Social Responsiveness as a Mediator in Adapted Cognitive Behavioral Therapy for Autistic Youth with Maladaptive and Interfering Anxiety.
Jeffrey J Wood, Eric A Storch, Katherine Sung and 2 others
PMID 40332656WHAT IT FOUND
Adapted CBT reduced anxiety in autistic youth partly by improving their ability to connect socially.
This suggests that teaching specific social skills, such as joining games or starting conversations, is a key active ingredient alongside standard exposure techniques.
Key findings
01Improvements in social connection during treatment were linked to greater reductions in anxiety symptoms.
02Adapted CBT also reduced broader mental health problems, such as internalizing and externalizing behaviors, through these same improvements in social connection.
03The adapted therapy included specific modules on social skills, such as perspective taking, joining group activities, and hosting play dates, which were not present in the standard CBT condition.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Social skills were measured only at the end of treatment, not during it, so the study cannot confirm the exact timing of when social improvements caused anxiety to drop. The sample was less racially and ethnically diverse than the general population and included only children with moderate-to-high verbal language skills, limiting applicability to non-speaking or minimally verbal youth. This is a secondary analysis of a larger trial, relying on data collected for other primary questions.
Declared interests
The study was funded by the National Institute of Child Health and Human Development. No other conflicts of interest are declared in the provided text.
The easy way to misread this
Do not assume that social skills training alone will reduce anxiety. The benefit came from an integrated CBT program that combined social coaching with exposure and coping strategies, so neither component should be viewed as sufficient on its own based on this data.