Original Article

Child Psychiatry & Human Development

, Volume 42, Issue 6, pp 634-649

First online:

Effects of Cognitive-Behavioral Therapy on Anxiety in Children with Autism Spectrum Disorders: A Randomized Controlled Trial

  • Min SungAffiliated withInstitute of Mental HealthChild Guidance Clinic Email author 
  • , Yoon Phaik OoiAffiliated withInstitute of Mental HealthDUKE-NUS Graduate Medical School
  • , Tze Jui GohAffiliated withInstitute of Mental Health
  • , Pavarthy PathyAffiliated withInstitute of Mental Health
  • , Daniel S. S. FungAffiliated withInstitute of Mental HealthDUKE-NUS Graduate Medical SchoolNanyang Technological University
  • , Rebecca P. AngAffiliated withNanyang Technological University
  • , Alina ChuaAffiliated withAutism Resource Center
  • , Chee Meng LamAffiliated withAutism Resource Center

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We compared the effects of a 16-week Cognitive-Behavioral Therapy (CBT) program and a Social Recreational (SR) program on anxiety in children with Autism Spectrum Disorders (ASD). Seventy children (9–16 years old) were randomly assigned to either of the programs (n CBT = 36; n SR = 34). Measures on child’s anxiety using the Spence Child Anxiety Scale—Child (SCAS-C) and the Clinical Global Impression—Severity scale (CGI-S) were administered at pre-, post-treatment, and follow-ups (3- and 6-month). Children in both programs showed significantly lower levels of generalized anxiety and total anxiety symptoms at 6-month follow-up on SCAS-C. Clinician ratings on the CGI-S demonstrated an increase in the percentage of participants rated as “Normal” and “Borderline” for both programs. Findings from the present study suggest factors such as regular sessions in a structured setting, consistent therapists, social exposure and the use of autism-friendly strategies are important components of an effective framework in the management of anxiety in children and adolescents with ASD.


Autism spectrum disorder Anxiety Cognitive-behavior therapy High-functioning autism Asperger syndrome Social recreational