Acceptability and caregiver-reported outcomes for young children with autism spectrum disorder whose parents attended a preventative population-based intervention for anxiety: A pilot study.
Six parent-only evenings slashed anxiety disorders in preschoolers with ASD from 77 % to 25 % over two years.
01Research in Context
What this study did
Researchers ran a small randomized trial of Cool Little Kids, a six-session parent group that teaches anxiety-prevention skills. Parents of preschoolers with autism attended weekly meetings in their community.
The team tracked anxiety diagnoses and separation-anxiety symptoms for two years after the classes ended.
What they found
Kids whose parents took the course were far less likely to have an anxiety disorder two years later. The rate dropped from 77 % to 25 %.
Separation-anxiety symptoms also fell sharply compared with the control group.
How this fits with other research
Perihan et al. (2020) looked at 23 child-focused CBT studies and saw moderate anxiety relief, but the gains were bigger when parents joined the sessions. Stephens et al. (2018) flips the focus: train only the parents of very young kids and you still get large, lasting cuts in anxiety.
Yu et al. (2019) and Li et al. (2023) both report that parent-only programs improve caregiver stress and mood. Cool Little Kids adds child-level diagnostic change to that list, showing the kids themselves benefit, not just the parents.
Tonge et al. (2014) tried 20 weeks of parent education plus behavior training for low-functioning preschoolers and saw gains in adaptive skills. Stephens et al. (2018) shows that a shorter, anxiety-targeted parent group can work for a different outcome in the same age band.
Why it matters
You can run a brief, low-cost parent group before anxiety takes hold. Six evenings in a church hall or clinic classroom cut later anxiety disorders by two-thirds. If you serve preschoolers with ASD, add Cool Little Kids to your preventive toolkit or refer families to community mental health teams already trained in the manual.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Email your local early-childhood mental health team and ask if they offer Cool Little Kids; if they do, hand parents the flyer at intake.
02At a glance
03Original abstract
This pilot study explored acceptability to parents and outcomes for children of a preventive intervention for anxiety problems in pre-schoolers with autism spectrum disorder (ASD) who were an identified sub-group within a population-based randomised trial of the Cool Little Kids parenting group programme. The population trial included 545 temperamentally inhibited pre-schoolers recruited across eight economically diverse areas of Melbourne, Australia. Within this sample, 26 parents reported that their child had received an ASD diagnosis. Trial measures included baseline inhibited temperament and developmental problems, post-intervention feedback on the programme, and caregiver-reported child mental health outcomes (anxiety diagnoses and internalising symptoms) at 1- and 2-year follow-up. Sample retention for the children with ASD over 2 years was strong (92%). At follow-up, fewer intervention than control children with ASD had anxiety disorders after 1 year (% (n): 25 (3) vs. 77 (10), P = .028) and separation anxiety symptoms after 2 years (M (SD): 4.22 (2.68) vs. 9.38 (5.91), P = .017). Similar effects favouring the intervention group were apparent across other child emotional outcome measures but without statistical significance in this small sample. Parents of the children with ASD reported that Cool Little Kids was "quite useful" in relation to their child's anxiety but also gave feedback that they would appreciate some tailoring of programme content to the context of ASD. These pilot findings suggest Cool Little Kids may be helpful for reducing comorbid anxiety in pre-schoolers with ASD. Further research is warranted to develop an ASD-specific adaptation which can be trialled with a larger sample of children with confirmed ASD diagnosis. Trial registration ISRCTN30996662 http://www.isrctn.com/ISRCTN30996662. Autism Res 2018, 11: 1166-1174. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Many children with autism spectrum disorder (ASD) also have anxiety. This pilot study explored acceptability to parents and outcomes for pre-schoolers with ASD of a parenting group programme to prevent anxiety problems. Among the sample of 26 pre-schoolers with ASD, we found reduced anxiety disorders and separation symptoms when their parents had received the intervention, as reported by caregivers in checklists and clinical interviews. Parents gave feedback that the programme was useful but suggested content be adapted to the context of ASD.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1002/aur.1963