Index

Note: Page numbers followed by “t” refer to tables.

A

Absence (AS), 19–20
Acceptance, 179–180
Acceptance and commitment therapy (ACT), 180
SMART implementation toolkit, 236
Agoraphobia, 6, 7–8, 41
Alexithymia, 79–81, 174–175
American Psychiatric Association (APA), 184, 211
Amygdala, 56–62, 62–65
function, 55–56
anxiety-based interventions, 146–147
in ASD, 8–10
behavioral treatments, 180
evidence-informed assessment of, 174–177
extant research in adults with ASD, 181–183
factors associated, 18–23
medical/pharmacological treatments, 184–186
mindfulness and acceptance, 179–180
next steps in research and practice, 187
prevalence and clinical presentation, 171–174
primary modifications to behavioral treatments for, 183–184
primary modifications to medical treatments of, 186–187
process, 177–178
targeting key mechanisms, 177
autonomic nervous system in, 65–69
CBT for, 127–136
challenges/recommendations for conducting group therapy, 150–164
cooccurrence, 2
multimethod assessment, 94–96
physiological component, 97
in schools, 213–218
clinical diagnosis and educational classification of ASD, 212–213
intervention development, implementation, and monitoring using IEP, 222–226
school-based assessment of anxiety, 218–221
in typically developing children, CBT for, 106
in youth with ASD, group therapy for, 147–150
Anxiety, Depression, and Mood Scale (ADAMS), 86
Anxiety Disorders Interview Schedule for DSM-IV, Child and Parent Versions (ADIS-IV-C/P), 37, 87, 108–109, 175
Anxiety Disorders Interview Schedule-Parent version (ADIS-P), 127–128
Anxiety management (AM), 181–182
Anxiety Scale for Children with ASD, Parent and Child versions (ASC-ASD), 81–85
Anxious avoidance, 94–95, 194–195
Applied Behavioral Analysis (ABA), 232
Asperger syndrome (AS), 5, 11, 181
Asperger’s disorder, See Asperger syndrome (AS)
Assessment of anxiety in youth with ASD
background, 79
case example, 96–98
clinical, 81
difficulty, 79–81
multimethod, 94–96
tools, 81–86
clinical interviews, 87–91
clinician-rated symptom measures, 91
direct observation, 91–92
physiological measures, 92–94
questionnaires/rating scales, 81–86, 82t, 88t
Autism Community Toolkit: Systems to Measure and Adopt Research-Based Treatments Implementation Toolkit (ACT SMART Implementation Toolkit), 238–245
Autism Comorbidity Interview—Present and Lifetime Version (ACI-PL), 87–90
Autism Quotient (AQ), 39–40
Autism spectrum disorder (ASD), 1, 5–6, 20, 33, 56–62, 79, 105, 123, 144, 171, 193, 211, 212–213, 213, 231–232
See also Anxiety, Behavioral treatments
anxiety symptomatology, 19
ASD-distinct anxiety, 33–34
ASD-idiosyncratic fears, 38–39
ASD-related anxiety symptomatology, 46
autonomic nervous system in, 65–69
CBT
for anxiety in, 127
clinical examples for anxiety, 133
clinical features for anxiety in children, 130
for core ASD symptoms, 135
estimating efficacy for children with, 111–112
for externalizing behavior in children with, 136
modifications for children with, 110, 112–115
challenges/recommendations for conducting group therapy, 150–164
community service systems, 236
group therapy for anxiety in youth with, 147–150
group treatment for youth with, 145–146
in schools, 213–218
clinical diagnosis and educational classification of ASD, 212–213
intervention development, implementation, and monitoring using IEP, 222–226
school-based assessment of anxiety, 218–221
symptoms, 135
treatment of anxious children with, 109–110
Autism Spectrum Disorders-Comorbidity for Children (ASD-CC), 85–86
Autistic disorder (AD), See Autism spectrum disorder (ASD)
Autonomic nervous system (ANS), 65–66
in anxiety, 65–69
in ASD, 65–69
findings, 55–56
Avoidance behavior, 196–197

B

Baby and Infant Screen for Children with aUtism Traits (BISCUIT), 86
Barlow and colleagues’ Unified Protocol, 179
Behavior monitoring, 200
Behavioral assessment, 197–198, 220–221
Behavioral avoidance test (BAT), 92, 200
Behavioral Interventions for Anxiety in Children with Autism (BIACA), 128, 130
manual’s modular format, 133
modules in program, 132–133
Behavioral interviews, 198
ACT SMART implementation toolkit, 238–245
adapted EPIS implementation framework with, 239t
implementation and sustainment strategies, 243t
adapted EPIS model of implementation, 236–238
framework with ACT SMART implementation toolkit, 239t
implementation science terms, 235t
developing effective anxiety interventions for youth, 233–234
evidence base in adults without ASD, 180
implementing existing anxiety interventions with youth, 234–236
research and routine care for anxiety in youth, 231–233
Brain
connectivity in ASD, 62–65
in context, 65–69

C

Caregiver anxiety and in child anxiety, 201–202
Caregivers, 34–35, 35, 35, 38
Child and Adolescent Psychiatric Assessment (CAPA), 90
Child and Adolescent Symptom Inventory-4R (CASI-4R), 85–86, 199–200
Child anxiety, caregiver anxiety and in, 201–202
Children’s Automatic Thoughts Scale (CATS), 45
Children’s Interview for Psychiatric Syndromes–Parent Version (P-ChIPS), 90
Children’s Yale-Brown Obsessive Compulsive Scale for Pervasive Developmental Disorders (CY-BOCS-PDD), 91, 172
Clinical Global Impressions-Improvement (CGI-I), 129
Clinical implications, 23
Clinical interviews, 87–91
Clinician Severity Ratings (CSRs), 149–150
Clinician-rated symptom measures, 91
Cognitive behavioral therapy (CBT), 105–106, 123–124, 144, 180, 183, 183–184, 202, 223, 231–232, 232
See also Autism spectrum disorder (ASD)
for anxiety, 127–136
in developing children, 106
for core autism symptoms, 127–136
EBT classification system, 126
efficacy estimation for children with ASD, 111–112
extant research for anxiety in youth, 138
frontline treatment for emotion dysregulation disorders, 124
method, 126–127
modification for children with ASD, 110, 112–115
RCTs of probably efficacious EBTs, 137t
treatment, 138
unproven treatments by parents and professionals, 125–126
Cognitive behavioral treatments, See Cognitive behavioral therapy (CBT)
Cognitive restructuring, 107, 123–124
Cognitive-behavioral principles
CBT for anxiety in developing children, 106
cognitive restructuring, 107
estimating efficacy of CBT for children, 111–112
exposure, 108–109
future directions and applications, 117–118
group therapy, 116–117
modifications of CBT for children, 112–115
modifying CBT for children, 110
options for treatment, 115–116
problem solving, 107–108
psychoeducation, 106–107
relaxation and somatic management, 107
treatment of anxious children, 109–110
Complementary and alternative medicine treatments (CAM treatments), 125
Conceptual considerations, 8
Coping strategies, 224–225
Core ASD symptomatology, 43–46
Core autism symptoms, 125
CBT for, 127–136
Cortisol, 93
Cues for Tension and Anxiety Survey Schedule (CTASS), 95–96

D

Developmental Behaviour Checklist (DBC), 86
Diagnostic and Statistical Manual (DSM), 1
DSM-5, 5, 25, 195, 212
DSM-IV, 5, 6
Diagnostic classification systems, 8–9
Diagnostic Interview Schedule for Children, Version IV (DISC-IV), 90
Diagnostic overshadowing, 79
Direct observation, 91–92
Dissemination, 234
Dissemination and implementation science (D&I science), 234

E

Electrocardiograph (ECG), 93
Electrodermal activity (EDA), 66
Emotion dysregulation, 123–124
CBT for, 124
Emotion learning perspective, 57
Emotion regulation (ER), 178–179
Emotions, 174–175, 178, 180
Error related potential (ERP), 93–94
Error-related negativity (ERN), 93–94
Etiology, 1–2, 3
Evidence base
in adults with ASD, 184–186, 185t
in adults without ASD, 180
practices, 2
psychosocial treatments, 2–3
Evidence-based interventions (EBIs), 231–232
Evidence-based treatment (EBT), 124
classification system, 126
Exploration, Preparation, Implementation, Sustainment (EPIS), 236–237
Exposure, 108–109
modification, 115–116
practice conducting in group context, 161

F

Facing Your Fears (FYF), 116–117, 144
Fear hierarchy, 115–116
Fear Survey for Children With and Without Mental Retardation (FSCMR), 85
Fear Survey Schedule for Children-Revised (FSSC-R), 85
Functional Assessment Interview (FAI), 96–97
Functional behavioral assessments (FBAs), 201, 220–221
Functional impairments, 1–2

G

Generalized anxiety disorder (GAD), 6–7, 18, 40, 172
Graduated exposure and reinforcement, 205–206
Group CBT
challenges/recommendations for conducting group therapy, 150–164
determining treatment focus, 146–147
group therapy for anxiety in youth, 147–150
group treatment for youth, 145–146
for anxiety in youth with ASD, 147–150
challenges/recommendations for conducting, 150–164

H

Heart rate (HR), 95–96
Heart rate variability (HRV), 67
vagal control, 68–69
High functioning autism (HFA), 11, 19–20, 85
High-functioning adolescents with ASD (HFASD), 215

I

Implementation science, 234
Individualized Education Program (IEP), 211, 218
intervention development, implementation, and monitoring using, 222–226
Informant rating scales, 85
Intellectual disability (ID), 7, 41, 202
International Classification of Disease, 10th Edition (ICD-10), 5
Intolerance of Uncertainty (IU), 43–44

L

Logistical considerations, 151
Long-term development, 3–4
Lower-functioning students with ASD (LFASD), 225

M

Medical/pharmacological treatments, 184–186
Methodological considerations, 8
Mindfulness, 179–180, 184
Mindfulness-and acceptance-based interventions (MABIs), 180
Mindfulness-based cognitive therapy (MBCT), 179–180
Mindfulness-based therapy (MBT), 182–183
Minimally verbal children with ASD
additional treatment components, 206
anxious avoidance, 194–195
behavioral
assessment, 197–198
interviews, 198
treatment, 202–204, 203t
caregiver anxiety and in child anxiety, 201–202
caregiver involvement, 206–207
diagnosis, 195–197
direct observation, 200–201
graduated exposure and reinforcement, 205–206
standardized rating forms, 199–200
Multidimensional Anxiety Scale for Children (MASC), 37–38, 81
Multimethod assessment of anxiety, 94–96
Multimodal Anxiety and Social Skills Intervention (MASSI), 146

N

Naturalistic observations, 200
Neurobiological mechanisms
See also Anxiety
amygdala, prefrontal cortex, and brain connectivity in ASD, 62–65
brain in context, 65–69
relationship between amygdala, anxiety, and ASD, 56–62
Neurodevelopmental disorders, 5–6
Nisonger Child Behaviour Rating Form (NCBRF), 86
“Normative” precipitants, 35

O

Obsessive compulsive disorder (OCD), 6, 41, 172, 196–197
One-Session Treatment (OST), 115

P

Panic, 41
Parasympathetic nervous system (PNS), 66, 67
Patient Protection and Affordable Care Act, 237
Pediatric Anxiety Rating Scale (PARS), 91, 129
Pervasive developmental disorder–not otherwise specified (PDD-NOS), 5, 212–213
Phenomenology and presentation of anxiety
See also Anxiety
anxiety around change, 50
anxiety/fears/worries associated, 43–46
factors associated with traditional, 46
findings
from qualitative studies, 34–35, 36t
from quantitative studies, 35–38, 36t
future directions and implications, 47–49
methodologies in studying, 33–34
separation and generalized anxiety, 49–50
shared and distinct anxiety presentations, 38–43
Phobia, 6
phobic avoidance, 202
social, 6–7, 7
specific, 6, 17, 38
Physical education (PE), 43
Physiological component of anxiety, 97
Physiological measures, 92–94
Posttraumatic stress disorder (PTSD), 6, 43
“PRECISE” mnemonic device, 113
Prefrontal cortex (PFC), 55–56, 62–65
Preschool Age Psychiatric Assessment (PAPA), 90
Present levels of performance (PLEP), 222
Prevalence of anxiety, 12t
anxiety, 6
in ASD, 8–10
factors associated, 18–23
ASD, 5–6
general population, 6–8
implications, 23–26
rates, 11–18, 15t
“Probably efficacious” treatments, 126
Psychoeducation, 106–107
Psychopathology, 10

Q

Qualitative studies, findings from, 34–35, 36t
Quantitative studies, 33–34, 36t
findings, 35–38
Questionnaires, 81–86, 82t

R

Randomized controlled trials (RCT), 126, 148, 180, 182–183
Rating scales, 81–86, 88t
Recruitment challenges, 151–152
Relaxation and somatic management, 107
Relaxation strategies, 224–225
Repetitive and/or restricted behaviors and interests (RRBIs), 86
Research implications, 24
Respiratory sinus arrhythmia (RSA), 93
Revised Child Anxiety and Depression Scale (RCADS), 81
Revised Children’s Manifest Anxiety Scale (RCMAS), 81–85

S

Schools, anxiety and ASD in, 211, 213–218
clinical diagnosis and educational classification of ASD, 212–213
intervention development, implementation, and monitoring using IEP, 222–226
school-based assessment of anxiety, 218–221
Screen for Child Anxiety Related Emotional Disorders (SCARED), 58–59, 81
“Self-help” groups, 143
Self-report questionnaires, 81
Semistructured interviews, 10
Separation anxiety, 40
Simple avoidance, 94–95, 194–195
Skin conductance, 66
Social anxiety, 39
Social anxiety disorder (SAD), 6, 17–18, 172
Social Anxiety Scale (SAS), 175
Social Anxiety Scale for Adolescents (SAS-A), 81–85
Social Anxiety Scale for Children revised (SASC-R), 81–85
Social Anxiety Scale for People with ASD (SASPA), 175
Social Communication Questionnaire (SCQ), 58–59
Social information processes, 55
Social phobia, 6–7, 7
Social Phobia and Anxiety Inventory (SPAI), 39–40
Social skills, 146–147
Social skills training groups (SST groups), 145
for children, 109–110
Social Worries Questionnaire (SWQ), 81–85
Specific anxiety disorders, 17
Specific fears, 38
Specific phobias, 6, 17, 38
Spence Children’s Anxiety Scale (SCAS), 81
SSRIs, 186
State-Trait Anxiety Inventory for Children (STAIC), 81–85
Stepping Stones Triple P (SSTP), 136
Stress, 216, 221
Stress Survey Schedule (SSS), 95–96, 96–97
Stressor-related disorders, 43
Subjective units of distress (SUDS), 108–109
Surveillance perspective, 56–57, 57
Sympathetic nervous system (SNS), 66
Symptom Check List (SCL), 175

T

Theory of Mind, 55, 69
“Thinking errors”, 46
“Traditional” anxiety, 33–34
triggers, 35
Trauma, 43
Treatment
See also Behavioral treatments
CAM, 125
CBT treatment, 138
exposure modification, 115–116
Treatment as usual (TAU), 109–110, 128–129, 149–150, 181–182

V

Ventral PFC, 63
Ventrolateral PFC (vlPFC), 63
Ventromedial PFC (vmPFC), 63

Y

Y-BOCS, 181–182
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