BackgroundMental health problems are common among individuals with autism spectrum disorder (ASD), and difficulties with emotion regulation processes may underlie these issues. Cognitive behavior therapy (CBT) is considered an efficacious treatment for anxiety in children with ASD. Additional research is needed to examine the efficacy of a transdiagnostic treatment approach, whereby the same treatment can be applied to multiple emotional problems, beyond solely anxiety. The purpose of the present study was to examine the efficacy of a manualized and individually delivered 10‐session, transdiagnostic CBT intervention, aimed at improving emotion regulation and mental health difficulties in children with ASD.MethodsSixty‐eight children (M age = 9.75, SD = 1.27) and their parents participated in the study, randomly allocated to either a treatment immediate (n = 35) or waitlist control condition (n = 33) (ISRCTN #67079741). Parent‐, child‐, and clinician‐reported measures of emotion regulation and mental health were administered at baseline, postintervention/postwaitlist, and at 10‐week follow‐up.ResultsChildren in the treatment immediate condition demonstrated significant improvements on measures of emotion regulation (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 in the waitlist control condition. Treatment gains were maintained at follow‐up.ConclusionsThis study is the first transdiagnostic CBT efficacy trial for children with ASD. Additional investigations are needed to further establish its relative efficacy compared to more traditional models of CBT for children with ASD and other neurodevelopmental conditions.

Emotion regulation (ER) difficulties are a potential common factor underlying the presentation of multiple emotional and behavioral problems in individuals with Autism Spectrum Disorder (ASD). To provide an overview of how ER has been studied in individuals with ASD, we conducted a systematic review of the past 20 years of ER research in the ASD population, using established keywords from the most comprehensive ER literature review of the typically developing population to date. Out of an initial sampling of 305 studies, 32 were eligible for review. We examined the types of methods (self-report, informant report, naturalistic observation/ behavior coding, physiological, and open-ended) and the ER constructs based on Gross and Thompson's modal model (situation selection, situation modification, attention deployment, cognitive change, and response modulation). Studies most often assessed ER using one type of method and from a unidimensional perspective. Across the 32 studies, we documented the types of measures used and found that 38% of studies used self-report, 44% included an informant report measure, 31% included at least one naturalistic observation/behavior coding measure, 13% included at least one physiological measure, and 13% included at least one open-ended measure. Only 25% of studies used more than one method of measurement. The findings of the current review provide the field with an in-depth analysis of various ER measures and how each measure taps into an ER framework. Future research can use this model to examine ER in a multicomponent way and through multiple methods. Autism Res 2014, 7: 629-648 [American Psychiatric Association, 2013], and there is considerable evidence that the majority also struggle with associated emotional problems. For instance, in a population derived cohort of 5-to 16-year-olds, Totsika, Hastings, Emerson, Lancaster, and Berridge [2011] found that 85% of youth with ASD without an intellectual disability (ID) had clinically significant levels of hyperactivity, 74% of emotional problems, and 64% of conduct problems, compared to much lower rates in a typically developing comparison group (19% hyperactivity, 18% emotional problems, and 22% conduct problems). Further, youth with ID and ASD had higher rates of emotional disorders than those with only ID (88% vs. 63% for hyperactivity, 71% vs. 42% for emotional problems, and 65% vs. 46% for conduct problems, respectively). There is also considerable co-occurrence of multiple emotional problems in individuals with ASD. Approximately 40-50% of youth with ASD are estimated to meet criteria for two or more psychiatric disorders, often combining attentional or behavioral problems (e.g. ADHD) with internalizing problems (e.g. anxiety disorder), even after taking into account symptoms that may be related to core ASD sociocommunicative and behavioral symptoms [Leyfer et al., 2006;Simonoff et al., 2008].

Four-year-olds' sensitivity to differences among faces in the spacing of features was tested under 4 task conditions: judging distinctiveness when the external contour was visible and when it was occluded, simultaneous match-to-sample, and recognizing the face of a friend. In each task, the foil differed only in the spacing of features, and spacing alterations were within normal limits. Children performed at chance levels in all but 1 task-match-to-sample, and in that task, only 10 of 18 children were correct on more than 50% of the trials. Sensitivity to the spacing of facial features in identity and distinctiveness tasks is very weak at 4 years of age-at least when the changes do not exceed +/-2.5 SD of normal variability.

Children with autism spectrum disorder (ASD) often present with comorbid psychopathology including problems with emotion regulation. The goal of the present research was to investigate the feasibility of a multicomponent manualized cognitive behavior therapy treatment program for improving emotion regulation in youth with ASD 8 to 12 years of age. Thirteen males and their parents participated in the intervention, reporting high satisfaction with the activities and program overall, and attending all sessions. Preliminary outcomes regarding emotion regulation and psychopathology, and feasibility of the intervention, are summarized and discussed.Keywords. Emotion regulation, autism spectrum disorder, cognitive behavior therapy, intervention, individual therapy. EMOTION REGULATION INTERVENTION IN ASD 3 Brief Report of Preliminary Outcomes of an Emotion Regulation Intervention forChildren with Autism Spectrum Disorder Children diagnosed with autism spectrum disorder (ASD) have difficulty with sociocommunicative functioning and restricted or repetitive behaviors or interests (American Psychiatric Association, 2013) and often present with significant levels of emotional difficulties. For example, in a sample of 5 to 16-year olds with ASD and no intellectual disability, 74% had clinically significant emotional difficulties, such as anger, sadness or anxiety, compared to 18% of typically developing peers (Totsika, Hastings, Emerson, Lancaster, & Berridge, 2011). Approximately 40% to 50% of youth with ASD (as per DSM-IV-TR criteria) are estimated to meet criteria for two or more psychiatric disorders, often combining externalizing problems, such as ADHD, with internalizing problems, such as anxiety disorders (Leyfer et al., 2006;Simonoff, et al., 2008), leading many to conceptualize emotional problems as involving underlying difficulties with emotion regulation (Mazefsky et al., 2013;Mazefsky & White, 2014). Emotion regulation (ER) can be defined as ''the extrinsic and intrinsic processes responsible for monitoring, evaluating, and modifying emotional reactions, especially their intensive and temporal features, to accomplish one's goals' ' (Thompson, 1994, pp. 27-28).Considerable evidence has related poor ER to emotional problems in children with ASD, such as anxiety (e.g., Fuji et al., 2013;Wood & Gadow, 2010) One pilot study reported promising outcomes of a modified CBT program to address ER in a small sample of young children with ASD (5 in the treatment group and 6 in a delayed treatment control), 6 to 8 years of age, measured by child reported coping strategies in response to vignettes, parent reported negativity/lability and emotion regulation, and parent reported outbursts (Scarpa & Reyes, 2011). Changes though were assessed using one-tailed comparisons, potentially inflating the likelihood of finding significance.More research is needed to assess how cognitive behavioral interventions can improve ER in children with ASD. The purpose of the present study was to evaluate the preliminary clinical utility (fea...