Attention-Based Cognitive Behavioral Treatments Show Uneven Results for Children with ASD

September 12, 2022

Therapies Reduced Temper Tantrums and Arguing but Failed to Stop Aggression

Problems with aggressive behavior occur in 25% to 68% of children and adolescents with autism. Recent evidence suggests that treatments that focus on the awareness of anger could be an effective way to treat this aggressive behavior. A new study has investigated the effectiveness of a treatment strategy that combines dialectical behavior therapy (DBT) and mindfulness-based cognitive therapy (MBCT) to stop aggression and increase adaptive anger coping strategies in children with autism. DBT specifically focuses on shifting and controlling attention, while MBCT focuses on skills that raise awareness of children’s aggression and the use of anger coping strategies. This research included 51 children (ages 8-13) at two child mental health treatment centers in the Netherlands. The children in this study had average IQ levels. The participants were split into two groups, an intervention group, and a control group. The intervention group received the MBCT and DBT anger control treatments, and their parents were given psychoeducation sessions. The control group received parental psychoeducation sessions only. At the end of the study, the intervention group showed a reduction in temper tantrums and arguing, but not in destroying things and physical violence. The children in the intervention group saw their temper tantrums decrease in frequency and intensity but not in duration. Parents observed these outcomes, but the children’s teachers did not notice a difference in behavior. The treatment improved coping strategies in the intervention group by boosting adaptive anger coping strategies diffusion and social support-seeking behaviors. However, the treatment did not improve maladaptive strategies of direct anger-out and avoidance behaviors. The children in the intervention group did not self-report improvements in their use of anger coping strategies. Unfortunately, the treatment did not affect secondary outcomes, including Quality of Life, parental stress, and subjective well-being. These results disappointed the research team, who now wonder if extending the treatment program with more sessions with the child, parents, siblings, and teachers could create a better response to DBT and MBCT. 

Original Study

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