Treatment of anxiety in older adolescents and young adults with autism spectrum disorders: A pilot study.

Anxiety disorders are commonly comorbid in adolescents and young adults with high-functioning autism. Cognitive-behavioral treatments (CBT) for anxiety, when adapted and expanded to target autism spectrum disorder (ASD) characteristics, may be beneficial, but there is minimal evidence to guide clinicians in their application. This multiple-baseline design study evaluated the initial efficacy of a CBT protocol adapted to address anxiety symptoms and adaptive functioning in this population. Anxiety and ASD symptoms were assessed for six participants at intake, after baseline, posttreatment, and at 1-month follow-up. Parent- and child-reported anxiety was also assessed during baseline and treatment. Visual inspection and reliable change index scores were used to evaluate change. All participants improved on clinician-rated measures of disorder severity, and gains were maintained at follow-up. Results were more equivocal for parent- and self-rated anxiety and parent-rated ASD, partly because of spontaneous changes during baseline.

Mothers' reports of play dates and observation of school playground behavior of children having high-functioning autism spectrum disorders.

BACKGROUND: Children with high-functioning autism spectrum disorders (ASD) are generally included with typically developing peers at school. They have difficulties interacting with peers on the school playground. Previous literature suggests that having play dates in the home may be related to better peer acceptance at school. METHODS: This study examines the relationship between mother-reported play date frequency and amount of conflict, and peer interaction observed on the school playground for a sample of 27 boys and 4 girls meeting structured interview and observation criteria for ASD. Measures of intellectual functioning, adaptive behavior, and social skills were included in a stepwise regression analysis to account for their impact on relationships between maternal play date reports, general peer acceptance at school (as rated by the child's teacher) and observations of school playground behavior. RESULTS: Results revealed that children with autism spectrum disorders who had more play dates in their home tended to spend a greater amount of time engaged in behaviors such as mutual offering of objects, conversing and other turn-taking activities with peers on the school playground. They also received more positive responses to their overtures from peers. These relationships remained highly significant even after accounting for other demographic, general social, and cognitive variables. CONCLUSIONS: The present results suggest that play date frequency is strongly related to school playground behavior. Owing to the design of this study, future research must assess whether play dates in the home promote better peer relationships on the playground or the reverse. In either case, the assessment of play dates, as well as observation of spontaneous unsupervised social interactions, are important outcome measures to consider in social skills interventions for children with high-functioning ASD.