Stepped-Care Cognitive Behavioral Therapy in Children on the Autism Spectrum with Co-occurring Anxiety

This trial examined stepped-care cognitive-behavioral treatment (CBT) among 96 autistic youth with co-occurring anxiety. Step 1 included an open trial of parent-led, therapist-guided bibliotherapy. Step 2 was family-based CBT for those who did not respond to Step 1 or maintenance for those who did....

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Bibliographic Details
Published in:Journal of autism and developmental disorders 2024, Vol.54 (1), p.93-108
Main Authors: Storch, Eric A., Schneider, Sophie C., Olsen, Sean M., Ramirez, Ana C., Berry, Leandra N., Goin-Kochel, Robin P., McNeel, Morgan, Candelari, Abigail E., Guzick, Andrew G., Cepeda, Sandra L., Weinzimmer, Saira, Voigt, Robert G., Quast, Troy, Goodman, Wayne K., Salloum, Alison
Format: Article
Language:English
Subjects:
Adolescent
Anxiety
Anxiety - therapy
Anxiety disorders
Autism
Autism Spectrum Disorder - psychology
Autism Spectrum Disorder - therapy
Autistic children
Autistic Disorder
Behavior modification
Behavioral Science and Psychology
Behavioral sciences
Bibliotherapy
Child
Child and School Psychology
Children & youth
Clinical outcomes
Cognitive ability
Cognitive Behavioral Therapy
Cognitive therapy
Cognitive-behavioral factors
Comorbidity
Families & family life
Functional impairment
Humans
Internalization
Neurosciences
Original Paper
Pediatrics
Post traumatic stress disorder
Psychology
Public Health
Social anxiety
Therapists
Therapy
Treatment Outcome
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Summary:This trial examined stepped-care cognitive-behavioral treatment (CBT) among 96 autistic youth with co-occurring anxiety. Step 1 included an open trial of parent-led, therapist-guided bibliotherapy. Step 2 was family-based CBT for those who did not respond to Step 1 or maintenance for those who did. Eighteen participants (28%) who completed Step 1 responded. Responders reported significantly lower pre-treatment anxiety, internalizing symptoms, and functional impairment than non-responders. After Steps 1 and 2, 80% of completers (55% intent-to-treat) were responders. Anxiety, impairment, and ASD-related impairments significantly improved. Youth in maintenance experienced faster improvement through post-treatment, though there were no group differences at 3-month-follow-up. A stepped approach may help some individuals in Step 1, particularly those who are less anxious.
ISSN:0162-3257
1573-3432
DOI:10.1007/s10803-022-05775-w