Development of a Cognitive-Behavioral Intervention Program to Treat Anxiety and Social Deficits in Teens with High-Functioning Autism

Abstract

Anxiety is a common co-occurring problem among young people with autism spectrum disorders (ASD). Characterized by deficits in social interaction, communication problems, and stereotyped behavior and restricted interests, this group of disorders is more prevalent than previously realized. When present, anxiety may compound the social deficits of young people with ASD. Given the additional disability and common co-occurrence of anxiety in ASD, we developed a manual-based cognitive-behavioral treatment program to target anxiety symptoms as well as social skill deficits in adolescents with ASD [Multimodal Anxiety and Social Skills Intervention: MASSI]. In this paper, we describe the foundation, content, and development of MASSI. We also summarize data on treatment feasibility based on a pilot study that implemented the intervention.

A Systematic Review of Effective Modifications to Cognitive Behavioural Therapy for Young People with Autism Spectrum Disorders

“…At this stage, a further 27 studies were excluded from the final review of data for the following reasons. Eight studies were reports of secondary data (Boyd et al 2012;King and Desaulnier 2011;Lang et al 2010;Langdon et al 2013;Reaven 2009, 2011, Reaven et al 2009Rotheram-Fuller and MacMullen 2011;Scattone and Mong 2013), one study (Sze and Wood 2008) was a duplicate that had not been previously filtered out, one (White et al 2013) reported a non-significant effect of the intervention, five studies reported the effects of CBT for core features of ASD rather than mental health symptoms (Drahota et al 2011;Kenworthy et al 2014;Scarpa and Reyes 2011;Wood et al 2009aWood et al , b, 2014 and 12 included (n = 1) designs (Cook et al 1993;Lehmkuhl et al 2008;Nadeau et al 2014;Reaven and Hepburn 2003;Schleismann and Gillis 2011;Wood 2007, 2008) or did not have a comparator group (Reaven et al 2012b;Ooi et al 2008;Ozsivadjian and Knott 2011;White et al 2010;White et al 2009). …”

Social Skill Group Interventions for Adolescents with Autism Spectrum Disorders: a Systematic Review

“…In terms of social competencies, most of the reviewed interventions targeted social skills comprehensively, while a smaller number of studies identified a more specific aspect of social competence, such as social cognition or nonverbal communication (e.g., Barnhill et al 2002). A number of studies targeted anxiety symptoms in addition to social skills (e.g., White et al 2010a;White et al 2013), suggesting that the performance deficits associated with co-occurring anxiety symptoms are a core intervention consideration. Mood symptoms, and specifically how these traits interact with social performance, must be considered when developing future interventions for adolescents on the spectrum.…”

“…While single-case designs are frequently used in autism research, only a handful of investigations (e.g., Dotson et al 2010;Mitchell et al 2010;Webb et al 2004) used this type of design, which may be attributed to difficulties adopting single-case methods to a group intervention context. Some articles assessed program feasibility characteristics, such as fidelity and consumer satisfaction (e.g., White et al 2010a), while others used qualitative methods, such as categorizing participant and parent responses to socially relevant inquiries and questionnaires (Fullerton & Coyne 1999;Rose & Anketell 2009). A large proportion of studies (39 %) used a pre-post design to assess treatment effects without a specified control group (e.g., Herbrecht et al 2009;MacKay et al 2007;Stichter et al 2010;Tse et al 2007).…”

“…While many social skills groups are guided by applied behavior analysis (ABA) principles-reinforcement, shaping, and scaffolding of skills (e.g., Dotson et al 2010;Stichter et al 2012;White et al 2010a) and some were explicitly behaviorally based (Mitchell et al 2010), many group interventions were also informed by other theories. For example, several existing groups were self-described as using cognitivebehavioral principles (e.g., White et al 2013), while others were based on theory of mind (Ozonoff & Miller 1995) or psychodynamic perspectives (Tyminski & Moore 2008).…”

Interaction modeling in automotive applications: A cognitive approach

“…However, the relevance of interactive navigation assistance is poor with respect to improve safety inside and outside the vehicle. As well, cognitive-behavioral analysis has been presented [11] with respect to social interaction but not tested in such particular environments as the car and the road are. Moreover, recent studies are trying to evaluate and demonstrate the potential of ICT technologies in persuading people and influencing their social activities and/or preferences towards the implementation of behavior change support systems [12].…”