Child Psychiatry & Human Development

, Volume 42, Issue 6, pp 634–649 | Cite as

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

  • Min Sung
  • Yoon Phaik Ooi
  • Tze Jui Goh
  • Pavarthy Pathy
  • Daniel S. S. Fung
  • Rebecca P. Ang
  • Alina Chua
  • Chee Meng Lam
Original Article


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 



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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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Min Sung
    • 1
    • 5
  • Yoon Phaik Ooi
    • 1
    • 2
  • Tze Jui Goh
    • 1
  • Pavarthy Pathy
    • 1
  • Daniel S. S. Fung
    • 1
    • 2
    • 3
  • Rebecca P. Ang
    • 3
  • Alina Chua
    • 4
  • Chee Meng Lam
    • 4
  1. 1.Institute of Mental HealthSingaporeSingapore
  2. 2.DUKE-NUS Graduate Medical SchoolSingaporeSingapore
  3. 3.Nanyang Technological UniversitySingaporeSingapore
  4. 4.Autism Resource CenterSingaporeSingapore
  5. 5.Child Guidance ClinicSingaporeSingapore

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