Publication Date

1-1-2024

Journal

Journal of Autism and Developmental Disorders

DOI

10.1007/s10803-022-05775-w

PMID

36239830

PMCID

PMC9561323

PubMedCentral® Posted Date

10-14-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Adolescent, Child, Humans, Anxiety, Autism Spectrum Disorder, Autistic Disorder, Cognitive Behavioral Therapy, Treatment Outcome, Autism spectrum disorder, Anxiety, Obsessive–compulsive disorder, Cognitive behavioral therapy, Treatment, Children

Abstract

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.

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