Autism Spectrum Disorder (ASD) – Dr Martin Fracker

One Session Treatments for Phobias in Young People with Autism Spectrum Disorder (ASD)

Children and young people with Autism Spectrum Disorder (ASD) commonly experience various fears and phobias. Davis & Brennan reviewed evidence for the effectiveness of treatments of these anxiety disorders, including the adaptation of One Session Treatments for ASD youth.

Two-Step Family Cognitive Behavior Therapy May Benefit Some Autism Spectrum Disorder (ASD) Children with Anxiety

Cognitive behavior therapies are generally effective for treating anxiety, but modifications may be needed when anxiety is accompanied by Autism Spectrum Disorder (ASD). Storch and associates evaluated the effectiveness of a two-step approach to family-based cognitive behavior therapy for anxiety with ASD children up to 14 years of age. The first step was parent-led with therapist assistance. The second step was therapist-led for children who had not shown improvement in step 1 (non-responders). These non-responders generally had higher levels of pre-treatment anxiety than those who had improved.

All children were evaluated again 12 weeks following step 1. At this point, the authors reported no difference between those that had improved in step 1 and those that had continued into step 2. A major weakness of this study however was a high attrition rate: of the 76 children who started in step 1, only 45 completed their entire treatment program. The authors noted that this attrition rate is higher than that observed with more standard forms of Cognitive Behavior Therapy, and noted that some of the attrition may have been due to the COVID-19 pandemic.

Patients with Autism Spectrum Disorder (ASD) and Anxiety Can Benefit From Cognitive Behavior Therapy

Standard Cognitive Behavior Therapy (CBT) focuses on teaching patients to recognize self-defeating ways of thinking and replace them with more constructive thoughts. Hollocks and colleagues knew that CBT treatments for Autism Spectrum Disorder (ASD) patients with anxiety were most effective when tailored to the specific needs of ASD patients. They hypothesized that patient decision-making ability and sensitivity to reward contingencies might underlie the superiority of specially tailored CBT treatments. Accordingly, they assessed the decision-making ability and reward sensitivity of 148 children with ASD who were randomly assigned to standard CBT or tailored CBT treatments. Their results suggested that ASD patient decision-making ability and reward sensitivity accounted for the superiority of tailored CBT.

Children with Autism Spectrum Disorder (ASD) Engage in More Verbal Aggression with Greater Intensity than Others

Quetsch and colleagues compared 450 autistic children to 432 neurotypical controls based on caregiver reports of aggressive behavior. Their analysis of results indicated that, across development, autistic children engaged in more verbal aggressive behavior with greater intensity than neurotypical children, although the degree of difference diminished as the children grew older.

Aggressive Behavior by Youth with Autism Spectrum Disorder (ASD) Is Influenced by the Environment

To what extent is the aggressive behavior of youth with Autism Spectrum Disorder (ASD) moderated (or aggravated) by attributes of their environment? Brown and colleagues tried to answer this question based on caregiver reports for 511 ASD youth. Overall, their data indicated that demographic and environmental factors accounted for up to 40% of the variance in children’s aggressive behavior. The main factors influencing reported aggressive behavior were:

Family income
The child’s age and social communication skills
Parental distress arising from having to deal with a difficult child

Besides these factors, the researchers also found a slight effect of family warmth as measured by the Family Environment Scale and Caregiver-Child Dyad Satisfaction, but this factor barely accounted for an additional one percent of the observed total variance.

High Functioning Individuals with Autistic Spectrum Disorder (ASD) Are Less Able to Process Their Emotions

Hill and colleagues compared 27 high functioning adults with Autism Spectrum Disorder (ASD) to 35 neurotypical controls and 49 biological relatives. They found that ASD individuals were less able to process their emotions and, perhaps for that reason, more depressed than both the controls and the relatives. Their findings join others in showing that, even for high functioning individuals, ASD is associated with poorer emotion regulation and higher negative affect.

Higher Functioning in Autism Spectrum Disorder (ASD) is Associated with Improved Emotion Regulation

While individuals with Autism Spectrum Disorder (ASD) generally may be less able to regulate their emotions and handle frustration than neurotypical individuals, we might reasonably expect higher functioning individuals with ASD to be better able to control their emotions than those who are lower functioning. In this article, Konstantareas and Stewart report data supporting this expectation, but they also found that higher functioning individuals experienced higher negative affectivity including more negative emotions such as anger or sadness and potentially lower self-esteem.

How Are Autism Spectrum Disorder (ASD) and Epilepsy Related?

Many researchers have noted an association between Autism Spectrum Disorder (ASD) and Epilepsy, including Benign Childhood Epilepsy, such that individuals with ASD are several times more likely to experience epileptic seizures. This association has caused researchers to ask how exactly the two disorders might be related. Does one cause the other? In this article, Tuchman and colleagues argue that while epilepsy does not cause autism, autism and epilepsy may share common physiological mechanisms that explain the association.

Inflexible Behavior Control in Autism Spectrum Disorder (ASD)

Individuals with Autism Spectrum Disorder (ASD) can engage in highly focused repetitive tasks for hours. Alvares and colleagues wondered if this persistent behavioral focus might reflect a diminished degree of flexibility in goal directed behavior such that once an individual with ASD becomes engaged with a task, they may be unable to redirect their behavior toward a different goal. To find out, they compared the behavior of individuals with ASD that of individuals in two other groups: a group of individuals with Social Anxiety Disorder (SAD), and a neurotypical control group. The participants were required to perform a high-value task up to the point where the value of the task diminished and the value of a different task increased.

The optimal response when relative task values change is to switch from the task with diminished value to the task that is now of highest value. But the researchers reported that both ASD and SAD participants persisted in the first task while only neurotypical individuals switched to the new high-value task. The authors suggest that ASD individuals may be unable to reorient their goal-directed behavior even though they know they should.