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

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Abstract

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.

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Acknowledgments

This study was supported by the National Medical Research Council (NMRC) grant (Ref No.: NMRC/1002/2005). We would like to extend our heartfelt thanks to the participants and their parents. We would also like to extend thanks to Joel Low for proofreading the article.

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Authors and Affiliations

  1. Institute of Mental Health, Singapore, Singapore

    Min Sung, Yoon Phaik Ooi, Tze Jui Goh, Pavarthy Pathy & Daniel S. S. Fung

  2. DUKE-NUS Graduate Medical School, Singapore, Singapore

    Yoon Phaik Ooi & Daniel S. S. Fung

  3. Nanyang Technological University, Singapore, Singapore

    Daniel S. S. Fung & Rebecca P. Ang

  4. Autism Resource Center, Singapore, Singapore

    Alina Chua & Chee Meng Lam

  5. Child Guidance Clinic, 3 Second Hospital Avenue, #03-01 Health Promotion Board Building, Singapore, 168937, Singapore

    Min Sung

Authors
  1. Min Sung
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  2. Yoon Phaik Ooi
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  3. Tze Jui Goh
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  4. Pavarthy Pathy
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  5. Daniel S. S. Fung
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  6. Rebecca P. Ang
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  7. Alina Chua
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  8. Chee Meng Lam
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Corresponding author

Correspondence to Min Sung.

Appendix

Appendix

See Table 5.

Table 5 CONSORT statement 2001 checklist
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Sung, M., Ooi, Y.P., Goh, T.J. et al. Effects of Cognitive-Behavioral Therapy on Anxiety in Children with Autism Spectrum Disorders: A Randomized Controlled Trial. Child Psychiatry Hum Dev 42, 634–649 (2011). https://doi.org/10.1007/s10578-011-0238-1

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