Interventions and Classroom use

There is a growing body of evidence to support the use of modified Cognitive Behavior Therapy (CBT) as an intervention for adolescences with Autism Spectrum Condition (ASC).  This is positive as modified CBT has been found to be useful in treatment of anxiety disorders in people with ASC (Ehrenreich-May et al 2014).  However there are also other interventions that may have similar positive effects for instance; Yoga and Art based interventions (Narasingharao, Pradhan, Naraneetham, 2017, Schweizer, Knorth, Spreen, 2014).  CBT, Yoga and Art therapies will be analyzed here.

Modified CBTs have been studied for teens with ASC with benefits found in a group of 20 teens (Ehrenreich-May et al., 2014). The program was run over 16 weeks with a 30 minute session for the child and 30 minute sessions with the parent.  The modules varied depending on participant needs however each participant started with basic coping strategies such as relaxing and positive self-talk.  The acronym KICK was also used (Knowing I am nervous, Icky thoughts, Calm thoughts, Keep practicing).  The trial found positive gains in improving the use of adaptive emotional regulation strategies in stressful situations.  Importantly these gains were maintained 1 month post intervention follow up.

An alternative intervention – Yoga Therapy – has also found to be effective in improving cognitive flexibility and the use of adaptive emotional regulation strategies (Narasingharao et al., 2017).  A trial of 64 children aged between 5 and 16 participated in a study of the benefits of Yoga Therapy for Sleep, digestive issues and behavioral problems in ASC youth.  32 participants completed 90 days of 75 minutes of yoga per day and 32 participants were used as a control.  The trial studied many aspects including anxiety and related behaviors. Pre and post intervention indicated a decrease from a mean score of just over 4 to a mean score of just over 1 for anxiety associated behaviors with a standard deviation, or spread of scores, remaining similar.  This indicates that self-harm and internalizing anxiety behaviors decreased substantially at a consistent rate across the group.  The control group showed no improvement.  Importantly, after this trial at the same school, teachers were trained to implement the program in the classroom and similar gains were also noted with the wider school group. 

The evidence for Art therapy is more qualitative than quantitative.  A literature review of evidence of art therapy effectiveness, summarized 18 studies of a variety of research techniques including case studies (Schweizer et al., 2014).  These studies were specific to ASC youth less than 18 years of age.  The review identified multiple overlapping and positive outcomes for emotional regulation. 5 of the studies looked at specifically at anxiety and all studies addressed social communication problems.  The benefits included cognitive flexibility improvements, improved emotional regulation, improved relaxation ability and a decrease in anxiety and anger. 

Classroom Use

CBT, yoga and art therapy can all be seen to improve the use of adaptive emotional regulation, thus these techniques can be used within the classroom in a variety of ways.  For instance, CBT requires practicing of coping strategies including relaxation, Yoga and Art therapies were both found to relax students.  Additionally given that there are three techniques reviewed here, it is possible to choose a selection of techniques dependent on your class.  For those who want to take a proactive approach, incorporating 10 minutes of Yoga, art or CBT practice may be a beneficial way to start lessons allowing all students to be in a calm spot before starting the lesson.

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