Effect of a Short-Term Treatment Program for Anxiety in Children Diagnosed with Autism Spectrum Disorders

Background:  Children with autism spectrum disorders (ASD) have difficulties in understanding and controlling their emotion. Especially, children diagnosed with high functioning autism and Asperger syndrome have more anxiety problems compared with a community sample (Kim et al., 2000). Furthermore, children with anxiety problems were also rated as more aggressive, and as having poorer relationships with peers and teachers (Kim et al., 2000). Therefore, interventions aimed at reducing anxiety for children with ASD may reduce aggression and improve relationships with family, peers and teachers. Sofronoff et al. (2005) developed a cognitive behavioral intervention program for anxiety in children with Asperger syndrome and demonstrated its effectiveness in randomized controlled trials. However, few anxiety treatment programs for children with ASD have been developed in Japan. 

Objectives:  The purpose of the present study was to evaluate the effectiveness of a short-term treatment program for understanding and controlling anxiety in children diagnosed with ASD. The program was conducted during a summer camp session of a non-profit organization in Japan.

Methods:  Six students with ASD aged 10 to 16 participated in the program. The presence of their anxiety symptoms was reported on parent reports. All children belonged to the NPO, the Asperger Society Japan. This organization runs the 5-day summer camp every year and the treatment program for this study was included in this camp. This program was designed to be highly structured, informative and entertaining. All children received materials for the three two-hour sessions (the second to fourth day of the summer camp) that included information on the relationship among emotion, cognition, and body, 5-point scale of emotion, 5-stage table of anxiety, and 5 cards with anxiety control strategy. In the first session, therapists and children discussed how to understand emotion of themselves through filling out 5-point scale of emotion and watching their own faces by movie. In the second session, the students reviewed a general emotion understanding with video self-monitoring, and then they learned how to understand and control their own anxiety. In the third session, they learned concrete strategy for controlling anxiety through a group-game. The degree of the students’ understanding and controlling their anxiety was measured using the Evaluation Sheet for Emotional Control (Myogan, 2009) that was rated by their parents, and observing the use of control strategies generated by children.

Results: Results indicated that all six children recognized the necessity of controlling emotion, controllability of emotion, and how to control emotion after the program; they had not demonstrated these before attending the program. In addition, the number of control strategies generated by children increased, and appropriateness of these strategies changed into more favorable. However, individual differences in understanding and utilizing own strategies existed.

Conclusions:  

A short-term summer treatment program for anxiety with children diagnosed with ASD was partially effective but some refinements are still needed. Further research is needed to improve the effectiveness of the program for anxiety in children diagnosed with ASD.

Part of this work was supported by JSPS Grant-in-Aid for Scientific Research (C) (22531048).