A Case Series of Cognitive-Behavioral Therapy Augmentation of Antidepressant Medication for Anxiety in Children With Autism Spectrum Disorders

Objective: To provide preliminary estimates of the effectiveness of cognitive-behavioral therapy (CBT) in treating anxiety disorders among youth with autism spectrum disorders (ASD) whose anxiety remained clinically problematic following an adequate course of pharmacotherapy.Method: Seven youth with ASD and one or more comorbid anxiety disorders, who were non- or partial-responders to serotonin reuptake inhibitor (SRI) treatment delivered by their community provider (age range = 12-15 years), received 16 sessions of weekly CBT. Assessments were administered at baseline, approximately 17 weeks following baseline (pre-treatment), and after receiving CBT (post-treatment).Results: Four of seven participants were classified as treatment responders (much or very much improved) at post-treatment. Clinician severity ratings for 6 of 7 participantsas measured by the PARS, ADIS-IV-P, and CGI-Severitydecreased following CBT, with effect sizes ranging from 1.35 to 1.54. Parent-rated anxiety and ASD symptoms in the child were not significantly reduced.Conclusions: This study provides preliminary support for use of CBT in augmenting SRI treatment in youth with ASD and anxiety.