Self-Directed Parent Education Program to Reduce Anxiety in Children with Autism

In this study, we aim to screen 3-7 year-old children who have been diagnosed with autism for symptoms of anxiety and then offer online, self-guided parent education programs to parents of those who score high. We want to see whether the education programs can improve parents’ understanding of anxiety and teach parents ways to help their children cope with anxiety.

You may be able to participate if: (1) you are the parent of a 3-7 year old with who has been diagnosed with an Autism Spectrum Disorder; (2) your child has basic language skills; (3) you are able to complete interviews and questionnaires in English; (4) you have reliable access to a working computer, tablet, or cellphone; (5) you live in Massachusetts

You may not be able to participate if: (1) your child has certain kinds of serious developmental delays; (2) your child has received cognitive-behavioral therapy for anxiety or is taking medication for anxiety; (3) your child has clinical levels of depression or aggressive or oppositional behavior.

Parents will be asked to complete an online questionnaire about anxious behaviors and worries that are common in young children. This questionnaire should take about 5 minutes. Parents whose children score high on the initial survey will be invited to take part in a more detailed assessment, consisting of online questionnaires about your child’s behaviors, your own responses to the child’s anxiety, and your personal and family stress. You will also take part in a 30-minute telephone interview with a study psychologist about your child’s anxiety symptoms and any treatments your child is receiving.

After these steps are completed, you will receive a feedback call in which one of our study psychologists will review your results and let you know whether you are eligible to participate in the study. If eligible, you will be randomly (by chance) assigned to one of three conditions during the feedback call. If you are assigned to one of the educational programs, you will get online access to it right away. At 1- and 4-months after baseline, you will repeat the online questionnaires, and at the 4-month mark, you will also repeat the phone interview. Parents in the two active (non-control) conditions will repeat the questionnaires and phone interview again 8 months after baseline.

At the 4-month follow-up, parents who were initially assigned to the control condition will have the option to be re-randomized to one of the two active (non-control) educational conditions, with equal chances of being assigned to either program. Parents who are re-assigned will repeat online questionnaires 1- and 4-months after being assigned to the new program, as well as the phone interview at 4 months.

Anxiety is very common in children with autism, with 40–80% meeting the criteria for a diagnosis. High anxiety can cause distress and can also interfere with school, friendships, and family life. It can also make it harder for children to learn social and daily living skills. Effective treatments for anxiety disorders have been developed, including family-based cognitive-behavioral therapy, and this approach has been piloted in those with autism. However, there is often a delay between onset of anxiety symptoms and proper diagnosis and treatment. Young children often do not receive treatment for anxiety because pediatricians, parents, and teachers do not realize that family-based cognitive-behavioral treatment can benefit them and because there is a shortage of providers trained to provide mental health care to young children. One way to provide anxiety management skills to young autistic children, and to potentially promote better functioning, is to offer online and self-guided educational programs that parents can complete without a clinician. Because the programs we are testing are brief and easy-to-use, they could be easily implemented routinely to improve and streamline early access to mental health care for anxiety in young autistic children.