Autism Spectrum Disorder and the Experience of Traumatic Events: Review of the Current Literature to Inform Modifications to a Treatment Model for Children with Autism.
Add visuals, parent roles, and praise to CBT and kids with both autism and OCD get better.
01Research in Context
What this study did
Stack et al. (2019) looked at 11 studies on kids who have both autism and OCD.
They asked: does regular CBT still work if we tweak it for autism?
The team pulled apart each study to see what changes therapists made and if symptoms eased.
What they found
CBT with autism-friendly twists helped reduce OCD rituals.
The winning tweaks were picture cues, parent coaching, and lots of praise.
No study reported harm; most kids kept the gains after therapy ended.
How this fits with other research
Carson et al. (2017) already showed teens with autism keep social gains three months after CBT ends. Alexia’s review says the same recipe—clear structure plus social bits—also calms OCD.
Byiers et al. (2025) went further. They added extra social-skills modules and saw bigger anxiety drops than with standard CBT. Their data backs up Alexia’s point: build in social teaching if you want stronger results.
Mierau et al. (2026) asked autistic adults what helped in group CBT. Like the kids in Alexia’s papers, adults wanted predictable sessions, visual aids, and real-life practice. The same fixes work across ages.
Why it matters
You already shape behavior with visuals and reinforcement. Keep doing it when OCD shows up. Start each session with a picture schedule, let the parent run part of the exposure, and reinforce every small step. These three moves turn classic CBT into an autism-ready tool you can use tomorrow.
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02At a glance
03Original abstract
Autism spectrum disorders (ASD) and obsessive-compulsive disorder (OCD) are highly comorbid, precipitating an urgent need to identify evidence-based practices that might be used to address this comorbidity exclusively. The aim of this study was to conduct a review of intervention research and clinical reports to examine the use of cognitive behavioral therapy (CBT) with individuals who have comorbid ASD and OCD. Based on the pre-determined review inclusion criteria, 11 studies were included in the review: three randomized control trials (RCT), one case controlled study, two single subject experimental designs, and five case studies. These studies offer promising data on the use of CBT interventions for individuals with ASD and comorbid OCD as well as for individuals with OCD and comorbid ASD when standard CBT protocol is enhanced with modifications such as parental involvement, increased use of visuals, personalized treatment metaphors, self-monitoring, positive reinforcement, and use of clear language and instructions. Limitations and implications for future research and practice are discussed.
Journal of autism and developmental disorders, 2019 · doi:10.1016/j.beth.2014.01.002