Abstract
•Children with autism spectrum disorders (ASD) typically require significant additional specialized care, and the presence of anxiety symptoms severely complicate treatment.•A specialized protocol was tested in a randomized controlled trial in the treatment of anxiety associated with ASD.•Findings suggest CBT was superior to waitlist, with children aged 10–12 benefiting most from intervention.
Autism spectrum disorders (ASD) are neurodevelopmental in nature and are frequently accompanied by anxiety. To fully assess treatment efficacy, we examined rates of anxiety symptom change by age groups following either cognitive behavioral therapy (CBT) or treatment as usual (TAU).
One hundred sixty-three children with ASD and ASD-related anxiety symptoms were randomly assigned to either CBT or TAU. Utilizing prediction by correspondence analysis (CA), we evaluated the age effect (defined in three groups; ages 6–9, 10–12, and 13–16) and the changes in correlations between age and anxiety severity levels over the course of treatment.
Significantly greater anxiety symptom reduction was associated with CBT compared with TAU across the three age groups. Of particular note, the children ages 10–12 who received CBT showed the greatest improvement compared to all other groups. Late childhood, prior to adolescence, showed the best response to CBT for anxiety in ASD.
These findings suggest that treatment programs need to more closely address developmental factors within narrower bands of age groups. The present results are limited in their generalization to the CBT efficacy for a specific age band (ages 10–12). Longitudinal investigations are recommended to confirm whether the similar age group children who receive CBT experience the greatest benefit in reducing their ASD-related anxiety symptoms.
