Modified Parent-Child Interaction Therapy (PCIT) for children with Autism spectrum disorder and comorbid anxiety symptoms



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Anxiety is often comorbid with Autism Spectrum Disorder (ASD) in children, and is associated with more symptoms than ASD alone (e.g., increased self-injury, depressive symptoms, and parental stress). However, evidence-based treatments addressing anxiety are limited among this population (especially among young children), compared to treatment options for children with anxiety but without ASD. Parent-Child Interaction Therapy (PCIT) appears promising for children with anxiety alone, as well as children with ASD alone. However, PCIT has not been examined among children with comorbid anxiety and ASD. Thus, the current study aimed to examine the effects of a modified PCIT program on child anxiety among children with comorbid anxiety and ASD, as well as parental outcomes (i.e., accommodation, parental anxiety, and stress). The intervention was modeled after the original Coaching Approach behavior and Leading by Modeling (CALM 1.0) program, a 12-session modified PCIT program for young children with anxiety. Modifications to CALM were made tailoring to ASD symptoms.

This study utilized a multiple baseline design, including four caregiver-child dyads and child participants aged between 5 and 9 years old. Visual analyses, descriptive analyses, and simulation modeling were used to analyze the data. It was hypothesized that child anxiety, as well as caregivers’ accommodating behaviors, anxiety, and stress would decrease throughout treatment. Positive parenting skills were predicted to increase throughout treatment, whereas negative parenting skills would decrease. Results revealed several of the child participants showed reductions in anxiety symptoms based on parent interview. Additionally, significant reductions in parental accommodating behaviors and improved parenting skills were found. This study provided the first examination of CALM in reducing child anxiety and improving parental outcomes among children with comorbid anxiety and ASD and their parents.



Autism, Child Anxiety