Proof of Principle:  A Modified CBT Curriculum for Young Autistic Children

Background Cognitive behavioral therapy (CBT) has been successfully applied to treat internalizing disorders in school-aged autistic children, but few studies have tested CBT in real-world settings with broader samples of autistic clients and notably in young 4–6 year old children. Further examination of CBT in these contexts is needed given the importance of early intervention for autistic children. Methods To establish proof of principle, we evaluated the effectiveness of a CBT-based curriculum in reducing externalizing and internalizing behaviors and psychiatric symptoms among participants in a day-treatment program using a quasi-experimental design. Children ages 4–6 participated in the day treatment program for 30 hours per week over 12 weeks, with a focus on behavior modification. The study compared children who attended the program before the CBT-based curriculum was implemented with those who received the curriculum after its implementation. Results Children (n = 25) who participated in the CBT curriculum demonstrated significantly greater improvement in internalizing behaviors ( F (2, 47) = 4.87, p < .05, ηp² = .094) and anxiety ( F (2, 47) = 7.19, p  = .01, ηp² = .133) compared to children who received standard treatment (n = 25). No significant differences were found for depressive symptoms. Discussion These findings are promising for the value of incorporating CBT practices into existing preschool aged therapeutic settings. Our results support the practical benefit of targeting internalizing behaviors, with explicit impacts on anxiety but less evidence on depression.