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Children with autism spectrum disorder (ASD) exhibit significant deficits in social communication and emotion regulation skills. While cognitive behavioral therapy (CBT) applications appear promising, trials to date have largely excluded social communication skill development and have not been designed to include a wider range of emotional challenges. To our knowledge, the present study is the first to pilot a uniquely modified CBT program targeting emotion regulation, including social communication training, and explicitly focusing on the child's areas of circumscribed interest in order to teach skills and promote generalization. Forty participants were randomly assigned to either the CBT group or a waitlist control (WLC) group, resulting in 20 school-aged children in each group. The treatment approach was determined to be feasible and acceptable, and therapy engagement and attendance were reasonably high. Caregivers expressed high satisfaction with the program, qualitatively citing gains in skills such as social problem-solving, emotion identification, and identifying and processing cognitive distortions. The primary outcome of postintervention changes was not significantly different between the groups (CBT vs. WLC). The mean Social Skills Improvement System score decreased by 0.44 points (95% confidence interval [CI]: −5.04, 4.15) in the CBT group and increased by 0.41 points (95% CI: −4.23, 5.04) in the WLC group, and the postintervention changes were not significantly different between the groups (difference: −0.85; 95% CI: −7.29, 5.60; p =.79). The estimated rate of emotional dysregulation episodes decreased by a factor of 0.94 (95% CI: 0.57, 1.56) in the CBT group and increased by a factor of 1.07 (95% CI: 0.51, 2.24) for WLC (p =.74). Among those who reported emotional dysregulation episodes, the mean duration decreased by 1.39 minutes (95% CI: −3.90, 6.67) less for CBT than waitlist (p =.60). Although satisfaction, acceptability, and emotional dysregulation outcome results from this preliminary CBT treatment for ASD are promising, sample size and measurement limitations will be important considerations to inform future trials. [ABSTRACT FROM AUTHOR]

While cognitive behavioral therapy (CBT) is a first-line treatment for anxiety, it is not typically offered to those with intellectual disability (ID). In this article, we provide a historical perspective on the treatment of mental health concerns in adults with ID, describe an adapted CBT treatment for anxiety in adults with Williams syndrome (WS) and mild to moderate ID, and discuss general modifications to CBT for adults with ID. Strategies used to successfully adapt CBT for adults with WS that may generalize to adults with ID more broadly include (a) using child-based CBT manuals as a framework, (b) involving a caregiver as a therapy partner, (c) incorporating a high level of repetition, (d) simplifying language, (e) slowing the pace of instruction, and (f) incorporating specific examples and adaptations for WS. [ABSTRACT FROM AUTHOR]

This article presents an individual intervention combining cognitive-behavioral and behavior-analytic approaches to target severe emotion dysregulation in verbal youth with autism spectrum disorder (ASD) concurrent with intellectual disability (ID). The article focuses on two specific individuals who received the treatment within a therapeutic school setting. Single-subject methodology utilizing a nonconcurrent multiple-baseline design across behaviors and participants was used to evaluate the intervention. The two participants presented with severe behavioral challenges, including physical aggression and verbal threats to harm others. Results suggest positive outcomes, including a reduction in the frequency and intensity of severe aggressive behavior and an increase in the use of coping skills, self-advocacy, and social participation. The planning and implementation of specific skills-generalization strategies was one innovative element of the intervention that proved to be pivotal to its successful application. Assessment and treatment techniques for different intervention phases are detailed along with two case examples. Intervention challenges, treatment outcomes, and future directions for clinical research are discussed.

Objective: The current study was performed to assess the evidence for effects of therapeutic intervention with mobile device applications (apps) for individuals with autism spectrum disorder (ASD).Design: The main methodology of the current study was systematic review with meta-analysis.Setting: Only randomised controlled trials (RCTs) for mobile device apps for individuals with ASD were considered for review in the current study.Patients: The target population was individuals clinically diagnosed with ASD.Interventions: Applications that are operable on a smart (mobile) device and interactive with users.Main Outcome Measures: The main outcomes were based on standardised mean differences in pretrial and post-trial scales in each control and intervention group.Results: Out of a total of 1100 studies (after duplicate removal), 7 RCTs were selected for final analysis. Of the seven studies, two RCTs were further analysed for effects based on the visual and fine motor subscales of the Mullen Scales of Early Learning, which favoured the intervention groups (standardised mean difference (SMD)=0.41, 95% CI 0.03 to 0.80; SMD=0.41, 95% CI 0.03 to 0.80), without either having any heterogeneity (p>0.1) or publication bias.Conclusions: Although it is still early to draw a conclusion, available studies are showing promise for use of mobile device apps for treatment of individuals with ASD. More well-designed and large-scale studies focused on improving behavioural symptoms of ASD are warranted.Prospero Registration Number: CRD42019128362. [ABSTRACT FROM AUTHOR]

Objective: The current study was performed to assess the evidence for effects of therapeutic intervention with mobile device applications (apps) for individuals with autism spectrum disorder (ASD)., Design: The main methodology of the current study was systematic review with meta-analysis., Setting: Only randomised controlled trials (RCTs) for mobile device apps for individuals with ASD were considered for review in the current study., Patients: The target population was individuals clinically diagnosed with ASD., Interventions: Applications that are operable on a smart (mobile) device and interactive with users., Main Outcome Measures: The main outcomes were based on standardised mean differences in pretrial and post-trial scales in each control and intervention group., Results: Out of a total of 1100 studies (after duplicate removal), 7 RCTs were selected for final analysis. Of the seven studies, two RCTs were further analysed for effects based on the visual and fine motor subscales of the Mullen Scales of Early Learning, which favoured the intervention groups (standardised mean difference (SMD)=0.41, 95% CI 0.03 to 0.80; SMD=0.41, 95% CI 0.03 to 0.80), without either having any heterogeneity (p>0.1) or publication bias., Conclusions: Although it is still early to draw a conclusion, available studies are showing promise for use of mobile device apps for treatment of individuals with ASD. More well-designed and large-scale studies focused on improving behavioural symptoms of ASD are warranted., Prospero Registration Number: CRD42019128362., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)