Ask the Expert – Cognitive Behavioral Therapy 101

It is not uncommon that a diagnosis of autism spectrum disorder (ASD) is accompanied by the presence of another mental health disorder. Most often, a comorbid diagnosis of an anxiety disorder or attention-deficit/hyperactivity disorder (ADHD) is present. Signs/symptoms of anxiety that may be displayed include: worried thoughts about performance, social interactions, and/or situation-specific concerns or fears. Hallmark features of ADHD include: difficulty sustaining attention, staying on-task and seated, and waiting one’s turn.

Research-supported interventions for the treatment of anxiety disorders include behavioral therapy and cognitive-behavioral therapy (CBT). Behavioral therapy may be chosen over CBT when the child is young, autism severity is greater, or the nature of the anxiety is fear-based or situationally-based in which exposure to the feared situation (for example: weather, toilets, or public speaking) is the most effective intervention. Behavioral intervention also may be favored over CBT due to challenges with perspective-taking that may interfere with being able to identify errors in thinking and challenging distorted thoughts.
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