What you need to know
A common issue among individuals with autism spectrum disorder (ASD) is mental health problems, and underlying these issues can be challenges with emotion regulation processes. As part of addressing anxiety in children, cognitive behavior therapy (CBT) is considered an effective treatment. However, more research is needed to determine how CBT may be used to address multiple emotional problems in children with ASD.
What is this research about?
In addition to core symptoms of atypical social communication and behavioral challenges, individuals with ASD often experience mental health problems. The most common emotional problems reflect anxiety, but there may be an overlap in internal and external symptoms. This study examined the effectiveness of a manualized and individually delivered 10-session, transdiagniostic CBT (tCBT) intervention, as a means of improving emotion regulation and mental health difficulties in children with ASD. This study presents results from a randomized waitlist-controlled trial of the Secret Agent Society: Operation Regulation, a manualized tCBT intervention delivered to children with ASD and their primary caregiver individually.
What did researchers do?
Over the period of January 2013 to April 2016, the researchers recruited participants through local autism service e-newsletters, website postings, and referrals from community health providers. Interested participants completed a telephone intake and an online survey, which included the Social Communication Questionnaire-Lifetime Versions (SCQ), and the Social Responsiveness Scales, Second Edition (SRS-2). There were 68 children and their parents from the Greater Toronto Area who participated in the study. Children completed a readiness for therapy interview and the Wechsler Abbreviated Scale of Intelligence – Second Edition (WASI-II), and parents completed the Anxiety Disorders Interview Schedule – Parent Version (ADIS-P). Participants were randomly assigned to either a treatment immediate (TI) or a 10-14 week waitlist. Parent-, child-, and clinician-reported measures of emotion regulation and mental health were administered at baseline, post-intervention/post-waitlist, and at 10-week follow-up.
What did the researchers find?
The researchers found that children in the treatment arm showed significant improvements on measures of emotion (i.e. emotionally, emotion regulation abilities with social skills) and aspects of psychopathology (i.e., a composite measure of internalizing and externalizing symptoms, adaptive behaviors) compared to those on the waitlist.
The researchers found that children in the treatment arm showed significant improvements on measures of emotion (i.e. emotionality, emotion regulation abilities with social skills) and aspects of psychopathology (i.e., a composite measure of internalizing and externalizing symptoms, adaptive behaviors), compared to those on the waitlist. Treatment gains were also maintained at follow-up.
How can you use this research?
This study is the first transdiagnostic CBT efficacy trial for children with ASD. The findings indicate that CBT can be adapted to move beyond an anxiety-specific framework by focusing on underlying mechanisms, and targeting multiple emotional problems concurrently. The results of this trial set the stage for future research into transdiagnostic approaches that may assist clinicians in working broadly and efficiently.
About the Researchers
Dr. Jonathan A. Weiss (Ph.D., C. Psych.) is an associate professor in the Department of Psychology at York University, and York Research Chair in Autism and Neurodevelopmental Disability Mental Health.
Dr. Kendra Thomson (Ph.D., BCBA-D) is an associate professor in the Department of Applied Disability Studies at Brock University.
Dr. Priscilla Burnham-Riosa (Ph.D., BCBA-D) is an assistant professor in the Centre for Applied Disability Studies at Brock University.
Carly Albaum (M.A., B.A.) is pursuing a Doctor of Philosophy at York University. Her research focuses on process factors in cognitive behavior therapy for children with autism.
Victoria Chan (M.A., BSc.) is pursuing a Doctor of Philosophy at York University. Her research is focused on parent therapeutic factors in mental health treatment for children with autism spectrum disorder (ASD).
Andrea Maughan (M.A., MSc., BSc.) is pursuing a Doctor of Philosophy at York University. She is interested in how families best adapt to and support children with developmental disabilities.
Paula Tablon (B.A.) is a Lab Coordinator in the Developmental Disabilities and Mental Health Lab at York University.
Karen Black (M.A., BSc., BFA) is pursuing a Doctor of Philosophy at York University. Her research is focused on understanding how pathways in the brain are involved in emotion regulation for children with neurodevelopmental conditions, and how these pathways are related to treatment response.
Citation:
Weiss, J.A., Thomson, K., Burnham-Roisa, P., Albaum, C., Chan, V., Maughan, A, Tablon, P., Black, K. (2018). A randomized waitlist-controlled trial of cognitive behavior therapy to improve emotion regulation in children with autism. Journal of Child Psychology and Psychiatry, 59(11), 1180-1191. Doi:10.1111/jcpp.12915
This summary was written by Patrice Walker, Research Assistant, in the Vocational Abilities Innovation Lab, Faculty of Social Work, University of Calgary.
Photo by Stephane YAICH on Unsplash
