Autism Spectrum Disorder, Obsessive-Compulsive Behavior
Conditions
Keywords
Cognitive Behavioral Therapy
Brief summary
Individuals with high functioning autism spectrum disorder (ASD) frequently experience obsessions and/or compulsions that are similar to those specified in Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for obsessive compulsive disorder (OCD). However, little research exists on effective interventions for OCD symptoms (referred to as OCBs) in ASD. In a randomized controlled trial, a manualized functional behavior-based cognitive-behavior therapy (Fb-CBT) consisting of traditional CBT components (psychoeducation and mapping, cognitive-behavioral skills training, exposure, and response prevention) as well as function-based behavioral assessment will be evaluated. Participants will be assigned randomly to Fb-CBT or treatment as usual (TAU). Primary and secondary outcome measures will be used to evaluate the efficacy of the treatment, and will be administered at pre and post-intervention as well as six month follow-up.
Interventions
BEHAVIORALFunctional Behavior-Based Cognitive Behavioral Therapy
Fb-CBT involved nine 2-hour weekly sessions with three to four children in each group and two therapists. Therapy consisted of group activities, individual work in parent-child dyads, group parent training, and social skills exercises.
Sponsors
Ontario Mental Health Foundation
Ontario Ministry of Health and Long Term Care
Tricia Vause
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
7 Years to 13 Years
Healthy volunteers
No
Inclusion criteria
* Previous diagnosis of ASD * Presence of OCBs as defined by Sameness, Ritualistic and Compulsive subscales on the RBS-R * a Full Scale IQ (WISC-IV; Wechsler, 2004) ≥ 70 * parent indicated no planned change in child medication during the study (unless the physician deemed the change medically necessary)
Exclusion criteria
* participation in treatment for anxiety * participation in treatment for repetitive behaviour * participation in treatment for intensive behavioural intervention
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Repetitive Behavior Scale (RBS_SCR) | Assessment occurred at baseline and 2 weeks following end of treatment, as well as at follow-up (6 months following the cessation of treatment) | The RBS is a 43-item parent rating measure of repetitive behavior. It is comprised of a four-point Likert scale ranging from (0) behavior does not occur, to (3) behavior occurs and is a severe problem . The RBS\_SCR scale specifically focusses on the assessment of sameness, compulsive, and ritualistic behaviors |
| Change in Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) | Assessment occurred at baseline and 2 weeks following end of treatment | A 10-item, semi-structured interview used to assess symptom severity for children ages 6 through 17 years. Each item is rated on a 5-point ordinal scale from 0 (none) to 4 (extreme)' For the purpose of this study, only the 5-item Compulsion score was used pre and post-treatment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Repetitive Behavior Scale 100 (RBS_100) | Assessment occurred at baseline and 2 weeks following the end of treatment, as well as at follow-up (6 months following the cessation of treatment) | The final item on the RBS-R asks caregivers to rate on a scale from 1 to 100 how much OCBs affect the child and the people around them (1 is not a problem to 100 is as bad as can be imagined; Bodfish et al., 1999). |
| Change in The child Obsessive-Compulsive Impact Scale-Revised (COIS-R) | Assessment occurred at baseline and 2-weeks following the end of treatment, as well as at follow-up (6 months following the cessation of treatment) | A 33-item, parent-report questionnaire that assesses OCD-related impairment in various areas of the child's life, including school, social, and home/family activities. For each item, the parent rates the child's level of impairment on a 4-point Likert scale from 0 (not at all) to 3 (very much). |
| Parent OCB Rating Scale. | Scale was completed by parents at baseline, each day throughout the 9-week treatment period, and at follow-up (6 months following the cessation of treatment) | A Likert-type scale ranging from 1 (desired post-treatment levels of OCBs) to 3 (partial improvement from pre-treatment levels) to 5 (pre-treatment levels of OCBs) was used by parents to rate OCBs. |
Countries
Canada
Outcome results
None listed