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Functional Behavior-Based Cognitive-Behavioral Therapy for Obsessive Compulsive Behavior in Children with Autism Spectrum Disorder: A Randomized Controlled Trial

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Abstract

Children with autism spectrum disorder (ASD) experience obsessions and compulsions similar to those specified in DSM-5 for obsessive compulsive disorder yet little controlled research exists on treating these behaviours. Thirty-seven children (7–13 years old) were randomly assigned to a 9-week functional behavior-based cognitive behavior therapy (Fb-CBT) or Treatment As Usual. Independent assessors administered measures pre- and post-treatment and at 6-months. Two primary outcome measures indicated statistically significant differences between groups, with large corrected effect sizes (Hedge’s g = 1.00 and 1.15, respectively). This is the first known RCT to exclusively treat obsessive compulsive behaviors (OCBs) in children and youth with high functioning (IQ ≥ 70) ASD, and suggests that Fb-CBT treatment shows promise in decreasing these behaviors and improving quality of life. Trial Registration This trial was registered with ClinicalTrials.gov (ID: NCT03123146).

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Acknowledgments

We sincerely thank the participants, their families, and agencies for their support of this project. This research was funded by the Ontario Mental Health Foundation and the Ministry of Health and Long-Term Care. Funding sources did not have a specific role in the study itself, or in decision to submit this paper for publication.

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Author notes

  1. Heather Jaksic

    Present address: Department of Psychology, University of Manitoba, Winnipeg, MB, Canada

  2. Nicole Neil

    Present address: Faculty of Education, University of Western Ontario, London, ON, Canada

Authors and Affiliations

  1. Department of Child and Youth Studies, Brock University, St. Catharines, ON, Canada

    Jan C. Frijters

  2. Department of Applied Disability Studies, Brock University, St. Catharines, ON, Canada

    Heather Jaksic & Nicole Neil

  3. Private Practice, Niagara Falls, ON, Canada

    Grazyna Jackiewicz

  4. Departments of Child and Youth Studies and Applied Disability Studies, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada

    Tricia Vause & Maurice Feldman

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  1. Tricia Vause
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Contributions

TV conceived of the project, oversaw clinical and methodological aspects, data analysis, and was the primary writer of the paper. HJ contributed to clinical aspects of the project, data collection and data analysis. NN contributed to clinical aspects of the project, data collection and analysis, and writing of the paper. JCF performed data analysis, contributed to methodological aspects of the paper and the writing of the results section. GJ contributed to participant recruitment, conceptualization of the clinical population, and expertise concerning participant characteristics and medication. MF contributed to research design, methodological aspects of the paper, and critical review of the paper.

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Correspondence to Tricia Vause.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Vause, T., Jaksic, H., Neil, N. et al. Functional Behavior-Based Cognitive-Behavioral Therapy for Obsessive Compulsive Behavior in Children with Autism Spectrum Disorder: A Randomized Controlled Trial. J Autism Dev Disord 50, 2375–2388 (2020). https://doi.org/10.1007/s10803-018-3772-x

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