Empirically-identified subgroups of children with autism spectrum disorder and their response to two types of cognitive behavioral therapy

Abstract Autism spectrum disorder (ASD) is heterogeneous and likely entails distinct phenotypes with varying etiologies. Identifying these subgroups may contribute to hypotheses about differential treatment responses. The present study aimed to discern subgroups among children with ASD and anxiety in context of the five-factor model of personality (FFM) and evaluate treatment response differences to two cognitive-behavioral therapy treatments. The present study is a secondary data analysis of children with ASD and anxiety (N=202; ages 7–13; 20.8% female) in a cognitive behavioral therapy (CBT) randomized controlled trial (Wood et al., 2020). Subgroups were identified via latent profile analysis of parent-reported FFM data. Treatment groups included standard-of-practice CBT (CC), designed for children with anxiety, and adapted CBT (BIACA), designed for children with ASD and comorbid anxiety. Five subgroups with distinct profiles were extracted. Analysis of covariance revealed CBT response was contingent on subgroup membership. Two subgroups responded better to BIACA on the primary outcome measure and a third responded better to BIACA on a peer-social adaptation measure, while a fourth subgroup responded better to CC on a school-related adaptation measure. These findings suggest that the FFM may be useful in empirically identifying subgroups of children with ASD, which could inform intervention selection decisions for children with ASD and anxiety.

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Adapting Cognitive Behavioral Therapy for Children with Autism Spectrum Disorder and Comorbid Anxiety and Obsessive-Compulsive Disorders

Cognitive Behavioral Therapy in Youth: Tradition and Innovation - Neuromethods ◽

10.1007/978-1-0716-0700-8_7 ◽

2020 ◽

pp. 125-140

Author(s):

Kelly N. Banneyer ◽

Rachel Fein ◽

Eric A. Storch

Keyword(s):

Autism Spectrum Disorder ◽

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Cognitive Behavioral ◽

Obsessive Compulsive ◽

Obsessive Compulsive Disorders ◽

Compulsive Disorders

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A Case Report of Intensive Exposure-Based Cognitive Behavioral Therapy for a Child With Comorbid Autism Spectrum Disorder and Obsessive-Compulsive Disorder

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.31.2.118 ◽

2017 ◽

Vol 31 (2) ◽

pp. 118-123

Author(s):

Katie L. Merricks ◽

Joshua M. Nadeau ◽

Amaya Ramos ◽

Eric A. Storch

Keyword(s):

Autism Spectrum Disorder ◽

Cognitive Behavioral Therapy ◽

Obsessive Compulsive Disorder ◽

Treatment Modality ◽

Behavioral Therapy ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Cognitive Behavioral ◽

Obsessive Compulsive ◽

Compulsive Disorder

Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) has proven to be an effective treatment modality for children with obsessive-compulsive disorder (OCD). Less research exists demonstrating efficacy for this treatment modality among children with comorbid diagnoses of OCD and autism spectrum disorder (ASD), and virtually, nothing has been reported examining intensive interventions for the most severe cases. As such, this article discusses the treatment of an adolescent male with severe OCD comorbid with ASD, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), and chronic tic disorder using a cognitive behavioral approach and ERP. We conclude with recommendations for continued clinical research to understand approaches to help nonresponders to standard therapeutic approaches with this challenging population.

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The therapeutic alliance in cognitive-behavioral therapy for school-aged children with autism and clinical anxiety

Autism ◽

10.1177/1362361319841197 ◽

2019 ◽

Vol 23 (8) ◽

pp. 2031-2042 ◽

Cited By ~ 4

Author(s):

Sami M Klebanoff ◽

Kashia A Rosenau ◽

Jeffrey J Wood

Keyword(s):

Autism Spectrum Disorder ◽

Cognitive Behavioral Therapy ◽

Therapeutic Alliance ◽

Behavioral Therapy ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Cognitive Behavioral ◽

Typically Developing ◽

Typically Developing Children

Little is known about the alliance between therapists and children with autism spectrum disorder who are receiving psychological therapies in outpatient treatment settings. This study examined the therapeutic alliance in children with autism spectrum disorder and clinical anxiety, who were receiving cognitive behavioral therapy in a randomized, controlled trial. The Therapeutic Alliance Scale for Children was administered to a sample of children and youth with autism spectrum disorder and anxiety ( N = 64; aged 7–14) as well as to their parents and therapists. A comparison sample of typically developing youth with clinical anxiety ( N = 36; aged 5–12) was included. The child-therapist alliance was more positive among typically developing children than among children with autism spectrum disorder; correspondingly, the parent-therapist alliance was also more positive among parents of typically developing children. Therapist reports of positive child-therapist alliance predicted post-treatment reductions in anxiety among children with autism spectrum disorder, although child reports of this alliance did not. Parent reports of positive parent-therapist alliance also predicted post-treatment reductions in the child’s anxiety in the group with autism spectrum disorder. A strong therapeutic alliance appears to be associated with better treatment outcomes in children with autism spectrum disorder receiving cognitive behavioral therapy, although a thoughtful and diagnostically sensitive approach is advisable to promote a positive alliance with children with autism spectrum disorder.

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