Elsevier

Research in Autism Spectrum Disorders

Volume 4, Issue 3, July–September 2010, Pages 346-354
Research in Autism Spectrum Disorders

Review
Cognitive-behavioral therapy for anxiety in children diagnosed with autism spectrum disorders: Modification trends

https://doi.org/10.1016/j.rasd.2009.10.015Get rights and content

Abstract

Anxiety disorders have been found to be highly comorbid with autism spectrum disorders (ASDs). Even so, the identification and dissemination of empirically supported treatments for anxiety in adults or children who have ASD has lagged behind the larger evidence-based trend. This review examines the efficacy of cognitive-behavioral therapy as a treatment for anxiety in children who have an ASD and delineates and summarizes the trends in modifying efficacious cognitive-behavioral therapies for anxiety for use with those having an ASD. Limitations and recommendations for future research toward a standardized treatment model for anxiety in children are discussed.

Section snippets

An introduction to CBT for typically developing children

CBT has been identified as an empirically supported treatment for typically developing children with anxiety issues (Davis, 2009, Davis and Ollendick, 2005, Kendall et al., 1997). The primary goals of traditional CBT are to identify and challenge dysfunctional beliefs, catastrophic cognitions, and automatic thoughts as well as change problematic behavior (Beck, 1991, Beck, 1993, Kendall, 1993). Typical CBT models for the treatment of anxiety aim to create a new coping template by using

General recommendations

Despite the fact that CBT has been shown to be an effective empirically supported treatment for typical children, there has been debate in the literature as to whether or not it can be used with other populations. Specifically, with the recent recognition of the high comorbidity of anxiety with ASDs, the use of CBT with children who have ASD has been highly debated. For instance, Sturmey (2005) argues against using a cognitive component to treat this population and is in favor of strict applied

Limitations and recommendations

Although anxiety disorders commonly co-occur with autism spectrum disorders, no single treatment has attained well-established or probably efficacious empirically supported treatment status for anxiety in children with an ASD. However, emerging CBT modification trends have provided an important step in establishing a standardized treatment approach. The purpose of this review was to (1) give an overview of the general recommendations and specific CBT modification trends being used to treat

Conclusions

Disorder specific hierarchies, use of more concrete, visual tactics, incorporation of child specific interests, and parental involvement are the four main modification trends that have proved to be successful in adapting CBT to treat anxiety issues in children with ASDs. Overall, these trends show a meaningful shift toward an effective treatment of anxiety for children with an ASD. Considering the current comorbidity rates of 11–84% (White et al., 2009), finding an effective, empirically

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