
Chalfant et al. 25 examined children ages eight to thirteen years (mean = 10.8) with ASDs and
one or more comorbid anxiety disorder diagnoses including separation anxiety, generalized
anxiety, social phobia, specific phobia, and panic disorder confirmed by structured clinical
interview using the Anxiety Disorders Interview Schedule. Children were randomly assigned to
treatment and waitlist conditions. Treatment involved a 12-session CBT-based group therapy
protocol, led by licensed clinical psychologists, with nine weekly two-hour sessions followed by
three monthly booster sessions.
The protocol for the study was based on a manualized CBT-based anxiety intervention for
children (Cool Kids) with adaptations made to account for the learning style of children with
ASDs (e.g., more visual aids and structured worksheets, increased focus on relaxation and
exposure, simplification and decreased emphasis on cognitive components of the treatment).
Parents of children in the intervention group participated in concurrent parent groups with a
manual also adapted from the Cool Kids program.
Measures were collected at baseline and at the completion of intervention (approximately
five and a half months later); clinicians administering the pre- and post-intervention measures
were the same clinicians who led treatment groups. No group differences were observed on any
measure at baseline. However, children in the treatment group improved significantly over time
while children on the waitlist did not in the number of anxiety disorder diagnoses present, as well
as in the number of anxiety symptoms reported by children on the Children’s Automatic
Thoughts Scale Internalising Scales, Revised Children’s Manifest Anxiety Scale, and Spence
Children’s Anxiety Scale, by parents in their report on the Spence Children’s Anxiety Scale—
Parent and the Strengths and Difficulties Questionnaire Emotional and Externalizing Scales, and
by teachers using the Strengths and Difficulties Questionnaire Emotional and Externalizing
Scales.
Table 13. Studies assessing interventions targeting conditions commonly associated with ASDs
Author, year, country Age, mean/yrs ± SD
Key outcomes
Groups, N enrollment / N
final
Study quality
IQ, mean ± SD
Reaven et al. 26 2009, US G1+G2:11.02 ± 1.9 • Anxiety symptoms in G1 decreased over time,
G1: Active CBT, 10/10
G1+G2: 102.65 ± 16.22 while symptoms in G2 did not (p=0.01).
G2: Wait list
Note: for children with
comorbid anxiety, 23/21
NR
Quality: Fair
47