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J Autism Dev Disord (2013) 43:5767 DOI 10.1007/s10803-012-1541-9
ORIGINAL PAPER
The Coping Cat Program for Children with Anxiety and Autism Spectrum Disorder: A Pilot Randomized Controlled Trial
Rebecca H. McNally Keehn Alan J. Lincoln
Milton Z. Brown Denise A. Chavira
Published online: 17 May 2012 Springer Science+Business Media, LLC 2012
Abstract The purpose of this pilot study was to evaluate whether a modied version of the Coping Cat program could be effective in reducing anxiety in children with autism spectrum disorder (ASD). Twenty-two children (ages 814; IQ C 70) with ASD and clinically signicant anxiety were randomly assigned to 16 sessions of the Coping Cat program (cognitive-behavioral therapy; CBT) or a 16-week waitlist. Children in the CBT condition evidenced signicantly larger reductions in anxiety than those in the waitlist. Treatment gains were largely maintained at two-month follow-up. Results provide preliminary evidence that a modied version of the Coping Cat program may be a feasible and effective program for reducing clinically signicant levels of anxiety in children with high-functioning ASD.
Keywords Cognitive-behavioral therapy Autism
spectrum disorder Anxiety disorders Randomized
controlled trial
Introduction
Since autism was originally described (Kanner 1943), anxiety has been accepted as an associated feature of the disorder. Previous studies have reported that 1184 % of individuals with autism spectrum disorder (ASD) experience clinically signicant levels of anxiety, with variables such as specic ASD subtype, level of intellectual ability, degree of social impairment, and method of assessment inuencing reported rates (White et al. 2009b). Thus, this population experiences higher levels of anxiety than typically developing (TD) children (APA 2000). Individuals with ASD may be at a greater risk for developing anxiety due to inhibited temperament, physiological hyperarousal (Bellini 2006), and information-processing biases (Happe and Frith 2006). In addition, it has been proposed that individuals with ASD are more vulnerable to stress and anxiety because they often lack an appropriate repertoire of skills to navigate social situations (Bellini 2006) and fail to develop adaptive coping mechanisms (Gillott and Standen 2007).
Anxiety in children with ASD is associated with pervasive consequences including increased maladaptive behavior (Kim et al. 2000), social skills decits (Bellini 2004), and negative life experiences (Farrugia and Hudson 2006). Further, without treatment, anxiety in children with ASD appears to run a chronic course...