York study shows cognitive behavioural therapy can improve emotion regulation in autistic children

New research from York University’s Faculty of Health shows cognitive behavioural therapy (CBT) can help children with autism manage not only anxiety, but other emotional challenges such as sadness and anger.

Jonathan Weiss

Jonathan Weiss

Led by Jonathan Weiss, associate professor in the Department of Psychology, Faculty of Health, and the Canadian Institutes of Health Research (CIHR) Chair in Autism Spectrum Disorders Treatment and Care Research, the study shows CBT can lead to significant improvements in children’s emotional regulation. It also shows – for the first time – that CBT can improve more than just anxiety.

This is the first trans-diagnostic CBT trial for children with autism, employing a randomized controlled trial.

Approximately 70 per cent of children with autism will struggle with some form of emotional challenge. About half of these children will struggle with anxiety and another 25 to 40 per cent will struggle with other emotional challenges such as anger or depression. In fact, there is a high co-occurrence among these conditions.

“We can use this same intervention to improve children’s skills more broadly regardless of what emotional challenge they have,” said Weiss. “We can make them more resilient to many emotional and mental health issues.”

Sixty-eight children from eight to 12 years of age and their parents, mostly mothers, participated in the study and were randomly assigned to two groups: one group receiving 10 sessions beginning right away and another group waiting to receive treatment later. Researchers tracked how their emotions and behaviour changed prior to and after treatment.

“We showed that children who received this treatment right away improved in their ability to manage their emotions, and in overall mental health problems, versus kids who were waiting for treatment,” said Weiss.

A clinician who was not involved in the direct provision of the treatment and did not know if children were in the treatment or the wait-list group rated 74 per cent of children receiving treatment as improved, compared to only 31 per cent of those in the wait-list group.

The treatment consisted of time-limited, spy-themed cognitive behavioural therapy involving a computer program, games and tools to help build the child’s emotional toolkit. The tools help children face situations that may have previously been challenging, head-on and in a more supportive way. During the intervention, parents also practise what they are learning with their children and serve as co-therapists in the therapy sessions.

“We believe that children grow and develop and improve within the context of healthy families and this intervention aids to help the family unit more broadly to be the agent of change,” said Weiss.

Researchers are now looking at how this intervention can be used for other neurodevelopmental conditions that often overlap with autism, such as ADHD.

This study was funded by the CIHR Chair in ASD Treatment and Care Research, in partnership with Health Canada, Kids Brain Health Network, Autism Speaks Canada, the Sinneave Family Foundation and the Canadian ASD Alliance, with additional funding from York University.

The study is published in The Journal of Child Psychology and Psychiatry.

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