Testing a cognitive behavioural therapy program for anxiety in autistic adolescents: a feasibility study

Figures & data

Table 1. Demographics and diagnostics characteristics of the participants.

N = 15
Age at time of treatment (Mean, SD)	15.8 (1.07)
Adolescents’ total IQ (Mean, SD)	101.8 (14.97)
Parents average education in years (Mean, SD)	14.9 (1.93)
Household income in DKK (Mean, SD)	803.333 (463.090)
Gender	(n=)
Female	9
Male	6
ASD diagnosis (ICD-10)
F84.0	5
F84.1	3
F84.5	1
F84.8	4
F84.12	2
On psychopharmacological medication
Yes*	5
No	10
Living with both biological parents
Yes	10
No	5
Primary anxiety diagnosis (N = 11)
SoP	9
GAD	1
SP	1
Number of anxiety disorders (N = 11)
1	4
2	3
3	3
4	1

Note: F84.0 – Infantile Autism; F 84.1 – Atypical Autism; F84.5 – Asperger’s Syndrome; F84.8 – Childhood Disintegrative Disorder; F98.8.

* Sertraline (4) and Ritalin Uno (1).

GAD: Generalized Anxiety Disorder; SoP: Social Phobia; SP: Specific Phobia.

Table 2. Results from the experience of service questionnaire in order of most to least endorsed statements.

Adolescents N = 13	True	Partly true	Not true
The treatment made me feel worse.	1	1	11
The treatment helped me.	7	5	1
If a friend needed this kind of help I would recommend the treatment.	7	3	3
I trusted the therapists.	6	5	2
The therapist understood the most important parts of my problems.	6	5	2
The wellbeing of the family has improved after treatment.	3	4	6
I feel more motivated to be with friend after the treatment.	3	4	6
Parents N = 13	True	Partly true	Not true
I trusted the therapists.	12	1	0
I feel I have been rightly informed about meaning, purpose, and process of the treatment.	12	1	0
The treatment made me feel worse.	0	1	12
The treatment made my child worse.	0	2	11
If a friend needed this kind of help I would recommend the treatment.	11	1	1
During the treatment I acquired a better understanding of my child’s psychological state.	10	2	1
During the treatment I became able to change my behaviour towards my child in a positive way.	9	3	1
The treatment helped my child.	8	5	0
The treatment helped me.	8	4	1
The wellbeing of the family has improved after treatment.	7	5	1

Table 3. Comments from parents and adolescents regarding satisfaction of the program.

Adolescents Positive statements

The treatment helped me.

I am feeling better. I can now do things I couldn’t before and I am less anxious now.

It was good to meet others in the same situation. It has helped me and given me the courage to try new things.

10/10

It was good and has helped me quite a lot.

Negative statements

Felt physically ill when there was conversation around the table for us young people.

I didn’t like the book.

Parents Positive statements

Help to self-help. Tools that can be used going forward in all situations that create anxiety. Our approach has changed and our child’s approach to trying out ‘new country’ has changed.

Useful tools. better knowledge of anxiety in relation to Autism. Good to meet other families.

It has contributed to a greater awareness of one’s own behaviour and approach as parents when something is difficult and anxiety-provoking for one’s child.

We have gained a common language which helps us understand each other.

Common language, systematic plan of attack, ladders, exposure, meeting others in a similar situation.

The process, the therapists and that we were a group.

Liked the focus on methods and focus on the parental role.

We got a common language.

Insight into our son’s perception of reality. The book seems easily accessible.

Good to be in a group with others in the same situation.

Negative statements

Consider some kind of reward system other than stickers, most people think it’s silly. Perhaps you should set a check mark - so that the young people themselves can follow with their active efforts.

Focus on process rather than pushing the goal.

Adapted more to young people. Table of contents in the material.

The manual is way too compressed.

The book could be aimed more at the youth group.

For me, there was a lack of clarity about exactly which pages/homework we had to do from time to time.

The layout of the written material is too messy.

Table 4. Mean scores, standard deviations, and effect sizes for all continuous measures.

	Pre M (SD)	Post M (SD)	FU M (SD)	Effect sizes Pre to Post	Effect sizes Post to FU
ADIS-CRS Primary diagnosis	6.73 (1.10) n = 11	4.73 (1.95) n = 11	3.91 (1.81) n = 11	d = 1.26	d = .43
ADIS-CRS All diagnosis	6.19 (1.11) n = 11	4.46 (1.81) n = 11	3.91 (1.42) n = 11	d = 1.15	d = .34
ADIS No. of anxiety diagnosis	2.09 (SD = 1.04) n = 11	1.55 (SD = 1.21) n = 11	1.18 (SD = 1.08) n = 11	d = .48	d = .32
SCAS-C Adolescents	40.69 (16.62) n = 13	31.85 (16.92) n = 13	28.77 (15.18) n = 13	d = .53	d = .19
SCAS-P Parents	42.77 (15.18) n = 13	30.38 (13.33) n = 13	28.38 (12.03) n = 13	d = .87	d = .16
CALIS-C Adolescents	18.62 (5.77) n = 13	12.23 (7.91) n = 13	11.77 (7.13) n = 13	d = .92	d = .06
CALIS-P Parent	24.23 (6.07) n = 13	21.46 (5.19) n = 13	16.62 (8.52) n = 13	d = .49	d = .69
CATS	44.23 (30.71) n = 13	26.92 (29.99) n = 13	26.77 (26.96) n = 13	d = .57	d = .005
KINDL-R* Adolescents	39.08 (8.64) n = 13	44.31 (9.30) n = 13	43.23 (9.97) n = 13	d = −0.58	d = .11
WHO-5* Parent	48 (18.48) n = 13	53.54 (19.22) n = 13	56.31 (21.26) n = 13	d = −0.29	d = −0.14
Attending school*	62% n = 13	77% n = 13	85% n = 13	d = −0.32	d = −0.18

Note: ADIS-CRS: Anxiety Disorder Interview Schedule for DSM-IV, Clinical Severity Rating (Clinicians rating); SCAS-C/P: Spence Children’s Anxiety Scale, Child/Parent version; CALIS-C/P: Child Anxiety Life Interference Scale, Child/Parent version; CATS: Children’s Automatic Thoughts Scale; KINDL-R: Quality of Life, Adolescent version; WHO-5: Quality of Life, Adult version.

* Negative effect sizes indicate improvement.

Data availability statement

The datasets generated and analysed during the current study are not publicly available due to the General Data Protection Regulations (GPDR) but are available in anonymised form from the corresponding author on reasonable request.