Optimising Anxiety Treatment for Autistic Children: a Narrative Review

Anxiety disorders occurs at a high rate amongst autistic children. Cognitive behaviour therapy (CBT) is a reasonably well-established multi-component intervention used to reduce anxiety in this population. Whilst there are known effective intervention components in CBT for treating anxiety among autistic children, there are few guidelines for how to weight these intervention components to maximise positive outcomes. The objective of this study is to evaluate whether CBT is an effective intervention for autistic children, and if so, what the key components of effective CBT programs are for autistic children. A review of studies using manualised group-based CBT programs with family involvement was completed. The key finding was that the exposure-focused CBT (EF-CBT) studies reviewed showed a greater improvement in anxiety symptoms compared with CBT studies with fewer or no exposure-focused sessions. Compared to CBT without an exposure focus, EF-CBT may better fit the profiles of autistic children, potentially resulting in greater client and family engagement, and possibly greater intervention efficacy.