2 - (SYM 20) Feasibility and Preliminary Efficacy of a Mechanistic Intervention for Anxiety in Young Autistic Children

Background

In autistic children, anxiety often begins in early childhood, i.e., < 7 years, and causes lifelong impairment. Yet, few studies have examined anxiety treatments for this group. Additionally, no studies have examined if targeting mechanistic factors that maintain anxiety, i.e., intolerance of uncertainty (IU) and parental accommodation (PA), enhances treatment response. More work is urgently needed to trial new interventions targeting anxiety, IU, and PA in young autistic children.

Objective

To present feasibility and preliminary efficacy data of a novel anxiety intervention, DINO Strategies for Anxiety and Intolerance of Uncertainty Reduction (DINOSAUR), in young autistic children with anxiety.

Methods

This randomized, controlled trial examines the feasibility of DINOSAUR, a manualized 14-week online intervention for parents and children that utilizes cognitive-behavioral strategies to target anxiety, IU, and PA. Participants include autistic children, 48 to 83 months, with moderately delayed to above average expressive language skills and their parents. Parent-child dyads are randomized to the intervention or an active control condition. Feasibility is assessed using retention and attendance rates and parental and child satisfaction ratings. Preliminary efficacy is assessed using the 1) Anxiety Disorder Interview Schedule-Autism Spectrum Addendum, collected pre/post-treatment, and 2) the Response to Uncertainty and Low Environmental Structure (RULES) scale and 3) the Family Accommodation Scale – Anxiety (FASA), collected pre/post-treatment and at 4-month follow-up.

Results

Data collection began in October 2023. We anticipate that 12 parent-child dyads will have completed post-treatment assessments by November 2024. This data will be presented with data obtained from a previous single-arm, pilot trial (n=14; 43% from traditionally underrepresented racial or ethnic groups). Results from this previous trial indicated low attrition (16%), high attendance (96% of sessions), and high parent satisfaction (1-5 Likert scale; M=4.3, SD=.86). Qualitative data of parents’ perceptions and response to the intervention, including elements targeting IU and PA, also support feasibility. Nine out of 11 participants completing the intervention demonstrated a reduction in ADIS/ASA primary anxiety disorder severity, suggesting the potential for treatment efficacy.

Conclusion

Preliminary data suggest that a mechanistic intervention for anxiety is feasible for young autistic children and their parents.