Teaching Emotion Regulation to Young Children with High Functioning Autism: An Intervention Study

Background: Previous research has found that children with Autism Spectrum Disorders (ASD) have pronounced deficits managing their emotions. Previous research has also shown that Cognitive Behavioral therapy improved symptoms related to anxiety and anger outbursts (Sofronoff et al., 2005, 2006). Researchers have found that parental confidence increases when parents are involved in the treatment process and become interventionist themselves (Schreibman, & Koegel, 2005). However, a CBT intervention for anxiety/anger in young children with ASD has never been tested.

Objectives: A group therapy intervention was implemented in order to examine: (i) whether children with ASD can improve regulation of their anger/anxiety related emotions, and (ii) whether parent’s reported confidence in themselves and their child increases after their intervention.

Methods: Data were collected from eleven 5-7 year-old children (2 girls, 9 boys) with high functioning autism (HFA) and their parents. The Autism Diagnostic Observation Schedule was administered to confirm children’s diagnosis. Participants were randomly assigned to either an experimental or delayed-treatment control group. Group therapy intervention consisted of 9 concurrent child and parent sessions. During the sessions, children were taught to recognize anger and anxiety and to use strategies to manage those emotions. Parents reviewed the child sessions via a monitor and learned how to implement the strategies for use in other settings. Parent’s perception of confidence in themselves and their child to manage their child’s anger/anxiety related emotions were rated on a scale of 1 through 10 (1=not very confident; 10=very confident). Child emotion regulation skills were assessed using (i) a Behavioral Monitoring Sheet in which parents reported the frequency of anger/anxiety outbursts in one week, and (ii) the Emotion Regulation Checklist.

Results: Parents in the experimental group reported that children showed greater emotion regulation (i.e., fewer number of outbursts) than the delayed treatment group, t(9)=1, p<0.05. Parents also reported higher levels of emotion regulation abilities on the Behavioral Monitoring Sheet after treatment in both groups, t(9)=12.51, p<0.05. Parents, in the delayed treatment group, also reported higher levels of emotion regulation abilities on the Emotion Regulation Checklist in their children after treatment, t(5)=-3.36, p<0.05. Parental confidence in managing children’s emotions increased in the experimental group for anxiety, t(4)=-3.54, p<05, and the delayed-treatment group for anger, t(5)=-6.71, p<05. Also, parent’s perception of their child’s confidence in regulating his/her anxiety increased in both the experimental, t(4)=-4, p<0.05, and the delayed-treatment group, t(5)=-2.77, p<0.05.

Conclusions: This study implemented a cognitive behavioral intervention to teach emotion management to young children with HFA. It was found that emotion regulation in the children improved after treatment. Additionally, including parents in the intervention appeared to increase parental self-confidence, as well as their confidence in their child to deal with emotional outbursts. In conclusion, cognitive behavioral intervention appears to be a promising tool for improving emotional regulation abilities in young children with HFA.