A family-centered positive behavior support approach for a child with autism and an anxiety disorder

A large proportion of children diagnosed with autism spectrum disorders (ASD) also experience anxiety-related problem behavior. This study evaluated an approach to behavioral family intervention that synthesized evidence-based practices in Positive Behavior Support (PBS) and the treatment of anxiety disorders in children. The study empirically investigated the effectiveness and acceptability of the integrated approach for ameliorating the anxiety-related problem behavior of a child with autism and an anxiety disorder in a community-based swimming routine. A 4-year-old child with the dual diagnosis of autism and an anxiety disorder, and her mother, who also had an anxiety disorder, participated in the study. The study employed an experimental, single-subject, changing criterion design and a case study time-series design, using a multiple-probe strategy. Results were constrained by the parent’s conditional withdrawal from the study during the intervention phase. A functional relationship was not documented but the approach was correlated with improvement in child participation in the swimming routine along the anxiety hierarchy. The intervention also was associated with a decrease in percentage of intervals of problem behavior but no improvements were observed in latency in minutes to termination or successful completion of the routine or in steps completed in the routine. Parent treatment fidelity data indicated that the parent implemented the PBS support plan with a high degree of accuracy. The parent also rated the plan as being socially valid and contextually appropriate. Results are discussed with reference to previous research, contributions to the literature, future directions, and implications for practitioners and researchers who are involved in interventions for children with ASD and anxiety-related problem behavior.Education, Faculty ofEducational and Counselling Psychology, and Special Education (ECPS), Department ofGraduat