Examining the Relationship Between Anxiety Severity and Autism-Related Challenges During Cognitive Behavioral Therapy for Children with Autism.
Madeleine N Fuselier, Andrew G Guzick, Jafar Bakhshaie and 6 others
PMID 36847894WHAT IT FOUND
In children with autism and anxiety who received CBT, drops in anxiety tracked with drops in repetitive behaviors and social communication difficulties.
The analysis did not prove anxiety caused these changes.
Key findings
01Anxiety symptoms decreased significantly during treatment.
02Repetitive and restrictive behaviors decreased significantly during treatment, and within individual participants decreases in anxiety were associated with decreases in these behaviors; the indirect effect was significant.
03Social communication/interaction difficulties decreased significantly during treatment, and within individual participants decreases in anxiety were associated with decreases in these difficulties; the indirect effect was significant.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only children with IQ scores of 70 or greater were included, so results may not apply to children with more severe cognitive impairment. The sample was mostly male (28% female), so findings may not represent autistic girls. The same parent reported both anxiety and autism-related challenges at each time point, which can make the scores move together. The Social Responsiveness Scale may have limited specificity for autism-related challenges. The mediation analyses are correlational and do not establish that reducing anxiety caused improvements in repetitive behaviors or social communication. The supplied text does not report dropout numbers or how many participants contributed to each analysis.
The easy way to misread this
Do not conclude that anxiety-focused CBT improves autism core symptoms because anxiety reduction caused them. The paper's mediation analyses are correlational over time and the authors state they are not causal models.