Anxiety in Children and Adolescents with Autism Spectrum Disorder

Anxiety in Children and Adolescents with Autism Spectrum Disorder

Evidence-Based Assessment and Treatment

1st Edition - January 3, 2017

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  • Editors: Connor Kerns, Patricia Renno, Eric Storch, Philip Kendall, Jeffrey Wood
  • Hardcover ISBN: 9780128051221
  • eBook ISBN: 9780128052679

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Anxiety in Children and Adolescents with Autism Spectrum Disorder: Evidence-Based Assessment and Treatment begins with a general overview of the history of research on anxiety in ASD and the path towards evidence-based assessment and treatment methods. Thereafter, chapters focus on the nature of ASD and anxiety comorbidity, the assessment of anxiety in ASD, and its treatment. Later chapters are devoted to future directions for research on this topic, including a discussion of anxiety assessment and treatment for adults and minimally verbal individuals. Anxiety disorders in children with autism spectrum disorder (ASD) can cause substantial distress and impairment over and above that caused by ASD alone. Emerging research on genetic, psychological, psychophysiological, and psychometric aspects of ASD establish anxiety as a valid and necessary treatment target in this population. This book is designed to help a broad array of providers who work with children with ASD understand cutting-edge, empirically supported treatments for anxiety, including specific treatment plans and strategies.

Key Features

  • Presents a balanced discussion of the scientific literature on anxiety in ASD
  • Provides a pragmatic, clinically applied focus that gives readers a ‘how-to’ guide for the treatment of anxiety in ASD
  • Considers the distinct ways in which anxiety presents in children and adolescents with ASD and the challenges this presents to assessment and treatment
  • Examines emerging areas of anxiety assessment and treatment research in ASD


Clinicians who treat those with ASD: primarily psychologists, but also psychiatrists, neurologists, behavior therapists, and nurse practitioners. Researchers involved in autism spectrum and anxiety disorders and their assessment and treatment

Table of Contents

    • Dedication
    • List of Contributors
    • Chapter 1. Introduction
      • Abstract
      • References
    • Chapter 2. Prevalence of Anxiety in Autism Spectrum Disorders
      • Abstract
      • Autism Spectrum Disorder
      • Anxiety
      • Prevalence of Anxiety Disorders in the General Population
      • Anxiety in ASD
      • Prevalence Rates of Anxiety in ASD
      • Factors Associated With Anxiety in ASD
      • Implications
      • References
    • Chapter 3. Phenomenology and Presentation of Anxiety in Autism Spectrum Disorder
      • Abstract
      • Methodologies Employed in Studying the Phenomenology and Presentation of Anxiety in ASD
      • Findings From Qualitative Studies
      • Findings From Quantitative Studies
      • Shared and Distinct Anxiety Presentations in ASD by Anxiety Type
      • Anxiety/Fears/Worries Associated With Core ASD Symptomatology
      • Factors Associated with Traditional and Distinct Anxiety Symptomatology
      • Future Directions and Implications for Research and Practice
      • Acknowledgments
      • Vignette 1—“Traditional” presentation: separation and generalized anxiety
      • Vignette 2—“Distinct” presentation: anxiety around change
      • References
    • Chapter 4. Neurobiological Mechanisms of Anxiety in ASD
      • Abstract
      • Introduction
      • The Relationship Between Amygdala, Anxiety, and ASD
      • Amygdala, Prefrontal Cortex, and Brain Connectivity in ASD
      • The Brain in Context: The Autonomic Nervous System in Anxiety and ASD
      • Conclusions and Future Directions
      • References
    • Chapter 5. Assessment of Anxiety in Youth With Autism Spectrum Disorder
      • Abstract
      • Assessment of Anxiety in Autism Spectrum Disorder
      • Clinical Assessment of Anxiety in ASD
      • Tools for Assessing Anxiety in ASD
      • Clinical Interviews
      • Clinician-Rated Symptom Measures
      • Direct Observation
      • Physiological Measures
      • Multimethod Assessment of Anxiety in Youth With ASD
      • Case Example
      • Conclusion
      • References
    • Chapter 6. Cognitive-Behavioral Principles and Their Applications Within Autism Spectrum Disorder
      • Abstract
      • CBT for Anxiety in Typically Developing Children
      • Psychoeducation
      • Relaxation and Somatic Management
      • Cognitive Restructuring
      • Problem Solving
      • Exposure
      • Treatment of Anxious Children With ASD
      • Modifying CBT for Children With ASD
      • Estimated Efficacy of CBT for Children With ASD
      • Suggestions for Specific Modifications of CBT for Children With ASD
      • Additional Options for Treatment
      • Group Therapy
      • Future Directions and Applications
      • References
    • Chapter 7. Individual CBT for Anxiety and Related Symptoms in Children With Autism Spectrum Disorders
      • Abstract
      • Use of Unproven Treatments by Parents and Professionals
      • Summary of EBT Classification System
      • Method
      • Results
      • Discussion
      • References
    • Chapter 8. Group Cognitive Behavior Therapy for Children and Adolescents With Anxiety and Autism Spectrum Disorders
      • Abstract
      • Introduction
      • Group Treatment for Youth With ASD—Initial Focus
      • Determining Treatment Focus—Social Skills or Anxiety-Based Interventions?
      • Group Therapy for Anxiety in Youth With ASD
      • Challenges/Recommendations for Conducting Group Therapy With Youth With ASD and Anxiety
      • Summary
      • Future Directions
      • Acknowledgments
      • References
    • Chapter 9. Behavioral Treatments for Anxiety in Adults With Autism Spectrum Disorder
      • Abstract
      • Introduction
      • Prevalence and Clinical Presentation
      • Evidence-Informed Assessment of Anxiety in Adults With ASD
      • Targeting Key Mechanisms
      • Basic Processes Underlying Anxiety in ASD
      • Emotion Regulation
      • Mindfulness and Acceptance
      • Behavioral Treatments
      • Extant Research in Adults With ASD
      • Primary Modifications to Behavioral Treatments for Adults With ASD and Anxiety
      • Medical/Pharmacological Treatments
      • Primary Modifications to Medical Treatments of Anxiety in ASD
      • Looking Forward: Next Steps in Research and Practice
      • References
    • Chapter 10. Behavioral Treatments for Anxiety in Minimally Verbal Children With ASD
      • Abstract
      • Diagnosis
      • Behavioral Assessment
      • Behavioral Interviews
      • Standardized Rating Forms
      • Direct Observation
      • Caregiver Anxiety and Its Role in Child Anxiety
      • Behavioral Treatment
      • Graduated Exposure and Reinforcement
      • Additional Treatment Components
      • Caregiver Involvement
      • References
    • Chapter 11. Anxiety and ASD in Schools: School-Related Issues and Individualized Education Programs
      • Abstract
      • Overview
      • Clinical Diagnosis and Educational Classification of ASD
      • Anxiety and ASD in Schools
      • School-Based Assessment of Anxiety
      • Intervention Development, Implementation, and Monitoring Using the IEP
      • Conclusion
      • Funding Acknowledgment
      • References
    • Chapter 12. Dissemination and Implementation of Behavioral Treatments for Anxiety in ASD
      • Abstract
      • Gaps Between Research and Routine Care for Anxiety in Youth With Autism
      • Developing Effective Anxiety Interventions for Youth With Autism
      • Implementing Existing Anxiety Interventions With Youth With Autism
      • Adapted EPIS Model of Implementation
      • The ACT SMART Implementation Toolkit
      • Conclusion
      • References
    • Index

Product details

  • No. of pages: 274
  • Language: English
  • Copyright: © Academic Press 2017
  • Published: January 3, 2017
  • Imprint: Academic Press
  • Hardcover ISBN: 9780128051221
  • eBook ISBN: 9780128052679

About the Editors

Connor Kerns

Dr. Connor Kerns is an Assistant Research Professor at the AJ Drexel Autism Institute with secondary appointments in the Department of Psychology and Community Health and Prevention in the School of Public Health at Drexel University. She is also a Visiting Scholar at the Center for Health Innovation at Adelphi University. Dr. Kerns has expertise in the differential diagnosis, assessment and evidence-based treatment of childhood psychological disorders, particularly childhood anxiety, child trauma and traumatic stress and the impact of these conditions on youth with autism spectrum disorder. Dr. Kerns has received grants from federal and private agencies for her research (Autism Science Foundation, NIH), has published over 2 dozen peer-reviewed scientific articles in child psychology and contributed as an author and editor to numerous books, chapters and research journals. Dr. Kerns lives in Philadelphia with her husband, son and Airedale terrier, Seamus. She is an avid walker, equestrian and reader.

Affiliations and Expertise

A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA USA

Patricia Renno

Patricia Renno, Ph.D. is a Postdoctoral Scholar and Clinical Instructor in the Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles. She received her doctoral degree in Educational Psychology at UCLA. Dr. Renno has worked on several clinical trials examining the efficacy of cognitive behavioral therapy to treat anxiety and related social difficulties in children with autism spectrum disorder (ASD). She received clinical training in modified cognitive behavioral therapy to treat anxiety in youth with ASD, as well as, in the assessment of anxiety and other conditions in youth with ASD. As part of the Center for Autism Research and Treatment (CART) at UCLA, she received training in psychophysiological research methodology, including fear potentiated startle paradigms and salivary cortisol collections. Her research focuses on the co-occurrence of anxiety in autism spectrum disorders and in particular on the construct validity of anxiety in ASD. Dr. Renno has published several journal articles and book chapters on these topics, and presented at a number of conferences. Her current research interests seek to determine underlying psychophysiological underpinnings of anxiety in ASD and to test a larger hypothetical model in which factors, such as increased daily stress, might contribute to greater anxiety and ASD symptom severity in youth with ASD.

Affiliations and Expertise

Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California USA

Eric Storch

Dr. Eric Storch is McIngvale Presidential Endowed Chair & Professor at Baylor College of Medicine. Dr. Storch has received multiple grants from federal agencies for his research (i.e., NIH, CDC), is a Fulbright Scholar, and has published over 14 books and over 500 articles and chapters. He specializes in the nature and treatment of childhood and adult obsessive-compulsive disorder and related conditions, anxiety disorders, and anxiety among youth with autism.

Affiliations and Expertise

McIngvale Presidential Endowed Chair and Professor, Vice Chair and Head of Psychology, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA

Philip Kendall

Philip C. Kendall’s doctorate in clinical psychology is from Virginia Commonwealth University where he has been honored with the Outstanding Alumnus Award. He is Board Certified by the American Board of Professional Psychology and is a Distinguished University Professor and Laura H. Carnell professor of Psychology at Temple University. Dr. Kendall has been president of the Society of Clinical Child and Adolescent Psychology (Division 53) of APA as well as President of the Association for the Advancement of Behavior Therapy (AABT, now ABCT). He has garnered prestigious awards: For example, Fellow at the Center for Advanced Study in the Behavioral Sciences, Research Recognition Award from the Anxiety Disorders Association of America, “Great Teacher” award from Temple University, and “top therapist” in the tristate area by Philadelphia Magazine. ABCT recognized and awarded him for his “Outstanding Contribution by an Individual for Educational / Training Activities” and the Society for a Science of Clinical Psychology (SSCP) of the Association for Psychological Science (APS) awarded him the Distinguished Scientist Award. He has over 600 publication credits, and his citations place him among the most “Highly-Cited” individuals in all of the social and medical sciences (H factor of 101).

Affiliations and Expertise

Department of Psychology, Temple University, Philadelphia, PA USA

Jeffrey Wood

Jeffrey J. Wood is a clinical child psychologist with a joint appointment as Associate Professor in the Division of Child Psychiatry and the Division of Psychological Studies in Education at UCLA. He is also a faculty member of the UCLA Center for Autism Research and Treatment. He received a Ph.D. in Clinical Psychology from UCLA, specializing in clinical trials of cognitive behavioral therapy for childhood anxiety disorders and OCD. As a doctoral student and psychology intern at the UCLA Neuropsychiatric Institute, he acquired expertise in the assessment and behavioral treatment of school­aged children with autism spectrum disorders. Dr. Wood was the PI of a CART Pilot Grant in 2004. He has also been the recipient of several awards from NIMH, AERA, and UCLA, and has attained multiple grants from NIMH, the Cure Autism Now foundation, Autism Speaks, and the Organization for Autism Research to study cognitive behavioral interventions for school­aged children with autism. Drawing upon contemporary cognitive science models of memory retrieval competition and cognitive neuroscience models of information processing in autism, Dr. Wood has been developing novel intervention techniques and adapting techniques from other areas of childhood psychopathology (e.g., emotional disorders, disruptive behavior disorders, and habit disorders) in the formation of a comprehensive cognitive behavioral therapy program for school­aged children with autism spectrum disorders and high levels of anxiety. Dr. Wood's research seeks to identify effective treatment methods that improve self­regulation, increase adaptive behaviors in social and academic contexts, and address the varying patterns of symptom expression (e.g., repetitive behaviors) and psychiatric comorbidity (e.g., anxiety, conduct problems) seen in many children with ASD.

Affiliations and Expertise

Child Psychiatry and Psychology Studies in Education, University of California Los Angeles, Los Angeles, CA USA

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