Autism Research: Evidence to Practice: Treatment of Anxiety in Individuals with Autism Spectrum Disorders

Applied Behavior Analysis Research:

Anxiety Coexisting with Autism Found to Be Best Treated by ABA-based Social Skills Instruction
Research Identifies Applied Behavior Analysis Based Social Skills Instruction as Effective for Treating Anxiety Associated with Autism

Anxiety is often associated with autism spectrum disorders, likely leading to increased difficulty with social interactions.  Recent research looked at the best treatments for improving social interactions and anxiety for individuals with autism.  The findings were published in an article titled Evidence to Practice: Treatment of Anxiety in Individuals with Autism Spectrum Disorders.

The research examined randomized clinical trials and systemic reviews to determine which methods are most effective for treating anxiety in people with autism.  The authors drew conclusions based upon analysis from 4 systemic reviews and 2 randomized clinical trials.  Their focus was on the best outcomes from the perspective of the individual with autism and their family members.

The authors found that cognitive behavior therapy combined with direct instruction of social skills based on applied behavior analysis (ABA) principles may be most effective for treating anxiety in individuals with high functioning autism.  For autism and anxiety also associated with intellectual disability, the researchers found that systematic desensitization may be the best method for treatment of anxiety-related symptoms.

The authors state that treatment methods should focus on social skills.  The methods utilized should be concrete, avoiding abstract concepts.  They also state that family members should be involved in the process and that reinforcers should be utilized to engage the individual with autism in the cognitive behavior therapy.

The research was published in Neuropsychiatric Disease and Treatment in January 2011.

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Autism News: Anxiety and Sensory Over-Responsivity in Autism

Autism News Update:

Autism Research Examines the Impact of Sensory Over-Responsivity and Anxiety On Each Other
Research Studies the Relationship Between Anxiety and Sensory Over-Responsivity in Autism

Anxiety and sensory over-responsivity are often both present in autism spectrum disorders.  A recent studied attempted to determine the impact of anxiety and sensory over-responsiveness on each other.  The findings were published in an article titled Anxiety and Sensory Over-Responsivity in Toddlers with Autism Spectrum Disorders: Bidirectional Effects Across Time.

The study included 149 toddlers diagnosed with autism and their mothers.  The participants were assessed twice at annual time points.

The researchers found that sensory over-responsivity remained stable over the study period while symptoms of anxiety increased.  The study also showed that sensory over-responsivity was a better predictor of changes in anxiety than child age, anxiety levels of the mother, and severity of autism symptoms in the toddler.   However, the results showed that anxiety was not a good predictor for changes in sensory over-responsivity.

The researchers claim their study suggests that sensory over-responsivity precedes anxiety.  The authors also suggest that sensory over-responsivity may be a good predictor to identify children with autism that will likely later develop anxiety.

The article was published in the Journal of Autism and Developmental Disorders on September 21, 2011.

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Autism News: Research Focuses on Anxiety Disorders Associated with Autism

Autism News Update:

Autism Research Examines Specific Types of Anxiety Present in Autistic Spectrum Disorders
Types of Anxiety Disorders Commonly Found in Children with Autism the Focus of Research

Previous research has shown that many children and adolescents with autism also struggle with anxiety.  However, limited research has been conducted showing which specific types of anxiety most affect autistic individuals.  To address this issue, a meta-analysis was conducted to determine the types of anxiety most common in autistic children.  The findings were published in an article titled Anxiety Disorders in Children and Adolescents with Autistic Spectrum Disorders: A Meta-Analysis.

The analysis utilized 31 different studies that had focused on anxiety in autism.  These studies combined had 2121 participants with ASD.  All participants were under the age of 18.  The anxiety disorders in these individuals had been assessed via diagnostic interviews or standardized questionnaires.

The results indicated that 39.6% of the individuals with autism in these studies had at least one anxiety disorder.  The three most common types of anxiety disorder found in the meta-analysis included:

  1. Specific Phobia (29.8%)
  2. Obsessive-Compulsive Disorder (17.4%)
  3. Social Anxiety Disorder (16.6%)

The meta-analysis also revealed that several key factors were associated with anxiety in general and specific types of anxiety.  These factors included age, ASD subtype, IQ, and whether anxiety was assessed via a questionnaire or an interview.

For example, the studies that reported lower mean IQ’s among the participants showed higher levels of anxiety in general and higher levels of social anxiety disorder.  On the other hand, studies reporting high mean IQ’s among participants resulted in higher levels of obsessive-compulsive disorder and higher levels of separation anxiety.

The authors use their findings to discuss whether or not anxiety disorders should be diagnosed separately from ASD.  They suggest that their research results indicate that management of specific anxiety disorders in autism may be under-diagnosed and undertreated.

The article was epublished in Clinical Child and Family Psychology Review on July 7, 2011.

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