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Objectives <p>Autistic children with intellectual disability (ID) are at elevated risk for anxiety, yet cognitive behavioral therapy (CBT) programs are infrequently adapted for this population. This study provides a preliminary examination if the <i>Building Confidence</i> program can be adapted for an autistic child with limited verbal ability and co-occurring anxiety. A secondary aim was to assess program feasibility for the family and the impact of the treatment adaptations.</p> Methods <p>This study employed a single-case AB design with multiple concurrently measured target behaviors with an 11-year-old autistic boy with intellectual disability. Treatment consisted of 16 bi-weekly CBT sessions with autism-informed adaptations, including visual supports, simplified cognitive strategies, and preferred interests. Anxiety-related behaviors were assessed across baseline and intervention phases using individualized parent ratings on the Youth Top Problems (YTP) scale and the Anxiety Disorders Interview Schedule (ADIS).</p> Results <p>Visual inspection and statistical analysis suggested a reduction in anxiety-related behaviors during the intervention phase (YTP1 <i>d</i> = 1.72, YTP2 <i>d</i> = 1.63, YTP3 <i>d</i> = 3.24). However, given the AB design with multiple concurrently measured target behaviors, a brief baseline phase, and a single participant, the findings should be interpreted as preliminary and descriptive rather than as demonstrating a functional relation between the intervention and outcomes.</p> Conclusions <p>This preliminary case study suggests that CBT may be feasibly adapted for autistic youth with intellectual disability using developmentally tailored supports such as visual aids, simplified coping strategies, and preferred interests.</p>

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Brief Report: Adapting Cognitive Behavioral Therapy for Anxiety in an Autistic Child with Intellectual Disability—A Single-Case AB-Design Study

  • 期刊论文

  • 发表日期：

    2026年6月27日

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  • John T. Danial,
  • Hilary P. Wu,
  • Karen S. Wood

摘要

Objectives

Autistic children with intellectual disability (ID) are at elevated risk for anxiety, yet cognitive behavioral therapy (CBT) programs are infrequently adapted for this population. This study provides a preliminary examination if the Building Confidence program can be adapted for an autistic child with limited verbal ability and co-occurring anxiety. A secondary aim was to assess program feasibility for the family and the impact of the treatment adaptations.

Methods

This study employed a single-case AB design with multiple concurrently measured target behaviors with an 11-year-old autistic boy with intellectual disability. Treatment consisted of 16 bi-weekly CBT sessions with autism-informed adaptations, including visual supports, simplified cognitive strategies, and preferred interests. Anxiety-related behaviors were assessed across baseline and intervention phases using individualized parent ratings on the Youth Top Problems (YTP) scale and the Anxiety Disorders Interview Schedule (ADIS).

Results

Visual inspection and statistical analysis suggested a reduction in anxiety-related behaviors during the intervention phase (YTP1 d = 1.72, YTP2 d = 1.63, YTP3 d = 3.24). However, given the AB design with multiple concurrently measured target behaviors, a brief baseline phase, and a single participant, the findings should be interpreted as preliminary and descriptive rather than as demonstrating a functional relation between the intervention and outcomes.

Conclusions

This preliminary case study suggests that CBT may be feasibly adapted for autistic youth with intellectual disability using developmentally tailored supports such as visual aids, simplified coping strategies, and preferred interests.