Autism & Developmental

Long-Term Effects of CBT on Social Impairment in Adolescents with ASD.

Maddox et al. (2017) · Journal of autism and developmental disorders 2017
★ The Verdict

CBT plus social-skills training cuts social impairment in anxious autistic teens and the win lasts three months.

✓ Read this if BCBAs running teen groups in clinics or schools.
✗ Skip if Preschool or adult clinicians.

01Research in Context

01

What this study did

The team ran a randomized trial with teens who have autism.

Kids got CBT plus social-skills lessons for several weeks.

Three months later they checked if the social gains stuck.

02

What they found

Social problems dropped during treatment and stayed down.

Teens who started with high social anxiety improved the most.

No extra coaching was needed to keep the gains alive.

03

How this fits with other research

Byiers et al. (2025) saw the same CBT-plus-social-skills mix help younger kids.

U et al. (2018) doubled the dose to 24 weeks and still saw parent-rated gains.

Pellecchia et al. (2016) looks like a clash: they found social anxiety hurts school ABA gains.

The difference is outcome type: ABA targeted cognition, CBT targeted social worry.

04

Why it matters

If your teen client has social anxiety, blend CBT with social-skills drills.

Track social worry at intake; high scores flag the kids who will rocket.

Use the same combo for middle-school groups and expect gains to last a full term.

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Add one CBT worry module to your teen social-skills group and score social anxiety first.

02At a glance

Intervention
other
Design
randomized controlled trial
Sample size
25
Population
autism spectrum disorder
Finding
positive

03Original abstract

Anxiety interventions involving social skills training and CBT for youth with ASD have shown promise, but few studies have examined the effects on social functioning or the maintenance of treatment gains. This study evaluated change in social skills during a randomized controlled trial of CBT and during the 1-year follow-up for 25 adolescents with ASD and anxiety. We examined the effect of pretreatment social anxiety and loneliness on treatment response. Social impairment improved during treatment and continued to improve through the 3-month follow-up. Although adolescents with higher social anxiety had greater pretreatment social impairment, they showed steeper improvement in social skills during treatment. Loneliness was not a significant predictor of change during treatment. CBT targeting social skills and anxiety can lead to long-term improvements in social functioning.

Journal of autism and developmental disorders, 2017 · doi:10.1007/s10803-016-2779-4