The Treatment of Anxiety in Autism Spectrum Disorder (TAASD) Study: Rationale, Design and Methods

Kerns, Connor M.; Wood, Jeffrey J.; Kendall, Philip C.; Renno, Patricia; Crawford, Erika A.; Mercado, Rogelio J.; Fujii, Cori; Collier, Amanda; Hoff, Alexandra; Kagan, Elana; Small, Brent J.; Lewin, Adam B.; Storch, Eric A.

doi:10.1007/s10826-016-0372-2

Cited by 43 publications

(21 citation statements)

References 69 publications

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“…Exclusion criteria (and rationale) included (a) a diagnosed or suspected intellectual disability (may struggle to understand cognitive-behavioral therapy concepts); (b) a diagnosis of bipolar or schizophrenia spectrum disorder or suicidality in the past 6 months (requires higher level of care than could be provided); (c) receiving concurrent therapy targeting anxiety, social skills, or behavioral interventions and unwilling to cease this treatment during the RCT (may confound experimental treatment); (d) family unwilling or unable to keep child’s medication regimen consistent during the RCT. Although additional, more stringent inclusion/exclusion criteria were assessed at the screening interview (e.g., confirmed clinically significant anxiety and ASD symptoms, specific IQ range) to determine eligibility for the RCT (see Kerns et al, 2016b), these criteria were not required for participants in the present study, who consisted of all those completing the screening interview. For example, though a verbal comprehension IQ greater than 70 was required for entry to the RCT, youth who completed the screening interview were enrolled in the present study as long as parents did not report a diagnosed or suspected intellectual disability during the initial phone screening.…”

Section: Methodsmentioning

confidence: 99%

“…Studies of the ADIS-C/P in children with ASD suggest that parent and child agreement about anxiety diagnoses is limited and that clinicians most often base their diagnostic impressions on parent report (Storch, Ehrenreich-May, et al, 2012b). As such, several studies utilizing the ADIS-C/P with ASD populations have relied solely on the parent-report tool (Kernd et al, 2016b; Reaven et al, 2012). …”

Section: Methodsmentioning

confidence: 99%

“…The correct diagnostic classification of these ambiguous anxiety-like symptoms is unclear, which presents a problem for both researchers attempting to measure and better understand co-occurring anxiety in ASD and clinicians seeking to determine whether co-occurring anxiety is present and deserving of targeted intervention in an individual with ASD (Kerns & Kendall, 2012; Kerns et al, 2016b). Sensory-related or special-interest related fears, anxiety about change, and difficulties with the unpredictable nature of social interactions have long been associated with ASD (Kanner, 1943; Lord, Rutter, & Le Couteur, 1994), but may also reflect symptoms of anxiety, altered in presentation by its co-occurrence with ASD (Kerns & Kendall, 2012; Wood & Gadow, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Anxiety Disorders Interview Schedule–Autism Addendum: Reliability and Validity in Children With Autism Spectrum Disorder

Kerns

Renno

Kendall

et al. 2016

Journal of Clinical Child & Adolescent Psychology

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124

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Objective Assessing anxiety in autism spectrum disorder (ASD) is inherently challenging due to overlapping (e.g., social avoidance) and ambiguous symptoms (e.g., fears of change). An ASD addendum to the Anxiety Disorders Interview Schedule–Child/Parent, Parent Version (ADIS/ASA) was developed to provide a systematic approach for differentiating traditional anxiety disorders from symptoms of ASD and more ambiguous, ASD-related anxiety symptoms. Method Inter-rater reliability and convergent and discriminant validity were examined in a sample of 69 youth with ASD (8–13 years, 75% male, IQ:68–143) seeking treatment for anxiety. The parents of participants completed the ADIS/ASA and a battery of behavioral measures. A second rater independently observed and scored recordings of the original interviews. Results Findings suggest reliable measurement of comorbid (ICC=0.85–0.98; κ =0.67–0.91) as well as ambiguous anxiety-like symptoms (ICC=0.87–95, κ=0.77–0.90) in children with ASD. Convergent and discriminant validity were supported for the traditional anxiety symptoms on the ADIS/ASA, whereas convergent and discriminant validity were partially supported for the ambiguous anxiety-like symptoms. Conclusions Results provide evidence for the reliability and validity of the ADIS/ASA as a measure of traditional anxiety categories in youth with ASD, with partial support for the validity of the ambiguous anxiety-like categories. Unlike other measures, the ADIS/ASA differentiates comorbid anxiety disorders from overlapping and ambiguous anxiety-like symptoms in ASD, allowing for more precise measurement and clinical conceptualization. Ambiguous anxiety-like symptoms appear phenomenologically distinct from comorbid anxiety disorders and may reflect either symptoms of ASD or a novel variant of anxiety in ASD.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anxiety Disorders Interview Schedule–Autism Addendum: Reliability and Validity in Children With Autism Spectrum Disorder

Kerns

Renno

Kendall

et al. 2016

Journal of Clinical Child & Adolescent Psychology

Self Cite

124

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“…A 5-item total score of 11.5 or greater on the PARS suggests significant risk for anxiety disorder. The PARS has demonstrated inter-rater reliability (.86), high test–retest reliability (.83), and convergent validity in anxious youth with ASD [128, 129] and has shown sensitivity to treatment effects in clinical trials of anxiety interventions for children with ASD [130, 131]. For this study, the PARS was administered by C.K.…”

Section: Children's Sleep Habits Questionnairementioning

confidence: 99%

Sleep in Children with Autism Spectrum Disorder

Souders

Zavodny

Eriksen

et al. 2017

Curr Psychiatry Rep

209

143

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The purposes of this paper are to provide an overview of the state of the science of sleep in children with autism spectrum disorder (ASD), present hypotheses for the high prevalence of insomnia in children with ASD, and present a practice pathway for promoting optimal sleep. Approximately two thirds of children with ASD have chronic insomnia, and to date, the strongest evidence on promoting sleep is for sleep education, environmental changes, behavioral interventions, and exogenous melatonin. The Sleep Committee of the Autism Treatment Network (ATN) developed a practice pathway, based on expert consensus, to capture best practices for screening, identification, and treatment for sleep problems in ASD in 2012. An exemplar case is presented to integrate key constructs of the practice pathway and address arousal and sensory dysregulation in a child with ASD and anxiety disorder. This paper concludes with next steps for dissemination of the practice pathway and future directions for research of sleep problems in ASD.

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“…Augmenting traditional CBT strategies with social skills training and parent management techniques have also been used to address broader deficits that potentially contribute to and/or exacerbate anxiety [69]. Research in treating adults with anxiety and ASD is more preliminary, but also suggests that CBT approaches and mindfulness techniques may be promising [70••, 71]. Behavioral treatment for individuals with OCD and ASD has received much less attention in the literature, but existing research suggests that obsessive-compulsive symptoms can improve with CBT [72].…”

Section: Current Approaches To Treatmentmentioning

confidence: 99%

Anxiety Disorders and Obsessive-Compulsive Disorder in Individuals with Autism Spectrum Disorder

Postorino

Kerns

Vivanti

et al. 2017

Curr Psychiatry Rep

Self Cite

144

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Purpose of Review This review aims to synthesize the most recent research on anxiety disorders and obsessive-compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD) and discuss the relationship between these conditions and challenges for assessment. Furthermore, implications for treatment and future directions are discussed. Recent Findings Research suggests that anxiety disorders and OCD are highly prevalent in individuals with ASD. However, the significant overlap of ASD features with anxiety and OCD symptomology makes differential diagnosis of these disorders particularly challenging. Though several treatments for anxiety have been adapted for youth with ASD (e.g., cognitive behavior therapy), pharmacological treatments and treatments for adults are still marked undeveloped. Summary Despite the high prevalence of anxiety disorders and OCD in ASD and some recent advances in assessment and treatment, research is needed to clarify the multifaceted relationship of these conditions and develop tailored assessment and treatment approaches appropriate for a full range of individuals with ASD.

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The Treatment of Anxiety in Autism Spectrum Disorder (TAASD) Study: Rationale, Design and Methods

Cited by 43 publications

References 69 publications

Anxiety Disorders Interview Schedule–Autism Addendum: Reliability and Validity in Children With Autism Spectrum Disorder

Anxiety Disorders Interview Schedule–Autism Addendum: Reliability and Validity in Children With Autism Spectrum Disorder

Sleep in Children with Autism Spectrum Disorder

Anxiety Disorders and Obsessive-Compulsive Disorder in Individuals with Autism Spectrum Disorder

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