New research from York University shows cognitive behavioral therapy (CBT) can help children with autism manage not only anxiety but other emotional challenges, such as sadness and anger.

Cognitive behavioral therapy is a form of psychotherapy aimed at identifying the patterns of behavior and thought behind an individual’s struggles, and modifying these patterns so as to change how the individual feels. It’s an established method of treatment for anxiety and depression for neurotypical patients. And there is growing consensus that it could and should be adapted to support people with autism spectrum disorder as well.

Led by Jonathan Weiss, an associate professor of psychology and the CIHR chair in autism spectrum disorders treatment and care research, the study shows cognitive behavioral therapy can lead to significant improvements in the ability of children with autism to regulate emotions. It also shows — for the first time — that CBT can improve more than just anxiety.

Most children with autism spectrum disorder will struggle with some form of emotional challenge. About half of these children will struggle with anxiety, and another 25 to 40% will struggle with other emotional challenges such as anger or depression. In fact, there is a high co-occurrence among these conditions.

“We can use this same intervention to improve children’s skills more broadly regardless of what emotional challenge they have,” Weiss says. “We can make them more resilient to many emotional and mental health issues.”

Sixty-eight children from 8 to 12 years of age and their parents, mostly mothers, participated in the study and were randomly assigned to two groups: one group receiving 10 CBT sessions beginning right away, and another group waiting to receive treatment later. Researchers tracked how their emotions and behavior changed prior to and after treatment.

“We showed that children who received this treatment right away improved in their ability to manage their emotions, and in overall mental health problems, versus kids who were waiting for treatment,” Weiss says.

A clinician who was not involved in the direct provision of the cognitive behavioral therapy, and who did not know if children were in the treatment or waitlist group, rated 74% of children receiving treatment as improved, compared to only 31% of those in the waitlist group.

The treatment consisted of time-limited spy-themed cognitive behavioral therapy involving a computer program, games and tools to help build the child’s emotional toolkit. The tools help children face head-on situations that may have previously been challenging, but in a more supportive way. During the intervention, parents also practiced what they were learning with their children and served as co-therapists.

“We believe that children grow and develop and improve within the context of healthy families and this intervention aids to help the family unit more broadly to be the agent of change,” Weiss says.

Researchers are now looking at how cognitive behavioral therapy can be used for other neurodevelopmental conditions that often overlap with autism, such as ADHD.

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