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A Randomized Controlled Trial of a Cognitive Behavioural Intervention for Anger Management in Children Diagnosed with Asperger Syndrome

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The purpose of the study described was to evaluate the effectiveness of a cognitive behavioural intervention for anger management with children diagnosed with Asperger syndrome. Forty-five children and their parents were randomly assigned to either intervention or wait-list control conditions. Children in the intervention participated in six 2-h weekly sessions while parents participated in a larger parent group. Parent reports indicated a significant decrease in episodes of anger following intervention and a significant increase in their own confidence in managing anger in their child. Qualitative information gathered from parents and teachers indicated some generalization of strategies learned in the clinic setting to both home and school settings. Limitations of the study and suggestions for future research are also discussed.

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We would like to acknowledge the families who participated in this research and the Apex Autism Trust Foundation who supported the trial with a grant.

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Correspondence to Kate Sofronoff.


Appendix A

Dylan is Being Teased

My friend at school is Dylan. We are in Mrs. Smith’s class. Dylan is a great friend and we like to do the same things at lunch time. Sometimes we play handball, or go to the library and read about volcanoes, and we both like The Simpsons.

There are three boys in our grade who are not our friends. They like to find someone and tease them and get them into trouble. We don’t know why they do it. Sometimes they can be really mean and call you names, which are not true, and want to punch you or push you onto the ground. Dylan and I don’t do that to anyone.

Dylan has been in trouble with the Principal for getting mad at them and hitting them. They start it but he gets in to more trouble then they do. He was suspended for three days last week when they called him a ‘Psycho’. When they said that, he told them to stop, but they didn’t, so he hit one of them on the nose. There was a lot of blood everywhere.

On Friday, at lunchtime, they started to tease him again; calling him chicken and saying he is fat and gay. If he gets mad at them again he will be suspended and have to leave the school forever. He is my only friend.

Tell me what you could do and say to help Dylan keep cool and not get mad with them.

Appendix B

Trainer’s Notes

  • Session 1 Introduction

    • Strengths and Talents

    • Being Happy

    • Feeling Relaxed

  • Session 2 Why we feel anxious

    • Heroes who become angry

    • A time when I have felt angry

    • An emotional tool box

      • physical tools

      • relaxation tools

  • Session 3 Emotional Tool Box

    • Social Tools

    • Thinking Tools

    • Other Tools

    • Inappropriate Tools

  • Session 4 Practice using the tool box

  • Session 5 Social Stories

    • Antidote to poisonous thoughts

  • Session 6 Sharing Strategies

Suggestions for Group Cohesion

Emphasise success and discovery

  • Be careful with idioms

  • Acknowledge intelligence

  • Use the special interest as a metaphor

  • No right or wrong answers

  • Ground rules will need to be established at the start of session 1

  • One person leads the activity. The other person’s function is recording information and maintaining attention

  • Use plenty of games from the list to break up the sessions

  • Incorporate rewards from the reward bank for every child

Session Two

Table 5  
Table 6  

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Sofronoff, K., Attwood, T., Hinton, S. et al. A Randomized Controlled Trial of a Cognitive Behavioural Intervention for Anger Management in Children Diagnosed with Asperger Syndrome. J Autism Dev Disord 37, 1203–1214 (2007).

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