For youth struggling with social skills, treating anxiety could be key


We all feel anxiety in certain social situations every now and then, but for those with autism spectrum disorder (ASD), social anxiety can be the spark that starts a wildfire.

Anxiety disorders frequently go hand-in-hand with ASD, particularly in adolescents- and the combination of the two disorders can be difficult to manage. As many as 40% of youth diagnosed with ASD also have a diagnosed anxiety disorder, which exacerbates the impaired social skills and feelings of loneliness contributed by ASD.  For example, an individual with an anxiety disorder can experience heightened arousal and fear of negative evaluation, which can lead to inaccurate processing of social interactions and social cues and avoidance of social interactions- which means fewer opportunities to practice social skills.  The takeaway: high levels of social anxiety may impede traditional treatments to improve social skills in children with ASD; so it is important for clinicians to be discerning and to consider treating anxiety separately when social skills treatments aren’t working on their own.

In a recent study, CAR researcher Brenna Maddox, PhD, demonstrated that cognitive behavioral therapy (CBT) that is modified to treat anxiety in children with ASD led to both reduced anxiety and improved social skills over the long term (one year after the treatment had ended). While previous studies had reported on the long-term outcome of anxiety disorder symptoms, no measures were taken for social skill improvement after CBT.

The findings in this new study also support previous findings which found significant posttreatment improvements for adolescents with ASD who participated in the Program for theEducation and Enrichment of Social Skills (PEERS), where parents assisted in the development of social skills by hosting group intervention classes.

Together, the studies contribute to the growing literature supporting CBT for youth with ASD and anxiety. The opportunity for adolescents to practice social skills with a therapist or in a group of other adolescents with ASD can reduce overall anxiety and social anxiety. When a child or adolescent with ASD is struggling with anxiety, it may feel like a hole they can never escape. Fortunately, CBT, backed by research and results, may be the light at the end of their tunnel.