The Impact of Stress and Anxiety on Individuals with Autism and Developmental Disabilities

  • June Groden
  • Joseph Cautela
  • Stacey Prince
  • Jennifer Berryman
Part of the Current Issues in Autism book series (CIAM)


Stress and anxiety have historically played a role in many theories of personality and behavior. Both psychoanalytic theorists and behaviorists have postulated that anxiety is the central component of neurotic disorders. Operant investigators, however, have been reluctant to use the concept of anxiety either as an explanatory concept or in a descriptive manner.


Developmental Disability Autistic Child Maladaptive Behavior Apply Behavior Analysis Relaxation Response 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Altmeyer, B. K., Williams, D. E., & Sams, V. (1985). Treatment of severe self-injurious and aggressive biting. Journal of Behavior Therapy and Experimental Psychiatry, 16(2), 169–172.PubMedCrossRefGoogle Scholar
  2. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., pp. 87-90). Washington, DC: Author.Google Scholar
  3. Ascher, L. M. (1980). Paradoxical intention. In A. Goldstein & E. B. Foa (Eds.), Handbook of behavioral interventions (pp. 266–321). New York: Wiley.Google Scholar
  4. Azrin, N. H., Hutchinson, R. R., & Hake, D. F. (1963). Pain-induced fighting in the squirrel monkey. Journal of experimental analysis of behavior, 6, 620.CrossRefGoogle Scholar
  5. Ball, T. S., Sibbach, L., Jones, R., Steele, B., & Frazier, L. (1975). An accelerometer-activated device to control assaultive and self-destructive behaviors in retardates. Journal of Behavior Therapy and Experimental Psychiatry, 6, 223–228.CrossRefGoogle Scholar
  6. Baumeister, A., & Forehand, R. (1973). Stereotyped acts. In N. R. Ellis (Ed.), International review of research in mental retardation (Vol. 6, pp. 55–96). New York: Academic.Google Scholar
  7. Bemporad, J. R. (1976). Adult recollections of a formerly autistic child. Journal of Autism and Developmental Disorders, 9, 179–197.CrossRefGoogle Scholar
  8. Benson, H. (1975). The relaxation response. New York: Morrow.Google Scholar
  9. Benson, H. (1984). Beyond the relaxation response. New York: Times Books.Google Scholar
  10. Benson, H., Klemchuk, H. P., & Graham, J. R. (1974). The usefulness of the relaxation response in the therapy of headache. Headache, 14, 49–52.PubMedCrossRefGoogle Scholar
  11. Benson, H., & Proctor, W. (1987). Your maximum mind. New York: Random House.Google Scholar
  12. Bernstein, D. S., & Borkovec, T. D. (1973). Progressive relaxation training. Champaign, IL: Research Press.Google Scholar
  13. Birnbrauer, J. S. (1968). Generalization of punishment effects—A case study. Journal of Applied Behavior Analysis, 1, 201–211.PubMedCrossRefGoogle Scholar
  14. Bruno-Golden, B. (1987). Theoretical considerations and applications of relaxation training for children. Journal of the Royal Society of Health, 107, 51–54.PubMedCrossRefGoogle Scholar
  15. Calhoun, K. S., & Matherne, P. (1975). The effects of varying schedules of time-out on aggressive behavior of a retarded girl. Journal of Behavior Therapy and Experimental Psychiatry, 6, 139–143.CrossRefGoogle Scholar
  16. Carr, E. G., & Durand, V. M. (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18, 111–126.PubMedCrossRefGoogle Scholar
  17. Carr, E. G., Newsom, C. D., & Binkoff, J. A. (1976). Stimulus control of self-destructive behavior in a psychotic child. Journal of Abnormal Child Psychology, 4, 139–153.PubMedCrossRefGoogle Scholar
  18. Cautela, J. R. (1970). Covert reinforcement. Behavior Therapy, 1, 33–50.CrossRefGoogle Scholar
  19. Cautela, J. R. (1976). The present status of covert modeling. Journal of Behavior Therapy and Experimental Psychiatry, 7, 323–326.CrossRefGoogle Scholar
  20. Cautela, J. R. (1981). Behavior analysis forms for clinical intervention (Vol. 2). Champaign, IL: Research Press.Google Scholar
  21. Cautela, J. R. (1984). General level of reinforcement. Journal of Behavior Therapy and Experimental Psychiatry, 15, 109–114.PubMedCrossRefGoogle Scholar
  22. Cautela, J. R., & Groden, J. (1978). Relaxation: A comprehensive manual for adults, children, and children with special needs. Champaign, IL: Research Press.Google Scholar
  23. Cautela, J. R., & Kearney, A. J. (1986). The covert conditioning handbook. New York: Springer-Verlag.Google Scholar
  24. Cautela, J. R., & Kearney, A. J., (Eds.). (1993) The Covert Conditioning Casebook. Pacific Grove, CA: Brooks/Cole.Google Scholar
  25. Clark, H. B., Rowbury, T., Baer, A. M., & Baer, D. M. (1973). Time out as punishing stimulus in continuous and intermittent schedules. Journal of Applied Behavior Analysis, 6, 443–455.PubMedCrossRefGoogle Scholar
  26. Clark, P., & Rutter, M. (1979). Task difficulty and task performance in autistic children. Journal of Child Psychology and Psychiatry, 20, 271–285.PubMedCrossRefGoogle Scholar
  27. Deffenbacher, J. L., & Snyder, A. L. (1976). Relaxation as self-control in the treatment of test and other anxieties. Psychological Reports, 39(2), 379–385.PubMedCrossRefGoogle Scholar
  28. DeLissovoy, V. (1964). Head banging in early childhood: Review of empirical studies. Pediatrics Digest, 6, 49–55.Google Scholar
  29. Deykin, E. Y., & MacMahon, B. (1979). The incidence of seizures among children with autistic symptoms. American Journal of Psychiatry, 136, 1310–1312.PubMedGoogle Scholar
  30. Doherty, L., & Swisher, L. (1978). Children with autistic behaviors. In F. D. Minifie & L. L. Lloyd (Eds.), Communicative and cognitive abilities: Early behavioral assessment (pp. 549–563). Baltimore: University Park.Google Scholar
  31. Dohrenwend, B., & Dohrenwend, B. (1974). Stressful life events: Their nature and effects. New York: Wiley.Google Scholar
  32. Donnellan, A. M., Mirenda, P. L., Mesaros, R. A., & Fassbender, L. L. (1984). Analyzing the communicative functions of aberrant behavior. The Journal of the Association for Persons with Severe Handicaps, 9(3), 201–212.Google Scholar
  33. Durand, V. M., & Crimmins, D. B. (1988). Identifying the variables maintaining self-injurious behavior. Journal of Autism and Developmental Disorders, 18(1), 99–117.CrossRefGoogle Scholar
  34. Finch, A. J., Jr., Montgomery, L. E., Kendall, P. C., & Morris, T. (1975). Effects of types of failure on anxiety. Journal of Abnormal Psychology, 84(5), 583–585.PubMedCrossRefGoogle Scholar
  35. Fish, B., Shapiro, T., & Campbell, M. (1966). Long-term prognosis and the response of schizophrenic children to drug therapy: A controlled study of trifluroperazine. American Journal of Psychiatry, 123, 32–39.PubMedGoogle Scholar
  36. Foxx, R. M. & Bechtel, D. R. (1982). Overcorrection. In M. Hersen & R. M. Eisler (Eds.), Progress in Behavior Modification (Vol. 13, pp. 227–288). New York: Academic.Google Scholar
  37. Foxx, R. M., McMorrow, M. J., Bittle, R. G., & Bechtel, D. R. (1986). The successful treatment of a dually-diagnosed deaf man’s aggression with a program that included contingent electric shock. Behavior Therapy, 17, 170–186.CrossRefGoogle Scholar
  38. Gatchel, R. J., Hatch, J. P., Watson, P. J., Smith, D., & Gaas, E. (1977). Comparative effectiveness of voluntary heart-rate control and muscular relaxation as active coping skills for reducing speech anxiety. Journal of Consulting & Clinical Psychology, 45(6), 1093–1100.CrossRefGoogle Scholar
  39. Grandin, T., & Scariano, M. M. (1986). Emergence: Labeled autistic. Novato, CA: Arena.Google Scholar
  40. Groden, G. (1989). A guide for conducting a comprehensive behavioral analysis of a target behavior. Journal of Behavior Therapy and Experimental Psychiatry, 20(2), 163–169.PubMedCrossRefGoogle Scholar
  41. Groden, J. (1984). Self-injurious behavior. Paper presented at the New England Society for Behavior Analysis and Therapy, Boston, MA.Google Scholar
  42. Groden, J., Berryman, J., & LeVasseur, P. (1987). Relaxation as a treatment for stress and anxiety for children with special needs. Paper presented at the Third Annual Conference on Behavior Disorders, Warwick, RI.Google Scholar
  43. Groden, J., & Cautela, J. R. (1984). Use of imagery procedures with students labeled “trainable retarded.” Psychological Reports, 54, 595–605.PubMedCrossRefGoogle Scholar
  44. Groden, J., & Cautela, J. R. (1987). Procedures to increase social interaction among adolescents with autism: A multiple baseline analysis. Unpublished manuscript, The Groden Center, Inc., Providence, RI.Google Scholar
  45. Groden, J., Cautela, J. R., & Groden, G. (1989). Breaking the Barriers: Relaxation procedures for people with special needs (Video). Champaign, IL: Research Press.Google Scholar
  46. Groden, J., Cautela, J. R., & Groden, G. (1991). Breaking the Barriers II: Imagery Procedures for People with Special Needs (Video). Champaign, IL: Research Press.Google Scholar
  47. Groden, J., Cautela, J. R., LeVasseur, P., Groden, G., & Bausman, M. (1993). Video Guide to Breaking the Barriers II. Champaign, IL: Research Press.Google Scholar
  48. Groden, J., & Prince, S. (1988). The acquisition of relaxation skills by children and youth with developmental disabilities. Paper presented at the Association for the Advancement of Behavior Therapy, New York, NY.Google Scholar
  49. Gross, A. M., Berler, E. S., & Drabman, R. S. (1982). Reduction of aggressive behavior in a retarded boy using a water squirt. Journal of Behavior Therapy and Experimental Psychiatry, 13, 95–98.PubMedCrossRefGoogle Scholar
  50. Guess, D., Helmstetter, E., Turnbull, R. E., & Knowlton, S. (1987). Use of aversive procedures with individuals who are disabled: A historical review and critical analysis. Seattle, WA: Association for Persons with Severe Handicaps.Google Scholar
  51. Guralnick, M. J. (1973). Behavior therapy with an acrophobic mentally retarded young adult. Journal of Behavioral Therapy and Experimental Psychiatry, 4, 263–265.CrossRefGoogle Scholar
  52. Haynes, S., Woodward, S., Moran, R., & Alexander, D. (1974). Relaxation treatment of insomnia. Behavior Therapy, 5, 555–558.CrossRefGoogle Scholar
  53. Hobson, R. P. (1986). The autistic child’s appraisal of expressions and emotion. Journal of Child Psychology and Psychiatry, 27(3), 321–342.PubMedCrossRefGoogle Scholar
  54. Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1982). Toward a functional analysis of self-injury. Analysis and Intervention in Developmental Disabilities, 2, 3–20.CrossRefGoogle Scholar
  55. Jacobson, E. (1973). Teaching and learning, new methods for old arts. Chicago: National Foundation for Progressive Relaxation.Google Scholar
  56. Kanner, L. (1943). Autistic disturbance of affective contact. Nervous Child, 2, 217–250.Google Scholar
  57. Kazdin, A. E. (1975). Behavior modification in applied settings (pp. 146–151). Homewood, IL: Dorsey.Google Scholar
  58. LaVigna, G. W., & Donnellan, A. M. (1986). Alternatives to punishment: Solving behavior problems with non-aversive strategies. New York: Irvington.Google Scholar
  59. Levine, H. G., & Langness, L. L. (1983). Context, ability, and performance: Comparison of competitive athletics among mildly retarded and nonretarded adults. American Journal of Mental Deficiency, 87, 528–538.PubMedGoogle Scholar
  60. Lovaas, O. L., Schreibman, L., Koegel, R. L., & Reim, R. (1971). Selective responding by autistic children to multiple sensory input. Journal of Abnormal Psychology, 77, 211–222.PubMedCrossRefGoogle Scholar
  61. Mansdorf, I. J. (1976). Eliminating fear in a mentally retarded adult by behavioral hierarchies and operant techniques. Journal of Behavioral Therapy and Experimental Psychiatry, 7, 189–190.CrossRefGoogle Scholar
  62. Matson, J. L. (1981a). Assessment and treatment of clinical fears in mentally retarded children. Journal of Applied Behavioral Analysis, 14, 287–294.CrossRefGoogle Scholar
  63. Matson, J. L. (1981b). A controlled outcome study of phobias in mentally retarded adults. Behavior Research and Therapy, 19, 101–107.CrossRefGoogle Scholar
  64. Mavissakalian, M., & Barlow, D. H. (1981). Phobia: Psychological and pharmacological treatment. New York: Guilford.Google Scholar
  65. McGee, G. G., Krantz, P. J., & McClannahan, L. E. (1984). Conversational skills for autistic adolescents: Teaching assertiveness in naturalistic game settings. Journal of Autism and Developmental Disorders, 14(3), 319–330.PubMedCrossRefGoogle Scholar
  66. McQuade, W., & Aikman, A. (1974). Stress: What it is, what it can do to your health, how to fight back. New York: Dutton.Google Scholar
  67. Mesibov, G. B. (1984). Social skills training with verbal autistic adolescents and adults: A program model. Journal of Autism and Developmental Disorders, 14(4), 395–404.CrossRefGoogle Scholar
  68. Oliver, S. D., West, R. C., & Sloane, H. N., Jr. (1974). Some effects on human behavior on aversive events. Behavior Therapy, 5, 481–493.CrossRefGoogle Scholar
  69. O’Neill, R. E., Horner, R. H., Albin, R. W., Storey, K., & Sprague, J. R. (1990). Functional analysis of problem behavior: A practical assessment guide. Sycamore, IL: Sycamore Publishing.Google Scholar
  70. Ornitz, E. M., & Ritvo, E. R. (1985). Perceptual inconstancy in early infantile autism. In A. M. Donnellan (Ed.), Classic readings in autism (pp. 142–178). New York: Teachers College Press.Google Scholar
  71. Peck, C. I. (1976). Desensitization for the treatment of fear in the high level adult retardate. Behavior in Research and Therapy, 15, 137–148.CrossRefGoogle Scholar
  72. Quinn, K., & Beisler, J. (1986). A curriculum for educating autistic students: A working draft. Unpublished manuscript, Iowa Department of Public Instruction.Google Scholar
  73. Romanczyk, R. G., Colletti, G., & Plotkin, R. (1980). Punishment of self-injurious behavior: Issues of behavior analysis, generalization, and the right to treatment. Child Behavior Therapy, 2(1), 37–54.CrossRefGoogle Scholar
  74. Russell, R. K., & Sipich, J. F. (1973). Cue-controlled relaxation in the treatment of test anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 4, 47–49.CrossRefGoogle Scholar
  75. Rutter, M. (1966). Behavioral and cognitive characteristics of a series of psychotic children. In. J. K. Wing (Ed.), Early childhood autism: Clinical, educational and social aspects (pp. 51–81). London: Pergamon.Google Scholar
  76. Rutter, M. (1977). Infantile autism and other child psychoses. In M. Rutter & L. Hersov (Ed.), Child psychiatry: Modern approaches (pp. 717–747). Oxford: Blackwell.Google Scholar
  77. Rutter, M. (1978). Diagnosis and definition. In M. Rutter & E. Schopler (Eds.), Autism: A reappraisal of concepts and treatment (pp. 1–25). New York: Plenum.Google Scholar
  78. Rutter, M. (1985). The treatment of autistic children. Journal of Psychology and Psychiatry, 26(2), 193–214.CrossRefGoogle Scholar
  79. Schroeder, S. R., Schroeder, C. S., Smith, B., & Dalldorf, J. (1978). Prevalence of self-injurious behaviors in a large state facility for the retarded: A three year follow-up study. Journal of Autism and Childhood Schizophrenia, 8, 261–269.PubMedCrossRefGoogle Scholar
  80. Selye, H. (1974). Stress without distress. Philadelphia: Lippincott.Google Scholar
  81. Shoemaker, J., & Tasto, D. (1975). Effects of muscle relaxation on blood pressure of essential hypertensives. Behavior Research and Therapy, 13, 29–43.CrossRefGoogle Scholar
  82. Sulzer-Azaroff, B., & Mayer, G. R. (1991). Behavior analysis for lasting change. Fort Worth, TX: Holt, Rinehart & Winston.Google Scholar
  83. Surwit, R., Williams, R., Jr., & Shapiro, Do. (1982). Behavioral approaches to cardiovascular disease. New York: Academic.Google Scholar
  84. Touchette, P. E., MacDonald, R. F., & Langer, S. N. (1985). A scatter plot for identifying stimulus control of problem behavior. Journal of Applied Behavior Analysis, 18, 343–351.PubMedCrossRefGoogle Scholar
  85. Volkmar, F. R., & Cohen, D. J. (1985). The experience of infantile autism: A first person account by Tony W. Journal of Autism and Developmental Disabilities, 15, 47–54.CrossRefGoogle Scholar
  86. Wolff, S., & Chess, S. (1965). An analysis of the language of fourteen schizophrenic children. Journal of Psychology and Psychiatry, 6, 29–41.CrossRefGoogle Scholar
  87. Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Stanford: Stanford University Press.Google Scholar
  88. Wolpe, J. (1990). Practice of behavior therapy (4th ed.). New York: Pergamon.Google Scholar
  89. Young. J. G., Kavanaugh, M. E., Anderson, G. M., Shaywitz, B. A., & Cohen, D. J. (1982). Clinical neurochemistry of autism and associated disorders. Journal of Autism and Developmental Disorders, 12, 147–165.PubMedCrossRefGoogle Scholar
  90. Zetlin, A. G., & Turner, J. L. (1985). Transition from adolescence to adulthood: Perspectives of mentally retarded individuals and their families. American Journal of Mental Deficiency, 89, 570–579.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • June Groden
    • 1
  • Joseph Cautela
    • 2
  • Stacey Prince
    • 3
  • Jennifer Berryman
    • 4
  1. 1.The Groden Center, Inc.ProvidenceUSA
  2. 2.Behavior Therapy InstituteSudburyUSA
  3. 3.Center for Clinical ResearchUniversity of WashingtonSeattleUSA
  4. 4.State University of New YorkBinghamtonUSA

Personalised recommendations