Thursday, May 20, 2010: 10:00 AM
Grand Ballroom E Level 5 (Philadelphia Marriott Downtown)
10:00 AM
Background: Children with high-functioning autism spectrum disorders (ASD) are at high risk for developing significant anxiety symptoms (Brereton et al. 2006). Anxiety problems can be especially “debilitating” for individuals with ASD (Greig & MacKay, 2005) by adversely impacting school performance, peer relationships, family functioning, and further exacerbating the core-deficits of ASD (Bellini, 2004; Sze & Wood, 2007). Cognitive-behavioral therapies (CBT) are frequently used for children with anxiety symptoms with good success (Walkup et al. 2008). In spite of the high co-occurrence between ASD and anxiety, most clinical trials examining the efficacy of CBT for children with anxiety, exclude children with pervasive developmental disorders (Barrett, Healy-Farrell, & March, 2004; Cobham, Dadds, & Spence, 1998; Walkup et al. 2008). However, recent treatment studies have demonstrated reductions in anxiety symptoms for children with ASD, following modified CBT interventions delivered in groups (Chalfant, Rapee, & Carroll, 2006; Reaven, et al., 2009) and individually (Wood, et al., 2008).
Objectives: To conduct a randomized trial of the treatment package by comparing Treatment As Usual (TAU) with parent and child participation in the 12 week CBT intervention specifically developed for children with ASD. Impact of the treatment package was primarily assessed by examining the reduction in severity of anxiety symptoms in children.
Methods: Forty-seven children ages 8-14 (and their parents) participated in the study and met the following inclusion criteria: 1) current clinical diagnosis of an autism spectrum disorder, 2) exceeding criteria for ASD on the ADOS, 3) exceeding criteria for ASD on the SCQ, 4) presenting with clinically significant symptoms of anxiety on the Anxiety Disorders Interview Schedule – Parent Version (ADIS-P; Silverman & Albano, 1998)), and 5) Verbal IQ of 80 or higher. Children and their parents were randomly assigned to either Active Treatment (AT) (N=22) or TAU (N=25). Key elements of the 12 week treatment included teaching cognitive strategies, somatic management of physical symptoms and use of graded exposure. An Independent Clinical Evaluator, blind to condition completed pre and post- assessments. Multiple outcome measures were used including the Clinical Global Impressions-Improvement Scale (CGI-I) derived from the ADIS-P and the Screen for Child Anxiety Related Disorders (SCARED; Birmaher et al. 1999). There were no pre-treatment differences on measures of IQ, age, autism severity and clinical anxiety symptoms.
Results: Child participants in both the TAU and AT groups presented with multiple psychiatric diagnoses in addition to their diagnosis of ASD. The number of co-morbid psychiatric diagnoses ranged from 2-8 (M = 5.13 and SD=1.48). Preliminary findings indicated that 75% of participants in the AT group demonstrated improvement in anxiety symptoms according to the CGI-I (e.g., a positive change in diagnostic status for 1 or more anxiety disorders) compared with 30.8% of children in the TAU group.
Conclusions: Initial results from this rigorously designed treatment study, suggests that a group CBT intervention specifically developed for children with ASD and complex psychopathology, may be effective in decreasing children’s anxiety symptoms. Limitations of this study include small sample size, as well as the lack of an attention control group.
Objectives: To conduct a randomized trial of the treatment package by comparing Treatment As Usual (TAU) with parent and child participation in the 12 week CBT intervention specifically developed for children with ASD. Impact of the treatment package was primarily assessed by examining the reduction in severity of anxiety symptoms in children.
Methods: Forty-seven children ages 8-14 (and their parents) participated in the study and met the following inclusion criteria: 1) current clinical diagnosis of an autism spectrum disorder, 2) exceeding criteria for ASD on the ADOS, 3) exceeding criteria for ASD on the SCQ, 4) presenting with clinically significant symptoms of anxiety on the Anxiety Disorders Interview Schedule – Parent Version (ADIS-P; Silverman & Albano, 1998)), and 5) Verbal IQ of 80 or higher. Children and their parents were randomly assigned to either Active Treatment (AT) (N=22) or TAU (N=25). Key elements of the 12 week treatment included teaching cognitive strategies, somatic management of physical symptoms and use of graded exposure. An Independent Clinical Evaluator, blind to condition completed pre and post- assessments. Multiple outcome measures were used including the Clinical Global Impressions-Improvement Scale (CGI-I) derived from the ADIS-P and the Screen for Child Anxiety Related Disorders (SCARED; Birmaher et al. 1999). There were no pre-treatment differences on measures of IQ, age, autism severity and clinical anxiety symptoms.
Results: Child participants in both the TAU and AT groups presented with multiple psychiatric diagnoses in addition to their diagnosis of ASD. The number of co-morbid psychiatric diagnoses ranged from 2-8 (M = 5.13 and SD=1.48). Preliminary findings indicated that 75% of participants in the AT group demonstrated improvement in anxiety symptoms according to the CGI-I (e.g., a positive change in diagnostic status for 1 or more anxiety disorders) compared with 30.8% of children in the TAU group.
Conclusions: Initial results from this rigorously designed treatment study, suggests that a group CBT intervention specifically developed for children with ASD and complex psychopathology, may be effective in decreasing children’s anxiety symptoms. Limitations of this study include small sample size, as well as the lack of an attention control group.