Measuring anxiety as a treatment endpoint in youth with autism spectrum disorder.
Only four anxiety scales are trial-ready for youth with autism, and each needs careful tweaks.
01Research in Context
What this study did
A panel of autism and anxiety experts hunted for anxiety tests that work in autism drug trials.
They screened every youth anxiety measure ever used with autistic kids.
Only four tools made the short list, and each came with strict rules.
What they found
The SCARED, MASC, ADIS, and CASI passed, but only if you tweak wording or skip items.
Every other checklist fell short—too many false positives or missed signs.
Bottom line: we still need better yardsticks for anxiety in autism.
Bottom line: we still need better yardsticks for anxiety in autism.
How this fits with other research
Laugeson et al. (2014) showed CBT can cut anxiety in high-functioning autistic youth, yet they used the same shaky measures Luc’s panel now limits.
Symons (2019) hunted for brain signals of anxiety in autism and also came up empty—no consistent heart-rate or EEG pattern—echoing Luc’s call for tighter tools.
Hudson et al. (2012) warned that few autism meds have solid proof; Luc adds that without sound anxiety endpoints, those drug studies stay weak.
Why it matters
Before you pick an anxiety measure for an autistic client, open Luc’s paper.
Check if your tool is one of the four, apply the listed tweaks, and note the gaps.
Share the list with your team so everyone uses the same, trial-ready yardstick and stops over-pathologizing typical autism cues.
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02At a glance
03Original abstract
Despite the high rate of anxiety in individuals with autism spectrum disorder (ASD), measuring anxiety in ASD is fraught with uncertainty. This is due, in part, to incomplete consensus on the manifestations of anxiety in this population. Autism Speaks assembled a panel of experts to conduct a systematic review of available measures for anxiety in youth with ASD. To complete the review, the panel held monthly conference calls and two face-to-face meetings over a fourteen-month period. Thirty eight published studies were reviewed and ten assessment measures were examined: four were deemed appropriate for use in clinical trials, although with conditions; three were judged to be potentially appropriate, while three were considered not useful for clinical trials assessing anxiety. Despite recent advances, additional relevant, reliable and valid outcome measures are needed to evaluate treatments for anxiety in ASD.
Journal of autism and developmental disorders, 2014 · doi:10.1007/s10803-013-1974-9