An Exploratory Analysis of Child Characteristics Predicting Clinical Outcomes in Parent-Led Cognitive Behavioral Teletherapy for Anxiety in Autistic Children

Parent-led cognitive behavioral therapy (CBT) is an efficient, promising form of therapy that may be well suited for autistic youth with anxiety disorders. A recent clinical trial found that parent-led CBT - in which parents led their child through a guided CBT workbook with varying degrees of therapist support - was efficacious for reducing anxiety and associated functional impairment. While such findings demonstrate promise for future intervention development and dissemination efforts with this population, more work is needed to elucidate clinical factors that impact response to treatment as well as drop-out. Using data from the aforementioned clinical trial (N = 87), the present exploratory study examined pre-treatment patient characteristics, including family accommodation (FA), anxiety severity, autism features, and externalizing psychopathology, and their relationship with relevant treatment outcomes (i.e., anxiety severity and functional impairment) at both post-treatment and three-month follow-up and drop-out/completer status. Our findings did not reveal any consistent relations between pre-treatment patient characteristics and clinical outcomes, with several isolated exceptions: (a) baseline autism features were associated with greater post-treatment functional impairment; (b) non-male (vs. male) gender was associated with greater functional impairment at 3-month follow-up; and (c) Hispanic ethnicity (vs. non-Hispanic) was associated with greater likelihood of premature treatment drop-out. Findings are discussed in the context of the importance of continuing to elucidate unique patient characteristics predictive of optimal clinical outcomes for autistic youth with anxiety disorders.