A systematic review of treatments for anxiety in youth with autism spectrum disorders.

Laugeson et al. (2014) hunted every paper that tried to calm anxiety in autistic kids. They kept only high-quality trials: CBT, pills, or both. The final count was 14 studies with kids who had strong talking skills.

They graded each study’s size and length. Most drug trials were tiny and lasted weeks. The CBT trials were larger and ran for months.

CBT cut anxiety scores by a medium amount in 7 out of 9 trials. The gains stayed for up to six months.

Medication looked shaky. Only open-label studies existed—no blind tests. Effect sizes were small and faded fast.

Lecavalier et al. (2014) looked at the same kids the same year. They found only four anxiety scales are fit for autism trials. Their warning: weak tools can hide real change. A et al. used those same four tools, so the CBT win looks solid.

Brondino et al. (2016) scanned GABA drugs for autism. They also saw thin, short studies. Their verdict matches A et al.: pills need tougher tests before we trust them.

Yorke et al. (2018) flipped the camera toward parents. When a child’s anxiety drops, parent stress drops too. CBT for the kid may give you a two-for-one benefit.

You can tell funders and families that CBT has real data behind it for verbal autistic youth. Use the four approved anxiety scales to track progress. Keep pills as a last resort while we wait for better trials. Start with a 12-week CBT package and measure before and after—evidence says it’s worth your time.