Treatment Maintenance of Cognitive-Behavioral Therapy for Anxiety in Youth with Autism Spectrum Disorders

Anxiety disorders commonly co-occur in children and adolescents with an autism spectrum disorder (ASD). Recently, treatment of anxiety using cognitive behavioral therapy (CBT) has been modified and studied in youth with ASD, with results consistently demonstrating positive treatment outcomes. In typically developing populations, CBT gains are well maintained as long as 14-years post-treatment; however, maintenance of CBT has not yet been studied in anxious youth with ASD. Using a sample of 32 youth who previously completed one of three CBT for anxiety in ASD treatment studies, the present study re-assessed parent report of anxiety symptoms in youth, 12-26 months (M = 17.16 Months; SD = 4.32) following treatment completion. Retrospective data from the original studies\u27 screening/baseline and post-treatment time points were used in combination with newly obtained follow-up data to determine treatment maintenance. Compared to baseline, follow-up scores on all measures of anxiety were associated with large effects for treatment. Compared to post-treatment, no significant differences in scores were observed; however, scores on the Pediatric Anxiety Rating Scale suggested a small effect for return in symptoms. While the percentage of individuals with remission of their primary anxiety diagnosis was identical at post-treatment and follow-up, significantly fewer individuals were rated as responders at follow-up as compared to post-treatment. Similar to CBT for anxiety in neurotypical youth, CBT for anxiety in youth with ASD appears to be relatively durable over a one to two year interval. Despite this, a significant portion of participants demonstrate some level of symptom regression. Future study should investigate factors associated with poor treatment maintenance, as well as modifications or additions to treatment protocols (e.g., booster sessions) that may help maintain treatment gains