Therapies for Children With Autism Spectrum Disorders

SCAS-P=Spence Child Anxiety Scale-Parent version; SRS=Social Responsiveness Scale; SD=standard deviation; SWQ=Social
Worries Questionnaire
A series of papers examined CBT approaches delivered directly to children and via parent
training. CBT provided by graduate students in psychology was assessed in high functioning
children with Asperger disorder with comparisons made across two intervention conditions
(child-only and parent-plus-child) and waitlist controls. 169,176 Significant improvements in
Spence Child Anxiety Scale-Parent scores were observed for both intervention groups on the
total score and separation anxiety, obsessive compulsive disorder, social phobia, panic, and
generalized anxiety scales; significant improvement on the personal injury scale was observed
for the parent-plus-child intervention group. No significant differences were observed from
baseline to six-week followup in the waitlist control group.
On the Social Worries Questionnaire, there were significant improvement in scores between
baseline and six-week followup observed for both intervention groups, but not for the waitlist
control group. Similarly, children in both intervention groups generated more strategies to cope
with anxiety at six-week followup than at baseline, while children in the waitlist control group
did not. Both intervention groups scored better than the wait-list control group at followup, and
children in the parent-plus-child condition scored better than children from the child-only groups
at followup. A separate study of the same intervention 168 to examine the impact of CBT-based
treatment on anger management difficulties in high-functioning (i.e., average IQ above 100)
children ages ten to fourteen years with Asperger syndrome found similarly positive results.
Parent training in using CBT approaches 174,175 for parents of children ages six to twelve years
with Asperger syndrome diagnoses includes psychoeducation, comic strip conversations and
social stories introduction, and management techniques for externalizing behaviors, rigid
behaviors, and anxiety. In studies of this approach, parents who attended a one-day workshop or
who participated in six weekly one-hour individual sessions reported fewer challenging
behaviors at both one-month post-treatment and three-month followup relative to baseline, while
there were no significant differences over time for the waiting list control group.
Parents from both intervention groups also reported significantly fewer challenging behaviors
in their children, decreased challenging behavior intensity and improved social skills at both time
points. At three-month followup, individual session participants reported significantly lower
intensity of challenging behaviors relative to both the waiting list control group and workshop
intervention group; the workshop group no longer showed differences from the control group by
three-month followup in terms of parental report of child challenging behavior intensity.
The Research Units on Pediatric Psychopharmacology (RUPP) Autism Network first
reported on the feasibility of a parent-training program for parents of children with autism
spectrum disorders ages 4 to 13 years who were on stable medications for behavior problems. 172
The parent training protocol consisted of 11 required sessions covering topics including
prevention strategies, schedules, reinforcement, planned ignoring, compliance training,
functional communication training, teaching techniques, and generalization. Two home visits
were always conducted, four optional sessions were available, and booster sessions were
provided to parents in later weeks; parent training was administered according to a structured
curriculum.
Outcome measures related to child functioning included the Home Situations Questionnaire ,
the Aberrant Behavior Checklist (ABC), the Clinical Global Impressions – Improvement Scale
(CGI-I), the VABS, and the Assessment of Basic Language and Learning Skills. Results
indicated significant decrease in noncompliance on the Home Situations Questionnaire over the
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