News and Knowledge

In December 2016, OAR’s Board of Directors authorized funding for six new applied autism research studies in 2017. These new grants, totaling $178,866, bring OAR’s total research funding to over $3.6 million since 2002. This is the second of six previews to be featured in “The OARacle” this year.

Approximately 40 percent of youth with autism spectrum disorder (ASD) have an anxiety disorder. Anxiety may contribute to problem behavior, social isolation, and difficulty participating in vocational programming. It may also place young adults at high risk for disengagement. When coupled with intellectual disability (ID), anxiety may become even more disabling.

In a one-year study funded in 2015 by OAR, researcher Audrey Blakeley-Smith, Ph.D., and her co-investigators, Judy Reaven, Ph.D., and Susan Hepburn, Ph.D., all clinical psychologists and associate professors in the Department of Psychiatry, University of Colorado, School of Medicine, created “Facing Your Fears: Adolescents with Autism and Intellectual Disabilities.” The program is a family-focused, group cognitive behavioral therapy treatment for adolescents with ASD and ID. Fifteen adolescents between the ages of 14 and 18 with a diagnosis of ASD, an IQ between 50 and 70, and clinically significant symptoms of anxiety participated in the pilot program along with their parents. That study was the first to date to explore the efficacy of a family-focused, group cognitive behavioral therapy treatment for adolescents with ASD and ID.

In 2016, the researchers were approved for a second OAR-funded study to enable them to:

• Conduct in-depth interviews with the families who participated in the 2016 study to build on their outcome data and better understand which components of the program the adolescents and their parents preferred and what, if any, barriers existed in implementing the interventions.
• Revise the program manual based on the parents’ feedback and create three modules with content specifically for adolescents with ASD and ID who are minimally verbal, emerging verbal, and verbally fluent.
• Expand their pilot study to include 12 additional families to test the revised program manual.

Method

In-depth interviews: The researchers will conduct individual interviews with parents of the teens who participated in the initial study to provide feedback on the program’s content, its therapeutic approach, whether the program was a good fit for the adolescent’s cognitive and language needs, and the outcome of the treatment. The researchers will use that feedback to revise the program manual.

Tailored modules: The researchers will revise the program based on parent feedback and tailor it to meet the needs of teens who are minimally verbal, emerging verbal, and verbally fluent. The revised program modules will contain three sets of activities/visual supports for those three groups.

Expanded pilot study: The researchers will complete three pilot groups with 12 teens, ages 14 to 18, and their parents, organized into groups according to language capabilities. The treatment will consist of 16 interventions: eight with parents only and eight with parent/teen pairs working together. In the parent-only sessions, parents will learn core concepts and receive support from other parents. In the one-to-one sessions with parents and teens, the teens will receive coaching face to face and deal with their fears through common cognitive behavioral therapy strategies, such as deep breathing, positive coping statements, and graded exposure (facing their fears a little at a time).

Outcomes

The results of this study will provide preliminary data about the intervention’s feasibility, acceptability, and effectiveness for reducing symptoms of anxiety within a diverse range of teens with ASD and ID. The primary benefit of the proposed study is to provide access to a psychosocial intervention program aimed towards building cognitive and somatic management skills for teens with ASD and ID.

Reductions in teen anxiety could lead to important functional outcomes for adolescents (such as increased engagement in activities, broader social experiences, and better quality of life) and their families (less isolation and improved quality of life). Given that anxiety and problem behavior typically isolate and restrict families, providing an intervention that will help expand a family’s support network through a group treatment intervention is valuable.