Journal of Autism and Developmental Disorders

, Volume 47, Issue 12, pp 3930–3948 | Cite as

Intervention for Anxiety and Problem Behavior in Children with Autism Spectrum Disorder and Intellectual Disability

  • Lauren J. Moskowitz
  • Caitlin E. Walsh
  • Emile Mulder
  • Darlene Magito McLaughlin
  • Greg Hajcak
  • Edward G. Carr
  • Jennifer R. Zarcone
S.I. : Anxiety in Autism Spectrum Disorders


There is little research on the functional assessment and treatment of anxiety and related problem behavior in children with autism spectrum disorder (ASD), particularly those with intellectual and developmental disability (IDD). In a recent study, we evaluated a multimethod strategy for assessing anxiety in children with ASD and IDD (Am J Intellect Dev Disabil 118:419–434, 2013). In the present study, we developed treatments for the anxiety and associated problem behavior in these same children. A multiple baseline design was used to evaluate the effectiveness of a multicomponent intervention package, incorporating individualized strategies from Positive Behavior Support and Cognitive Behavioral Therapy. During intervention, all three participants showed substantial decreases in anxiety and problem behavior and significant increases in respiratory sinus arrhythmia in the situations that had previously been identified as anxiety-provoking.


Autism Anxiety Intellectual disability Applied behavior analysis Positive Behavior Support Cognitive Behavioral Therapy Respiratory sinus arrhythmia 


Author Contributions

Dr. Lauren Moskowitz conceptualized, designed, and implemented the study, analyzed the behavioral data, drafted the initial manuscript, reviewed and revised the manuscript, and approved the submission of the final manuscript. Dr. Caitlin Walsh was the primary coder of anxious behavior and problem behavior, assisted with conceptualizing the study, reviewed and revised the manuscript, and approved the submission of the final manuscript. Dr. Emile Mulder analyzed the HR and RSA data, carried out the statistical analyses for the physiological data, and drafted the results for the physiological data. Dr. Darlene Magito McLaughlin helped design and conceptualized the study as well as reviewed and revised the manuscript. Dr. Greg Hajcak supervised the physiological data collection and analysis and reviewed the manuscript. The late Dr. Edward G. Carr (Ted Carr) was instrumental in helping to design and conceptualize the study. Dr. Jennifer Zarcone helped to conceptualize the study and analyze the behavioral data as well as played a major role in reviewing and revising several drafts of the manuscript and approving the final manuscript as submitted.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Lauren J. Moskowitz
    • 1
  • Caitlin E. Walsh
    • 2
  • Emile Mulder
    • 3
  • Darlene Magito McLaughlin
    • 4
  • Greg Hajcak
    • 5
  • Edward G. Carr
    • 5
  • Jennifer R. Zarcone
    • 6
  1. 1.St. John’s UniversityQueensUSA
  2. 2.University of Colorado School of MedicineDenverUSA
  3. 3.The Shoreline CenterGrand HavenUSA
  4. 4.Positive Behavior Support ConsultingCenterportUSA
  5. 5.Stony Brook UniversityStony BrookUSA
  6. 6.Johns Hopkins School of MedicineBaltimoreUSA

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