Autism Spectrum Disorder
Signs and Symptoms of Autism Spectrum Disorder
Autism is a neurodevelopmental disorder which first appears during infancy or childhood and which follows a steady course. It is characterized by a triad of impairments:
- impairments in social interaction including deficits in social-emotional reciprocity (e.g., abnormal social approach, failure of normal back-and-forth conversation, reduced sharing or interests or emotions, failure to initiate or respond to social interactions);
- impairments in communication including deficits in nonverbal communicative behaviors used in social interaction (e.g., poorly integrated verbal and nonverbal communication, abnormalities in eye contact and body language, deficits in understanding of gesture);
- restricted interests and repetitive behaviors including stereotyped or repetitive motor movements, inflexible adherence to routines, fixated interests with a high intensity of focus.
Individuals with autism might experience difficulties in developing, maintaining, and understanding relationships with other people. These might range from difficulties adjusting behavior to suit various social contexts and difficulty making friends, to a complete absence of interest in other people.
People on the autism spectrum are more likely than the general population to experience mental health problems. Conditions including anxiety disorders, obsessive-compulsive disorders, and depression are all experienced with a higher frequency in the autistic population.
Evidence-Based Psychological Approaches for Working with People on the Autism Spectrum
There is evidence that cognitive behavioral therapy is an effective treatment for mental health conditions in children and adults with autism spectrum disorders (e.g., Lang, Regester, Lauderdale, Ashbaugh, & Haring, 2010; Spain, Sin, Chalder, Murphy, & Happe, 2015). Expert consensus converges on the idea that CBT benefits from adaptations to enhance effectiveness in this population. Ozsivadjian (2013) suggests adaptations including:
- spending a longer initial period focusing on identifying and measuring emotions and discussing feelings;
- using visual aids throughout therapy (e.g., a thermometer for measurement of feelings, timetables to explain session outlines);
- incorporating an individual’s special interests into therapy (e.g., ‘What would Spiderman think in this situation?’);
- using more concrete and simplified techniques for cognitive aspects of therapy (e.g., using multiple choice quizzes instead of open questions);
- making greater use of parents or carers to aid generalization of skills.
Lang, R., Regester, A., Lauderdale, S., Ashbaugh, K., & Haring, A. (2010). Treatment of anxiety in autism spectrum disorders using cognitive behaviourtherapy: A systematic review. Developmental Neurorehabilitation, 13(1), 53–63.
Ozsivadjian, A. (2013). Cognitive behaviourtherapy for people with autism.National Autistic Society. Retrieved from: https://network.autism.org.uk/sites/default/files/ckfinder/files/CBT%20for%20people%20with%20autism.pdf
Spain, D., Sin, J., Chalder, T., Murphy, D., & Happe, F. (2015). Cognitive behaviourtherapy for adults with autism spectrum disorders and psychiatric co-morbidity: A review. Research in Autism Spectrum Disorders, 9, 151–162.
- Individual and group CBT for anxiety disorders amongst people with autism spectrum disorder / conditions download archived copy
- A manual of cognitive behavior therapy for people with learning disabilities and common mental disorders download archived copy
- Adapting CBT for children with autism spectrum disorders
- Cognitive behaviour therapy for people with autism – guide by Dr Ann Ozsivadjian download archived copy
Exercises, Worksheets & Workbooks
- CBT for young people with autism spectrum disorder | Ozsivadjian
- CBT in autism spectrum disorders: the role of the speech therapy | McLeod download archived copy
- The development of psychological interventions for adults with high functioning autism spectrum disorder | Hammond
- Sukhodolsky, D. G., Bloch, M. H., Panza, K. E., & Reichow, B. (2013). Cognitive-behavioral therapy for anxiety in children with high-functioning autism: a meta-analysis. Pediatrics, 132(5), e1341-e1350 download archived copy
- Ung, D., Selles, R., Small, B. J., & Storch, E. A. (2015). A systematic review and meta-analysis of cognitive-behavioral therapy for anxiety in youth with high-functioning autism spectrum disorders. Child Psychiatry & Human Development, 46(4), 533-547. download archived copy
- Weston, L., Hodgekins, J., & Langdon, P. E. (2016). Effectiveness of cognitive behavioural therapy with people who have autistic spectrum disorders: A systematic review and meta-analysis. Clinical psychology review, 49, 41-54. download archived copy