A systematic review of the treatments of anxiety in children with autism spectrum disorder

Objectives Anxiety symptoms are frequently observed in children with autism spectrum disorder (ASD). While there is substantial research on treatment options for anxiety in typically developing (TD) children, there is a significant gap in understanding the management of anxiety in children with ASD. The aim of this review is to evaluate the evidence base of current research on various treatments for anxiety in children under 18 years of age with ASD, assess the effectiveness of these interventions, and examine the potential adverse effects associated with these treatment options to inform clinical practice and caregiver decisions.Methods A systematic literature review was conducted using the databases Scopus, PubMed, and MEDLINE. The search employed relevant keywords to identify articles published between 2014 and 2023 (inclusive). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered to throughout the review process.Results A total of 33 studies met the inclusion criteria for this review. Significant heterogeneity was observed in the methodologies of the included studies, including variations in assessment of anxiety, measures of treatment response, treatment duration, and follow-up periods. Cognitive Behavior Therapy (CBT) emerged as the most evidence-based treatment for managing anxiety in autistic children. Notably, adapted CBT specifically designed for children with ASD demonstrated superior outcomes compared to standard CBT approaches. There is a notable lack of pharmacological studies addressing anxiety in this population.Conclusion Further research is essential to address the gaps in treatments available for managing anxiety in autistic children. Moreover, the development of sophisticated and customized anxiety measurement scales specifically designed for autistic children would enhance the validity and reliability of future research.