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Cognitive Behavioral Therapy in High-Functioning Autism: Review and Recommendations for Treatment Development

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Evidence-Based Practices and Treatments for Children with Autism

Abstract

Individuals with autism spectrum disorders (ASDs) who have acquired functional communication strategies – particularly more cognitively able individuals at or beyond the elementary school age group – may be candidates for talk-based therapies similar to those employed with children and adults with mental health disorders, such as anxiety (e.g., cognitive behavioral therapy, CBT). While talk-based therapies are widely used in community settings for school-aged youth and adults with ASD (Hess et al. 2008), the evidence base for using many such treatments is surprisingly weak. Compared to other types of intervention in autism (e.g., applied behavior analysis for young children) and interventions for other types of neurodevelopmental disorder (e.g., attention deficit/hyperactivity disorder, ADHD), there are very few well-designed studies of CBT and other talk-based therapies for individuals with autism. Of those studies that have been conducted, results are mixed, requiring a careful comparative analysis of the extant treatment literature to distinguish potentially promising practices from those that are less promising. This chapter endeavors to provide such an analysis and, in so doing, to draw preliminary conclusions about worthwhile practices currently available for implementation, as well as to identify directions for further development of treatment techniques.

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Abbreviations

ADHD:

Attention deficit hyperactivity disorder

ADI-R:

Autism diagnostic interview – revised

ADOS:

Autism diagnostic observation schedule

ASDs:

Autism spectrum disorders

CARS:

Childhood Autism Rating Scale

CBT:

Cognitive behavioral therapy

CGI:

Clinical global improvement

DSM-IV-TR:

Diagnostic and Statistical Manual of Mental Disorders 4th edition

NIMH:

National Institutes of Mental Health

OCD:

Obsessive – compulsive disorder

ODD:

Oppositional defiant disorder

PCIT:

Parent – child interaction therapy

PDD-NOS:

Pervasive developmental disorder not otherwise specified

RCT:

Randomized control trial

RUPP:

Research Units on Pediatric Psychopharmacology

SRS:

Social Responsiveness Scale

SSED:

Single subject experimental design

SST:

Social skills training

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Authors and Affiliations

  1. UCLA Department of Education, University of California at Los Angeles, Los Angeles, CA, USA

    Jeffrey J. Wood, Cori Fujii & Patricia Renno

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  1. Jeffrey J. Wood
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  2. Cori Fujii
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Editors and Affiliations

  1. Yale Child Study Center, South Frontage Rd. 230, New Haven, 06520, Connecticut, USA

    Brian Reichow

  2. Center for Autism Research, The Children's Hospital of Philadelphia, Market Street 3535, Philadelphia, 19146, Pennsylvania, USA

    Peter Doehring

  3. Yale Child Study Center, South Frontage Rd. 230, New Haven, 06520, Connecticut, USA

    Domenic V. Cicchetti

  4. Yale Child Study Center, South Frontage Rd. 230, New Haven, 06520, Connecticut, USA

    Fred R. Volkmar

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Wood, J.J., Fujii, C., Renno, P. (2011). Cognitive Behavioral Therapy in High-Functioning Autism: Review and Recommendations for Treatment Development. In: Reichow, B., Doehring, P., Cicchetti, D., Volkmar, F. (eds) Evidence-Based Practices and Treatments for Children with Autism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-6975-0_7

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