A Therapy for Anxiety with Autism

Children with autism and anxiety appeared to benefit slightly from cognitive behavioral therapy

(RxWiki News) It's not uncommon for children with autism spectrum disorders to have other mental health conditions as well. Children with autism can often experience anxiety symptoms.

A recent study found that a treatment called cognitive behavioral therapy (CBT) may help children with autism reduce anxiety.

Cognitive behavioral therapy is often used to treat depression, bipolar disorder and other mental health conditions. This therapy is available through most mental health clinics and mental healthcare professionals.

The study showed that the effects of the therapy on these children, however, were small.

"Ask your child's doctor about cognitive behavioral therapy."

This study, led by Denis G. Sukhodolsky, PhD, of the Yale Child Study Center at Yale University, aimed to understand whether CBT could help children with autism reduce anxiety.

During cognitive behavioral therapy, a therapist helps patients reframe the way they see things and how they emotionally respond to events in their lives. This therapy is based on the idea that people's thoughts — rather than things like people and situations — cause their feelings. By approaching the problem from this viewpoint, people can address the way they think to feel better about a situation, even if that situation doesn't change.

The researchers looked through medical research databases to find all studies involving the use of CBT for anxiety in children with autism spectrum disorders.

The studies needed to compare cognitive behavioral treatment with another treatment or no treatment to be included in this analysis.

The researchers identified a total of eight studies that met their requirements. The combined number of participants from across all the studies was 469 children.

Then the researchers pulled all the data from these eight studies and analyzed it together.

The results relied on seeing changes in the children's levels of anxiety based on standard assessments given to the children, the clinicians and/or the parents.

In the six studies that reported the parents' ratings about their child's anxiety, the use of cognitive behavioral therapy was better at reducing anxiety symptoms than the use of other methods or no treatment at all.

The effect of the treatment, however, was relatively small. The overall analysis was also influenced by one study that showed much higher positive results than the others.

There was also a small improvement seen in the anxiety symptoms of children undergoing CBT in the analysis of clinician ratings in the five studies with this data available.

Again, one study reported a much higher success rate than the other four.

In the five studies with data from the children themselves, there did not appear to be much improvement or difference in anxiety symptoms for the children who underwent cognitive behavioral therapy compared to those who didn't.

One challenge to analyzing all this data together was that the different studies included were all very different from one another, so it was difficult to interpret the results as one set of findings.

The researchers also explored possible reasons for the differences in reports from the parents and the children.

"It is possible that children do not perceive their anxiety symptoms as being as troublesome as their parents do, which would [lessen] the change in child self-report from pretreatment to post-treatment," the authors wrote. "Thus, parent ratings commonly reveal greater levels of anxiety in children with autism spectrum disorders than child self-reports."

Or, the researchers suggested, it's possible that the children actually do perceive the treatments as less helpful than their parents do.

The researchers noted it also can be difficult to gather reliable reports from children regarding treatments because of the poor communication skills often associated with autism.

Overall, it appeared that CBT modestly helped children with autism with anxiety symptoms, but more research is needed and it's not clear that the children themselves saw the positive effects.

This study was published October 28 in the journal Pediatrics. The research was funded by the National Institutes of Health.

One author receives royalties from an edited book on evidence-based treatments for autism. The other authors declared no conflicts of interest.

Review Date: 
October 28, 2013