Cognitive Behaviour Therapy for a Child with Autism Spectrum Disorder and Verbal Impairment: A Case Study

The current case study describes the implementation of a number of modifications made to traditional cognitive behavioural therapy (CBT) to address anxiety in a child with autism spectrum disorder (ASD), aggressive behaviour, and mild intellectual impairment. Cognitive behavioural therapy (CBT) is the primary psychosocial therapy for the treatment of mood and anxiety disorders in typically developing children and those with ASD who have at least average intelligence quotient (IQ); however, less work has discussed how to address the needs of youth with ASD and cognitive impairments. The purpose of the present case study is to describe the use of modifications to the Coping Cat program (Kendall & Hedtke, 2006) in the treatment of anxiety of a 9-year-old boy, Chris. Chris participated in a modified group therapy with a substantial individual therapy component, due to behavioural and language difficulties. Modifications included visual aids as the primary method of treatment delivery, inclusion of special interests, physical play activities, and parental involvement. A number of qualitative treatment gains were noted in session; however, quantitative data did not support these gains. Limitations of the CBT group intervention and the need for tailoring supports to meet the cognitive needs of children with ASD, aggressive behaviour, and intellectual impairment are discussed.