Evidence-based Classroom Strategies for Reducing Anxiety in Primary Aged Children with High-functioning Autism

Abstract

This paper systematically reviews research on evidence-based intervention strategies for reducing anxiety in primary age children with High-functioning Autism (HFA) and Asperger Syndrome (AS). Systematic searches of electronic databases, journals, and reference lists identified 20 studies meeting the inclusion criteria. Interventions were sorted under the following categories: Environment and context, Social life and interaction, and Cognition. Results show that a preventative, multi-faceted approach is recommended with interventions that both directly and indirectly reduce anxiety. Interventions must address the Autistic Spectrum Disorder (ASD) characteristics that underlie the visible behaviour. Environmental and context interventions supports are recommended. Modified Cognitive Behaviour Therapy (CBT) and Functional Behaviour Analysis-Applied Behaviour Analysis (FBA/ABA) are the most researched direct interventions with a strong evidence base resulting in largely positive results. There is some promise for computer assisted CBT. Social skills taught by using social stories, video self-modelling and comic strip conversations have a fair evidence base, with a limited amount of research and mixed results. Recommendations are that interventions need to be driven by the assessment of each individual child and use a combination of the recommended strategies. Modified CBT is to be used, if possible, with FBA, ABA, and preventative environmental and context strategies to address the social deficits of ASD. An example of a checklist of strategies is proposed for use in school/home settings.