Intolerance of Uncertainty Predicts Anxiety Outcomes Following CBT in Youth with ASD.

Keefer et al. (2017) ran a small before-and-after study. They gave kids with autism a tweaked CBT course called Facing Your Fears. Parents filled out anxiety forms at the start and end.

All sessions happened in a clinic. No control group. The team also asked parents how well the child handles not knowing what comes next. They call this trait intolerance of uncertainty, or IU.

Parents said their children's anxiety dropped after the course. The surprise: kids who started with high IU still had more anxiety at the end. High IU did not block progress, but it left the kids more worried than peers with low IU.

In short, the therapy helped everyone, yet the most uncertainty-averse kids finished last in the race.

Cai et al. (2018) extends the story. Their survey of teens with ASD shows IU sits in the middle, linking poor emotion control to both anxiety and depression. Amy's finding now makes sense: if IU is the engine, just teaching CBT skills without cutting IU may leave the motor running.

Morrison et al. (2017) used the same Facing Your Fears script in Singapore schools and also saw anxiety fall. The two studies together tell us the program works in both clinic and classroom, but Amy's IU warning still applies. School staff should expect smaller gains for the uncertainty-averse students.

Tassé et al. (2013) looked at heart rate and problem behavior during lab tasks. They showed that anxiety spikes can be spotted with quick body checks. Pairing their tip with Amy's IU score gives you two low-cost ways to flag kids who may need extra support before CBT even starts.

Check IU at intake. A short parent scale takes five minutes and tells you who will need booster sessions or extra coping drills. Add uncertainty games, like mystery prizes, into your CBT plan. These simple twists can turn a so-so outcome into a solid win for kids who hate not knowing what comes next.