Group cognitive behavior therapy for children with high-functioning autism spectrum disorders and anxiety: a randomized trial

J Child Psychol Psychiatry. 2012 Apr;53(4):410-9. doi: 10.1111/j.1469-7610.2011.02486.x.


Background: Children with high-functioning autism spectrum disorders (ASD) are at high risk for developing significant anxiety. Anxiety can adversely impact functioning across school, home and community environments. Cognitive behavioral therapies (CBT) are frequently used with success for children with anxiety symptoms. Modified CBT interventions for anxiety in children with ASD have also yielded promising results.

Methods: Fifty children with high-functioning ASD and anxiety were randomizedto group CBT or treatment-as-usual (TAU) for 12 weeks. Independent clinical evaluators, blind to condition, completed structured interviews (Anxiety Disorders Interview Schedule – Parent Version;ADIS-P) pre- and post-intervention condition.

Results: Forty-seven children completed either the CBT or TAU condition. Results indicated markedly better outcomes for the CBT group. Significant differences by group were noted in Clinician Severity Ratings, diagnostic status, and clinician ratings of global improvement. In the intent-to-treat sample, 10 of 20 children (50%) in the CBT group had a clinically meaningful positive treatment response, compared to 2 of 23 children (8.7%) in the TAU group.

Conclusions: Initial results from this randomized, designed treatment study suggest that agroup CBT intervention specifically developed for children with ASD may be effective in decreasing anxiety. Limitations of this study include small sample size, lack of an attention control group, and use of outcome measures normed with typically developing children

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Anxiety Disorders / complications
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Child
  • Child Development Disorders, Pervasive / complications
  • Child Development Disorders, Pervasive / psychology
  • Child Development Disorders, Pervasive / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Family Therapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Interviews as Topic
  • Male
  • Parents / psychology
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Severity of Illness Index