Brief Report of Preliminary Outcomes of an Emotion Regulation Intervention for Children with Autism Spectrum Disorder

Abstract

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...

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“…The subscales of family involvement and affective strength both had moderate effect sizes, while the interpersonal strength was short of a moderate effect size, even though statistical significance was not reached. The findings were consistent with previous studies, where children's emotion regulation skills improved after receiving the CBT interventions (Scarpa & Reyes, 2011;Thomson et al, 2015). Further, Scarpa and Reyes (2011) found that the parents rated their children with a significantly higher level of confidence to handle negative emotions after intervention, similar to the increased intrapersonal strength measured by BERS.…”

“…Besides modifying the content to be developmentally appropriate, most CBT programs incorporate instructional strategies of applied behavior analysis (ABA) when working with individuals with ASD, such as assistive prompts and token economies (Lang et al, 2010). For example, Thomson, Riosa, and Weiss (2015) employed a CBT-based emotion regulation intervention for children with ASD with a token economy to promote and maintain motivation for children in the program. The parents reported a significant improvement in overall emotion regulation for their children, and the children reported decreased emotion dysfunction.…”

Emotion regulation in autism spectrum disorder: Where we are and where we need to go

“…Apart from directly examining the relationships between ER and internalizing and externalizing problems, we can also infer the role that ER plays in the maintenance of these problems by studying the changes in symptoms post interventions that target ER. Although ER intervention research in ASD is still in its infancy, preliminary results from recent pilot studies are encouraging and indicate that ER intervention approaches including cognitive behavior therapy [Scarpa & Reyes, ; Thomson, Riosa, & Weiss, ] and mindfulness‐based intervention [Conner & White, 2017] are feasible and effective, and can improve emotional acceptance, impulse control, negative reactivity, and internalizing and externalizing symptoms in both children and young adults. Research in non‐ASD populations has also demonstrated the efficacy of ER intervention in reducing symptoms of mental health disorders [e.g., see Mennin & Fresco, ].…”

Remediating Deficits or Increasing Strengths in Autism Spectrum Disorder Research: a Content Analysis

“…For instance, cognitive-behavioural interventions have been used to successfully decrease emotion regulation difficulties and increase coping skills in youth with ASD (e.g. Sofronoff et al 2007;Thomson et al 2015). Likewise, behavioural interventions, such as functional communication training (Carr and Durand 1985), have been shown to decrease a host of maladaptive behaviours by increasing desired ones, reflecting a mixed focus.…”