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Just some points from our chat in class. Keep the details on the table brief and use my points to further develop your discussion/implementation sections.

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P children and YP with ASD
I CBT
C standard care or usual care
O anxiety levels

Search string: child* OR young person OR adolescen* AND "Cognitive behavioural Therapy"....and so on...

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What is presented is not as clear

Just an example:

Does CBT improve anxiety in children with ASD?

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Evidence based Nursing Assessment and Guidelines

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Strengths
Randomly assigned
ITT, Follow up completed
3 month follow up included after the CBT intervention had ceased
Computerised randomisation and Therapist and Principal investigator blinded
Exclusion criteria included.
Cool kids intervention more cost effective

Weaknesses
Small sample size
Danish not first language?
Small sample group
Low percentage of candidates followed through with treatment to completion- including post treatment questionnaire.
Little variation between candidates.
No control group used- making blinding impossible.
Not all results clinically significant.
Language barrier

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Strengths
Randomly assigned
ITT
Clear focus

Substantial patient sample group

Mixture of ethnicities between participants
Randomisation by external body
Positive response to CBT- clinical significance
Used intention to treat
Blinding- Research individuals

Weaknesses
Selection bias?
Attrition?
Duration of CBT sessions
CBT which yielded best results requires specific professional training- not easily accessible.
Heterogeneous- few females
Duration of CBT differ between interventions.
Financial incentive to join $75, resulting in potential bias  13% drop out rate.
No follow up after intervention ceased.

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PUBMED
RCT (LEVEL 2)
Search term- Behavioural therapy AND children autism AND anxiety - 382 results
Narrowing to 5 years- 177 results
Free full text- 89 results
RCT- 14 results

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Group Based Cognitive Behavioural Therapy for Anxiety in Children with Autism Spectrum Disorder: A Randomised Controlled Trial in a General Child Psychiatric Hospital Setting - PubMed

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Cognitive Behavioural Therapy (CBT) programs adapted to children with Autism Spectrum Disorder (ASD) effectively reduce anxiety when run in university clinics. Forty-nine children aged 8-14 years participated in a waitlist controlled study in a general child psychiatric hospital setting. Post-treatm…

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PUBMED
search term- Children and Autism and Cognitive Behavioural Therapy
622 RESULTS
2017 onward- 311
Free full text- 145
RCT- 21 (LEVEL 2)
RCT and SReview- 28

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https://pubmed.ncbi.nlm.nih.gov/31755906/

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Affiliations

¹ Department of Education, University of California, Los Angeles, Los Angeles.

² Department of Psychiatry, University of California, Los Angeles, Los Angeles.

³ Department of Psychology, Temple University, Philadelphia, Pennsylvania.

⁴ Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada.

⁵ University of South Florida School of Aging Studies, Tampa.

⁶ Departments of Pediatrics and Psychiatry, University of South Florida, Tampa.

⁷ Baylor College of Medicine, Houston, Texas.

Free PMC article

Randomized Controlled Trial

Free PMC article

Affiliations

¹ Department of Education, University of California, Los Angeles, Los Angeles.

² Department of Psychiatry, University of California, Los Angeles, Los Angeles.

³ Department of Psychology, Temple University, Philadelphia, Pennsylvania.

⁴ Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada.

⁵ University of South Florida School of Aging Studies, Tampa.

⁶ Departments of Pediatrics and Psychiatry, University of South Florida, Tampa.

⁷ Baylor College of Medicine, Houston, Texas.

Abstract

Importance: Anxiety is common among youth with autism spectrum disorder (ASD), often interfering with adaptive functioning. Psychological therapies are commonly used to treat school-aged youth with ASD; their efficacy has not been established.

Objective: To compare the relative efficacy of 2 cognitive behavioral therapy (CBT) programs and treatment as usual (TAU) to assess treatment outcomes on maladaptive and interfering anxiety in children with ASD. The secondary objectives were to assess treatment outcomes on positive response, ASD symptom severity, and anxiety-associated adaptive functioning.

Design, setting, and participants: This randomized clinical trial began recruitment in April 2014 at 3 universities in US cities. A volunteer sample of children (7-13 years) with ASD and maladaptive and interfering anxiety was randomized to standard-of-practice CBT, CBT adapted for ASD, or TAU. Independent evaluators were blinded to groupings. Data were collected through January 2017 and analyzed from December 2018 to February 2019.

Interventions: The main features of standard-of-practice CBT were affect recognition, reappraisal, modeling/rehearsal, in vivo exposure tasks, and reinforcement. The CBT intervention adapted for ASD was similar but also addressed social communication and self-regulation challenges with perspective-taking training and behavior-analytic techniques.

Main outcomes and measures: The primary outcome measure per a priori hypotheses was the Pediatric Anxiety Rating Scale. Secondary outcomes included treatment response on the Clinical Global Impressions-Improvement scale and checklist measures.

Results: Of 214 children initially enrolled, 167 were randomized, 145 completed treatment, and 22 discontinued participation. Those who were not randomized failed to meet eligibility criteria (eg, confirmed ASD). There was no significant difference in discontinuation rates across conditions. Randomized children had a mean (SD) age of 9.9 (1.8) years; 34 were female (20.5%). The CBT program adapted for ASD outperformed standard-of-practice CBT (mean [SD] Pediatric Anxiety Rating Scale score, 2.13 [0.91] [95% CI, 1.91-2.36] vs 2.43 [0.70] [95% CI, 2.25-2.62]; P = .04) and TAU (2.93 [0.59] [95% CI, 2.63-3.22]; P < .001). The CBT adapted for ASD also outperformed standard-of-practice CBT and TAU on parent-reported scales of internalizing symptoms (estimated group mean differences: adapted vs standard-of-practice CBT, -0.097 [95% CI, -0.172 to -0.023], P = .01; adapted CBT vs TAU, -0.126 [95% CI, -0.243 to -0.010]; P = .04), ASD-associated social-communication symptoms (estimated group mean difference: adapted vs standard-of-practice CBT, -0.115 [95% CI, -0223 to -0.007]; P = .04; adapted CBT vs TAU: -0.235 [95% CI,-0.406 to -0.065]; P = .01); and anxiety-associated social functioning (estimated group mean difference: adapted vs standard-of-practice CBT, -0.160 [95% CI, -0.307 to -0.013]; P = .04; adapted CBT vs TAU: -0.284 [95% CI, -0.515 to -0.053]; P = .02). Both CBT conditions achieved higher rates of positive treatment response than TAU (BIACA, 61 of 66 [92.4%]; Coping Cat, 47 of 58 [81.0%]; TAU, 2 of 18 [11.1%]; P < .001 for each comparison).

Conclusions and relevance: In this study, CBT was efficacious for children with ASD and interfering anxiety, and an adapted CBT approach showed additional advantages. It is recommended that clinicians providing psychological treatments to school-aged children with ASD consider developing CBT expertise.

Trial registration: ClinicalTrials.gov identifier: NCT02028247.

Conflict of interest statement

Conflict of Interest Disclosures: Dr J. Wood reported grants from National Institute of Child Health and Human Development and National Institute of Mental Health during the conduct of the study. Dr Kendall reported receiving royalties, and his spouse has income from the sales of publications of materials about the treatment of anxiety disorders in youth. Dr Kerns reported receiving honoraria for presenting on her research on anxiety and autism, as well as consultation fees for training staff at other research sites in anxiety and autism assessment, outside the submitted work. Dr Storch reported personal fees from Levo Therapeutics, Elsevier, Wiley, the American Psychological Association, Springer, and Oxford and grants from Red Cross, ReBuild Texas, the National Institutes of Health, and Texas Higher Education Coordinating Board outside the submitted work. No other disclosures were reported.

A Systematic Review of Mental Health Interventions for ASD: Characterizing Interventions, Intervention Adaptations, and Implementation Outcomes.

Dickson KS, Lind T, Jobin A, Kinnear M, Lok H, Brookman-Frazee L. Dickson KS, et al. Adm Policy Ment Health. 2021 Sep;48(5):857-883. doi: 10.1007/s10488-021-01133-7. Epub 2021 Apr 21. Adm Policy Ment Health. 2021. PMID: 33884535

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autism spectrum disorder / complications

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national center for biotechnology information

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Cognitive Behavioral Treatments for Anxiety in Children With Autism Spectrum Disorder: A Randomized Clinical Trial - PubMed

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1 Department of Education, University of California, Los Angeles, Los Angeles. 2 Department of Psychiatry, University of California, Los Angeles, Los Angeles. 3 Department of Psychology, Temple University, Philadelphia, Pennsylvania. 4 Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada. 5 University of South Florida School of Aging Studies, Tampa.

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Types of evidence
Cross sectional study
Randomised control trial
Systematic Reviews

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Search terms
P- Children AND autism (ASD), young people AND autism (ASD), child,
I- CBT, Cognitive Behavioural Therapy, Behavioural therapy, talking therapy,
C- Leave blank
O- anxiety levels, anxiety, social anxiety, social functioning

Boolean
children AND autism AND cbt
autism AND CBT
Children OR young people AND autism
Children OR Young people AND cbt
Children OR young people AND cbt or talking therapy AND anxiety

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PICO question
P- Children on Autism spectrum
I- CBT
C- Standard Care (No intervention)
O- Anxiety Levels