Abstract | Summary | Original Article

Treating Anxiety Disorders in Children with High Functioning Autism Spectrum Disorders

Chalfant AM, Rapee R, Carroll L

Question: Did a family-based cognitive behavioural therapy treatment reduce anxiety in children with High Functioning ASD?

Background: Children and adolescents with High Functioning Autism (HFA) so frequently experience symptoms of anxiety that it appears to be a core feature of their condition. Typically developing children and teens and those with other developmental problems do not have the same rates of anxiety as do their peers with HFA. Often medication is used to treat anxiety, but most of them are not officially approved for use in children under 18. Cognitive Behavioural Therapy (CBT) is considered the preferred treatment for young children. It has been shown to be highly effective in young children and teens without ASD who experience anxiety. No studies of this treatment have previously been conducted with young people with HFA.

Design: The participants were randomly assigned to either the treatment group or to remaining on a 7-month-long wait list for treatment.

Setting: A clinic in New South Wales, Australia.

Participants: Thirty-five boys and 12 girls with ASD, aged 8 to 13, who were diagnosed with an anxiety disorder took part in the study. Children who were upset because of teasing at school were excluded from the study. Children who had an intellectual impairment, physical disability or were taking anti-anxiety or anti-depressant medication, who had serious behavior problems, or whose parents severe marital problems were excluded from the study.

Intervention: Changes were made to a standard treatment program to accommodate the learning style of children with HFA. The adapted program was longer, put more emphasis on relaxation techniques, used more visual aids, and placed less emphasis on the participants’ communication skills. There was also a parent component that provided education about anxiety, relaxation, changing thinking patterns. Parents were also taught how to help manage their child’s anxiety and help them to keep from becoming anxious after the end of treatment.

Main Outcome Measures: Standard tests were used to diagnose anxiety disorders and to assess the children’s and parents’ opinions about the children’s symptoms. Objective measures of anxiety symptoms were also used. M

Main Results: Assessment after the treatment ended showed that over 71% of the children no longer had a diagnosis of anxiety disorder. All of the children in the comparison group retained their diagnosis during the 7 months wait time. Only one participant dropped out because of no benefit. Researchers have believed that children and teens with HFA have difficulties talking about their own feelings and beliefs. However, this study demonstrated that CBT can be used successfully in this group.

Source: Chalfant AM, Rapee R, Carroll L. Treating anxiety disorders in children with High Functioning Autism Spectrum Disorders: A controlled trial.  Journal of Autism and Developmental Disorders. 2007; 37: 1842-1857.