Reducing Anxiety Symptoms in Adolescents With Autism Spectrum Disorder

PURPOSE: The purpose of this study was to determine whether participation in a group intervention to increase knowledge of body awareness and self-regulation using interoceptive cues would reduce anxiety symptoms associated with autism spectrum disorder (ASD). An estimated 80% of children with ASD have sensory processing deficits (Lord et al., 2000), and anxiety disorders follow depression as the most prevalent mental health condition co-occurring with ASD (Van Steensel et al., 2011). Those who experience anxiety often have deficits in interoception (Boswell et al., 2013). New evidence implies that interoceptive exposure could play a beneficial adjunctive role in the treatment plan of adolescents with ASD to enhance their ability to cope with anxiety-related sensations and increase their self-efficacy in task performance (Khalsa & Lapidus, 2016).

METHOD: For this quasi-experimental design study, participants aged 11–17 with a documented diagnosis of ASD who were able to verbally communicate, comprehend, and follow simple commands were recruited from both a middle school and high school in a rural underserved community. A weekly intervention group was held for 8 wk guided by an intervention protocol designed to focus on different sensory systems, incorporating interoceptive teaching techniques and visual supports. Data were obtained pre- and postintervention using the Beck Youth Inventory–Second Edition and the Adolescent/Adult Sensory Profile. Paired sample t tests for pre and post scores were used to determine efficacy of the intervention and compare scores between the middle school and high school participants.

RESULTS: Results of this study are pending final data collection and analysis. We hypothesize that use of this protocol as an occupational therapy intervention in a school setting will significantly reduce participants’ anxiety symptoms, resulting in improvement in self-efficacy to participate in chosen occupations.

CONCLUSION: In line with priorities voiced in Vision 2025 addressing the mental health needs of adolescents with ASD, reducing anxiety symptoms supports successful navigation of complex social environments and transitions to future student and worker roles (American Occupational Therapy Association, 2017). Use of this protocol as a Tier 2 intervention in school settings by occupational therapy practitioners may provide benefit for middle and high school students with ASD to reduce anxiety symptoms.

References

American Occupational Therapy Association. (2017). Vision 2025. American Journal of Occupational Therapy, 71, 7103420010. https://doi.org/10.5014/ajot.2017.713002

Boswell, J. F., Farchione, T. J., Sauer-Zavala S., Murray, H. W., Fortune, M. R., & Barlow, D. H. (2013). Anxiety sensitivity and interoceptive exposure: A transdiagnostic construct and change strategy. Behavior Therapy, 44, 417–431. https://doi.org/10.1016/j.beth.2013.03.006

Khalsa, S. S., & Lapidus, R. C. (2016). Can interoception improve the pragmatic search for biomarkers in psychiatry? Frontiers in Psychiatry, 7, 121. https://doi.org/10.3389/fpsyt.2016.00121

Lord, C., Cook, E. H., Leventhal, B. L., & Amaral, D. G. (2000). Autism spectrum disorders. Science Direct, 28, 355–363. https://doi.org/10.1016/S0896-6273(00)00115-X

Van Steensel, F. J., Bogels, S. M., & Perrin, S. (2011). Anxiety disorders in children and adolescents with autistic spectrum disorders: A meta-analysis. Clinical Child and Family Psychology Review, 14, 302–317. https://doi.org/10.1007/s10567-011-0097-0