Cognitive behavioural therapy intervention for children and adolescents with Autism Spectrum Disorders and anxiety : A systematic literature review from 2009 to 2019.

Abstract: Young people with Autism Spectrum Disorders (ASD) are more prone to experience anxiety disorders at a greater level compared to their neurotypical developing counterparts, causing lifelong impairments in family, social, academic and adaptive functioning. Early interventions in childhood have been designed to minimize these stressful events and to optimize children’s developmental outcomes. Cognitive behavioural therapy (CBT) is considered a first-line intervention of anxiety. The review aimed to synthesize empirical literature on modified CBT interventions from 2009 until 2019 focusing on reducing anxiety in children and adolescents with ASD. A systematic review of the literature was conducted in five databases. As a result, 10 articles were included to review. Modifications found were: a) audiovisual support and written materials, b) parental partic-ipation, c) sessions length, d) language, e) sensory and motor accommodations, f) emphasis into the behav-ioural component, g) enhancement of individual’s attention and participation, h) facilitating materials to access the content of CBT, and i) participants’ specific interests and worries. The interventions showed significant reductions in youth anxiety levels. Future research should focus on addressing which specific modifications contribute to anxiety reduction since to date, there is no evidence comparing standard CBT to modified CBT interventions. Moreover, there is a lack of anxiety-assessment instruments specially designed for individuals with ASD. In addition, considering the longstanding prevalence of male autistic rates, ASD diagnostic instru-ments should be revised to reduce bias that can mislead to an inattentive ascertainment of females with ASD.