ABSTRACT
BACKGROUND: Youth with autism spectrum disorder (ASD) experience high rates (approximately 50-79%) of comorbid anxiety problems. Given the significant interference and distress that excessive anxiety can cause, evidence-based intervention is necessary in order to reduce long-term negative effects. Cognitive behavioral therapy (CBT) has demonstrated efficacy for treating anxiety disorders across the lifespan, both in individual and group formats. Recently, modified CBT programs for youth with ASD have been developed, showing positive outcomes. To date, these modified CBT programs have primarily been evaluated in controlled research settings. METHODS: The current community effectiveness study investigated the effectiveness of a modified group CBT program (Facing Your Fears) delivered in a tertiary care hospital and across six community-based agencies providing services for youth with ASD. Data were collected over six years (N = 105 youth with ASD; ages 6-15 years). RESULTS: Hospital and community samples did not differ significantly, except in terms of age (hospital M = 10.08 years; community M = 10.87 years). Results indicated significant improvements in anxiety levels from baseline to post-treatment across measures, with medium effect sizes. An attempt to uncover individual characteristics that predict response to treatment was unsuccessful. CONCLUSIONS: Overall, this study demonstrated that community implementation of a modified group CBT program for youth with ASD is feasible and effective for treating elevated anxiety.
Subject(s)
Anxiety/psychology , Anxiety/therapy , Autism Spectrum Disorder/psychology , Autism Spectrum Disorder/therapy , Cognitive Behavioral Therapy , Community Mental Health Services , Psychotherapy, Group , Adolescent , Analysis of Variance , Anxiety/diagnosis , Applied Behavior Analysis , Autism Spectrum Disorder/diagnosis , Child , Cognitive Behavioral Therapy/methods , Community Mental Health Services/methods , Female , Humans , Male , Prognosis , Psychotherapy, Group/methods , Symptom Assessment , Treatment OutcomeABSTRACT
Unintentional injuries are the leading cause of death for children. Prior research has implicated both child behavioral attributes and parent supervisory patterns as risk factors. The present study assessed interactions between these two risk factors and determined whether supervision moderates the relation between child attributes and injury. Mothers completed questionnaire measures of child attributes and supervisory patterns and also recorded how they supervised their young child (2-5 years) at home on each of 10 randomly selected days within a 3-week period. Results provide support for the moderating effect of supervision: Supervision interacted with some child attributes to elevate children's risk of medically attended injury and with other attributes to decrease injury risk. Implications for preventing childhood injuries are discussed.
Subject(s)
Accidents, Home/prevention & control , Attitude to Health , Child Behavior/psychology , Child Care , Mothers/psychology , Wounds and Injuries , Accident Prevention/methods , Accidents, Home/statistics & numerical data , Age Factors , Analysis of Variance , Child , Child Care/methods , Child Care/psychology , Child, Preschool , Exploratory Behavior , Female , Humans , Male , Mother-Child Relations , Parenting/psychology , Regression Analysis , Risk Assessment , Risk Factors , Risk-Taking , Sex Factors , Surveys and Questionnaires , Wounds and Injuries/etiology , Wounds and Injuries/prevention & controlABSTRACT
Unintentional injury is a leading cause of death and hospitalization of young children. Many of these injuries occur in the home when children presumably are being supervised. This study focused on the under-explored issue of sibling supervision in the home, drawing on data collected from a sample of Canadian mothers. Mothers in this sample completed a structured telephone interview and mailed back questionnaires to provide information about the nature and extent of sibling supervision that occurs in the home, as well as the younger child's injury history. Results indicated that older siblings supervise younger ones about 11% of their mutual wake time, with children typically playing and parents usually doing other chores during this time. Time spent with siblings as supervisors was positively related to the supervisee's history of injuries suggesting that sibling supervision may elevate younger children's risk of injury. However, the behavior of the supervisee contributed to risk more so than that of the supervisor. Specifically, sibling supervisors were reported to utilize the same types of strategies as their mother and father in their efforts to supervise and persuade younger children to stop things that could lead to injury. However, poor compliance by the younger child when the older sibling was supervising predicted injury. Implications for childhood injury and directions for future research are discussed.