A Review of the Role of Anxiety in Diagnosis of Children and Adolescents with Autism Spectrum Disorder: A Paradigm Shift in Conceptualization and Diagnosis

Early evidence of co-occurring anxiety symptoms in children and adolescents with autism spectrum disorder (ASD) dates back to the first descriptions of ASD by Leo Kanner (1943) and Hans Asperger (Frith & Mira, 1992). While current research has identified anxiety disorders as one of the most prevalent co-occurring disorders in children and adolescents with ASD, little is known about the nature of the relationship between these disorders. In an effort to explain these high prevalence rates, recent research has started to investigate the relationship between these two disorders. To join these efforts, this clinical research project explored the role of anxiety in diagnosis of children and adolescents with ASD. To guide the exploration of this role, the following research questions were answered: How prevalent or significant is anxiety in children and adolescents with ASD?; How do symptoms of anxiety manifest in children and adolescents with ASD?; and How is anxiety conceptualized, assessed, and treated in ASD? Results from this literature review indicate that there are current limitations in this area of research that need to be addressed to form an accurate conceptualization of anxiety symptoms in this population. Steps to resolve these limitations are discussed and areas of further research are explored. Recommendations for accurately assessing and treating co-occurring symptoms of anxiety in youth with ASD are provided and a suggested conceptualization model based off current research is proposed