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Assessment of the Prerequisite Skills for Cognitive Behavioral Therapy in Children with and Without Autism Spectrum Disorders

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Abstract

The purpose of this study was to assess the cognitive skills of children with autism spectrum disorders (ASD) thought to be necessary for Cognitive Behavioral Therapy (CBT). Forty children with ASD and forty age-matched typically developing children between the ages of 7–12 years participated. Groups were comparable with regard to nonverbal IQ, but children with ASD had significantly lower verbal IQ. Children completed three CBT-related tasks requiring emotion recognition, discrimination among thoughts, feelings and behaviors, and cognitive mediation. With the exception of the emotion recognition task, children with ASD performed comparably to typically developing children and with a high rate of accuracy.

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References

  • Anderson, S., & Morris, J. (2006). Cognitive behaviour therapy for people with Asperger syndrome. Behavioural and Cognitive Psychotherapy, 34(3), 293–303.

    Article  Google Scholar 

  • Attwood, T. (2004). Cognitive behaviour therapy for children and adults with Asperger’s syndrome. Behaviour Change, 21(3), 147–161.

    Article  Google Scholar 

  • Baron-Cohen, S. (1991). Do people with autism understand what causes emotion? Child Development, 62(2), 385–395.

    Article  PubMed  Google Scholar 

  • Berument, S., Rutter, M., Lord, C., Pickles, A., & Bailey, A. (1999). Autism screening questionnaire: Diagnostic validity. British Journal of Psychiatry, 175, 444–451.

    Article  PubMed  Google Scholar 

  • Cardaciotto, L., & Herbert, J. (2004). Cognitive behavior therapy for social anxiety disorder in the context of Asperger’s syndrome: A single-subject report. Cognitive and Behavioral Practice, 11, 75–81.

    Article  Google Scholar 

  • Celani, G., Battachi, M. W., & Arcidiacono, L. (1999). The understanding of the emotional meaning of facial expressions in people with autism. Journal of Autism and Developmental Disorders, 29, 57–66.

    Article  PubMed  Google Scholar 

  • Chalfant, A., Rapee, R., & Carroll, L. (2007). Treating anxiety disorders in children with high functioning autism spectrum disorders: A controlled trial. Journal of Autism and Developmental Disorders, 37(10), 1842–1857.

    Article  PubMed  Google Scholar 

  • Charman, T. (2002). The prevalence of autism spectrum disorders: Recent evidence and future challenges. European Child and Adolescent Psychiatry, 11, 249–256.

    Article  PubMed  Google Scholar 

  • Chung, M., & Thomson, D. (1995). Development of face recognition. British Journal of Psychology, 86, 55–87.

    Article  PubMed  Google Scholar 

  • Dagnan, D., Chadwick, P., & Proudlove, J. (2000). Toward an assessment of suitability of people with mental retardation for cognitive therapy. Cognitive Therapy and Research, 24(6), 627–636.

    Article  Google Scholar 

  • Doherr, L., Reynolds, S., Wetherly, J., & Evans, E. (2005). Young children’s ability to engage in cognitive therapy tasks: Associations with age and educational experience. Behavioural and Cognitive Psychotherapy, 33(2), 201–215.

    Article  Google Scholar 

  • Ekman, P., & Friesen, W. L. (1976). Pictures of facial affect. Palo Alto, CA: Consulting Psychologist Press.

    Google Scholar 

  • Ellis, A. (1979). Negative linking of RET to positive thinking. PsycCRITIQUES, 24(12), 1058–1059.

    Article  Google Scholar 

  • Farber, B. (1985). The genesis, development, and implications of psychological-mindedness in psychotherapists. Psychotherapy: Theory, Research, Practice, Training, 22(2), 170–177.

    Article  Google Scholar 

  • Flavell, J., Flavell, E., & Green, F. (2001). Development of children’s understanding of connections between thinking and feeling. Psychological Science, 12(5), 430–432.

    Article  PubMed  Google Scholar 

  • Fombonne, E. (2003). Epidemiological surveys of autism and other pervasive developmental disorders: An update. Journal of Autism and Developmental Disorders, 33, 365–382.

    Article  PubMed  Google Scholar 

  • Gillott, A., Furniss, F., & Walter, A. (2004). Theory of mind ability in children with specific language impairment. Child Language Teaching & Therapy, 20(1), 1–11.

    Article  Google Scholar 

  • Golan, O., Ashwin, E., Granader, Y., McClintock, S., Day, K., Leggett, V., et al. (2010). Enhancing emotion recognition in children with autism spectrum conditions: An intervention using animated vehicles with real emotional faces. Journal of Autism and Developmental Disorders, 40(3), 269–279.

    Article  PubMed  Google Scholar 

  • Golan, O., Baron-Cohen, S., & Golan, Y. (2008). The ‘Reading the Mind in Films’ Task (Child version): Complex emotion and mental state recognition in children with and without autism spectrum conditions. Journal of Autism and Developmental Disorders, 38(8), 1534–1541.

    Article  PubMed  Google Scholar 

  • Grave, J., & Blissett, J. (2004). Is cognitive behavior therapy developmentally appropriate for young children? A critical review of the evidence. Clinical Psychology Review, 24(4), 399–420.

    Article  PubMed  Google Scholar 

  • Greig, A., & MacKay, T. (2005). Asperger’s Syndrome and cognitive behaviour therapy: New applications for educational psychologists. Educational and Child Psychology, 22(4), 4–15.

    Google Scholar 

  • Haddock, K., & Jones, R. (2006). Practitioner consensus in the use of cognitive behaviour therapy for individuals with a learning disability. Journal of Intellectual Disabilities, 10(3), 221–230.

    Article  PubMed  Google Scholar 

  • Hare, D. (1997). The use of cognitive-behavioral therapy with people with Asperger syndrome: A case study. Autism, 1(2), 215–225.

    Article  Google Scholar 

  • Herba, C., Landau, S., Russell, T., Ecker, C., & Phillips, M. (2006). The development of emotion-processing in children: Effects of age, emotion, and intensity. Journal of Child Psychology and Psychiatry, 47(11), 1098–1106.

    Article  PubMed  Google Scholar 

  • Hobson, R. (1986a). The autistic child’s appraisal of expressions of emotion. Journal of Child Psychology and Psychiatry, 27(3), 321–342.

    Article  PubMed  Google Scholar 

  • Hobson, R. (1986b). The autistic child’s appraisal of expressions of emotion: A further study. Journal of Child Psychology and Psychiatry, 27(5), 671–680.

    Article  PubMed  Google Scholar 

  • Kaufman, A. S., & Kaufman, N. L. (2004). KBIT-2: Kaufman Brief Intelligence Test (2nd ed.). Minnesota: AGS Publishing.

    Google Scholar 

  • Kendall, P. (1993). Cognitive-behavioral therapies with youth: Guiding theory, current status, and emerging developments. Journal of Consulting and Clinical Psychology, 61(2), 235–247.

    Article  PubMed  Google Scholar 

  • Kendall, P., & Choudhury, M. (2003). Children and adolescents in cognitive-behavioral therapy: Some past efforts and current advances, and the challenges in our future. Cognitive Therapy and Research, 27(1), 89–104.

    Article  Google Scholar 

  • Kendall, P. C., Robin, J., Hedtke, K., Suveg, C., Flannery-Schroeder, E., & Gosch, E. (2005). Considering CBT with anxious youth? Think exposure. Cognitive and Behavioral Practice, 12, 136–148.

    Article  Google Scholar 

  • Kendall, P., Stark, K., & Adam, T. (1990). Cognitive deficit or cognitive distortion of childhood depression. Journal of Abnormal Child Psychology, 18(3), 255–270.

    Article  PubMed  Google Scholar 

  • Kerr, S., & Durkin, K. (2004). Understanding of thought bubbles as mental representations in children with autism: Implications for theory of mind. Journal of Autism and Developmental Disorders, 34(6), 637–648.

    Article  PubMed  Google Scholar 

  • Kim, J., Szatmari, P., Bryson, S., Streiner, D., & Wilson, F. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism, 4(2), 117–132.

    Article  Google Scholar 

  • Kingery, J., Roblek, T., Suveg, C., Grover, R., Sherrill, J., & Bergman, R. (2006). They’re not just ‘little adults’: Developmental considerations for implementing cognitive-behavioral therapy with anxious youth. Journal of Cognitive Psychotherapy, 20(3), 263–273.

    Article  Google Scholar 

  • Klinger, L., & Williams, A. (2009). Cognitive-behavioral interventions for students with autism spectrum disorders. Cognitive-behavioral interventions for emotional and behavioral disorders: School-based practice (pp. 328–362). New York, NY, USA: Guilford Press.

    Google Scholar 

  • Lang, R., Regester, A., Lauderdale, S., Ashbaugh, K., & Haring, A. (2010). Treatment of anxiety in autism spectrum disorders using cognitive behaviour therapy: A systematic review. Developmental Neurorehabilitation, 13(1), 53–63.

    Article  PubMed  Google Scholar 

  • Lenti, C., Lenti-Boero, D., & Giacobbe, A. (1999). Decoding of emotional expressions in children and adolescents. Perceptual and Motor Skills, 89(3), 808–814.

    Article  PubMed  Google Scholar 

  • Leyfer, O., Folstein, S., Bacalman, S., Davis, N., Dinh, E., Morgan, J., et al. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36(7), 849–861.

    Article  PubMed  Google Scholar 

  • Lord, C. (1996). Treatment of a high-functioning adolescent with autism: A cognitive-behavioral approach. In M. Reinecke, F. M. Dattilio, & A. Freeman (Eds.), Cognitive therapy with children and adolescents: A casebook for clinical practice (pp. 394–404). New York, NY: Guilford Press.

    Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E., Leventhal, B., DiLavore, P., et al. (2000). The Autism Diagnostic Observation Schedule—Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P., & Risi, S. (1999). Autism Diagnostic Observation Schedule-WPS Edition. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview—Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.

    Article  PubMed  Google Scholar 

  • Oathamshaw, S., & Haddock, G. (2006). Do people with intellectual disabilities and psychosis have the cognitive skills required to undertake cognitive behavioural therapy? Journal of Applied Research in Intellectual Disabilities, 19(1), 35–46.

    Article  Google Scholar 

  • Ooi, Y. P., Lam, C. M., Sung, M., Tan, W. T., Goh, T. J., Fung, D. S., et al. (2008). Effects of cognitive-behavioural therapy on anxiety for children with high-functioning autistic spectrum disorders. Singapore Medical Journal, 49, 215–220.

    PubMed  Google Scholar 

  • Pons, F., Harris, P., & de Rosnay, M. (2004). Emotion comprehension between 3 and 11 years: Developmental periods and hierarchical organization. European Journal of Developmental Psychology, 1(2), 127–152.

    Article  Google Scholar 

  • Puleo, C. M., & Kendall, P. C. (2010). Anxiety disorders in typically developing youth: Autism spectrum symptoms as a predictor of cognitive-behavioral treatment. Journal of Autism and Developmental Disorder. (Advance online publication). doi:10.1007/s10803-010-1047-2.

  • Quakley, S., Coker, S., Palmer, K., & Reynolds, S. (2003). Can children distinguish between thoughts and behaviours? Behavioural and Cognitive Psychotherapy, 31(2), 159–167.

    Article  Google Scholar 

  • Quakley, S., Reynolds, S., & Coker, S. (2004). The effect of cues on young children’s abilities to discriminate among thoughts, feelings and behaviours. Behaviour Research and Therapy, 42(3), 343–356.

    Article  PubMed  Google Scholar 

  • Reaven, J. (2009). Children with high-functioning autism spectrum disorders and co-occurring anxiety symptoms: Implications for assessment and treatment. Journal for Specialists in Pediatric Nursing, 143, 192–199.

    Google Scholar 

  • Reaven, J., Blakeley-Smith, A., Nichols, S., Dasari, M., Flanigan, E., & Hepburn, S. (2009). Cognitive-behavioral group treatment for anxiety symptoms in children with high-functioning autism spectrum disorders, a pilot study. Focus on Autism and Other Developmental Disabilities, 24, 27–37.

    Article  Google Scholar 

  • Reaven, J., & Hepburn, S. (2003). Cognitive-behavioral treatment of obsessive-compulsive disorder in a child with Asperger syndrome: A case report. Autism, 7(2), 145–164.

    Article  PubMed  Google Scholar 

  • Reynolds, S., Girling, E., Coker, S., & Eastwood, L. (2006). The effect of mental health problems on children’s ability to discriminate amongst thoughts, feelings and behaviours. Cognitive Therapy and Research, 30(5), 599–607.

    Article  Google Scholar 

  • Safran, J., Segal, Z., Vallis, T., & Shaw, B. (1993). Assessing patient suitability for short-term cognitive therapy with an interpersonal focus. Cognitive Therapy and Research, 17(1), 23–38.

    Article  Google Scholar 

  • Sauter, F., Heyne, D., & Westenberg, P. (2009). Cognitive behavior therapy for anxious adolescents: Developmental influences on treatment design and delivery. Clinical Child and Family Psychology Review, 12(4), 310–335.

    Article  PubMed  Google Scholar 

  • Seligman, L. D., & Ollendick, T. H. (2011). Cognitive-behavioral therapy for anxiety disorders in youth. Child and Adolescent Psychiatric Clinics of North America, 20(2), 217–238.

    Article  PubMed  Google Scholar 

  • Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 921–929.

    Article  PubMed  Google Scholar 

  • Sofronoff, K., Attwood, T., & Hinton, S. (2005). A randomised controlled trial of a CBT intervention for anxiety in children with Asperger syndrome. Journal of Child Psychology and Psychiatry, 46(11), 1152–1160.

    Article  PubMed  Google Scholar 

  • Sofronoff, K., Attwood, T., Hinton, S., & Levin, I. (2007). A randomized controlled trial of a cognitive behavioural intervention for anger management in children diagnosed with Asperger syndrome. Journal of Autism and Developmental Disorders, 37(7), 1203–1214.

    Article  PubMed  Google Scholar 

  • Stallard, P. (2002). Cognitive behaviour therapy with children and young people: A selective review of key issues. Behavioural and Cognitive Psychotherapy, 30(3), 297–309.

    Article  Google Scholar 

  • Steffenburg, S., Gillberg, C., & Steffenburg, U. (1996). Psychiatric disorders in children and adolescents with mental retardation and active epilepsy. Archives of Neurology, 53(9), 904–912.

    Article  PubMed  Google Scholar 

  • Sturmey, P. (2005). Against psychotherapy with people who have mental retardation. Mental Retardation, 43(1), 55–57.

    Article  PubMed  Google Scholar 

  • Sze, K., & Wood, J. (2007). Cognitive behavioral treatment of comorbid anxiety disorders and social difficulties in children with high-functioning autism: A case report. Journal of Contemporary Psychotherapy, 37(3), 133–143.

    Article  Google Scholar 

  • Thomas, L., De Bellis, M., Graham, R., & LaBar, K. (2007). Development of emotional facial recognition in late childhood and adolescence. Developmental Science, 10, 547–558.

    Article  PubMed  Google Scholar 

  • Tonks, J., Williams, W., Frampton, I., Yates, P., & Slater, A. (2007). Assessing emotion recognition in 9–15-years olds: Preliminary analysis of abilities in reading emotion from faces, voices and eyes. Brain Injury, 21(6), 623–629.

    Article  PubMed  Google Scholar 

  • Wechsler, D. (1999). Wechsler abbreviated scale of intelligence. San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • White, S., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29(3), 216–229. doi:10.1016/j.cpr.2009.01.003.

    Article  PubMed  Google Scholar 

  • Willner, P. (2005). The effectiveness of psychotherapeutic interventions for people with learning disabilities: A critical overview. Journal of Intellectual Disability Research, 49(1), 73–85.

    Article  PubMed  Google Scholar 

  • Willner, P., & Hatton, C. (2006). CBT for people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 19(1), 1–3.

    Article  Google Scholar 

  • Wing, L., & Potter, D. (2009). The epidemiology of autism spectrum disorders: Is the prevalence rising? Assessment of autism spectrum disorders (pp. 18–54). New York, NY USA: Guilford Press.

    Google Scholar 

  • Wood, J., Drahota, A., Sze, K., Har, K., Chiu, A., & Langer, D. (2009). Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: A randomized, controlled trial. Journal of Child Psychology and Psychiatry, 50(3), 224–234.

    Article  PubMed  Google Scholar 

  • Yirmiya, N., Sigman, M., Kasari, C., & Mundy, P. (1992). Empathy and cognition in high-functioning children with autism. Child Development, 63(1), 150–160.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank the agencies that assisted in obtaining participants for this study: the Interactive Autism Network (IAN) Research Database at the Kennedy Krieger Institute and Johns Hopkins Medicine, the Autism Society of America, and the Albany County School District #1. We also acknowledge the children and families who volunteered their time to participate in this study.

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Authors and Affiliations

  1. Department of Psychology, University of Wyoming, 1000 E. University Ave., Laramie, WY, 82071, USA

    Athena Lickel & William E. MacLean Jr.

  2. University of Colorado, Anschutz Medical Campus, School of Medicine, JFK Partners, 13121 E. 17th Ave, PO Box 6511, Aurora, CO, 80045, USA

    Audrey Blakeley-Smith & Susan Hepburn

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  1. Athena Lickel
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  2. William E. MacLean Jr.
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  3. Audrey Blakeley-Smith
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  4. Susan Hepburn
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Correspondence to Athena Lickel.

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Lickel, A., MacLean, W.E., Blakeley-Smith, A. et al. Assessment of the Prerequisite Skills for Cognitive Behavioral Therapy in Children with and Without Autism Spectrum Disorders. J Autism Dev Disord 42, 992–1000 (2012). https://doi.org/10.1007/s10803-011-1330-x

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