Researcher Clinician Evdokia Anagnostou discusses new anxiety management program for ASD

April 28, 2014

Dr. Evdokia Anagnostou was interviewed by Autism Research Chair Jonathan Weiss for his ASD and mental health blog on the funding of a research program focused on anxiety and its impacts not only on the individual with autism but the family as a whole.

Earlier this month, Holland Bloorview Kids Rehabilitation Hospital announced that the RBC Foundation had donated $1 million to its Autism Research Centre to fund the RBC Anxiety Management Program for Kids with Autism. Dr. Weiss, a Dr. Weiss, whose research focuses on on mental health in ASD, has a particular interest in bullying prevention and increasing social competence among children and youth on the autism spectrum.

The conversation between these NeuroDevNet-affiliated researchers, transcribed below, and many other interesting postings research on ASD and mental health on can be accessed via the ASD Mental Health blog.

About Dr. Evdokia Anagnostou

Dr. Evdokia Anagnostou is a child neurologist, and works as clinician scientist at the University of Toronto and the Bloorview Research Institute at Holland Bloorview Kids Rehabilitation Centre. At Bloorview, she co-leads the Autism Research Centre. The Autism Research Centre research spans several areas, with an overarching goal to translate basic research findings into therapeutic treatments.

RBC Anxiety Management Program for Kids with Autism

In early April, Holland Bloorview Kids Rehabilitation Hospital announced that the Autism Research Centre had received a donation of one million dollars from the RBC foundation. This funding will go towards the RBC Anxiety Management Program for Kids with Autism. Dr. Anagnostou spoke with us about this exciting announcement.

Question: Can you tell us a bit about what the RBC Anxiety Management Program for Kids with Autism looks like?

Response: The RBC Anxiety Management Program for Kids with Autism is based on a cognitive behaviour therapy (CBT) curriculum developed in Denver, called Facing your Fears. CBT has been known to help treat anxiety, and this program has been tailored to suit children with autism.

The grant from the RBC foundation will help us introduce the program to Ontario, and train therapists in the community. Over the next five years, we will run a series of groups out of Bloorivew, and have one facilitator from another community agency involved in each group. Having staff from other community agencies involved will help to train therapists in the community, and support the delivery of this program across Ontario.

Question: I understand there is a parent component to the program, what are the anticipated benefits of this?

Response: We see anxiety is not only experienced by the child, but by the whole family. The techniques children learn in our program will be more effective if there is support from the parents, and if the parents are trained in the curriculum too. Parents and children both learn the techniques and how to implement them in effective ways. With this approach, we see improvements across the whole family

Question: Would you say anxiety is a common challenge children with autism face today?

Response: Yes, absolutely. Research shows clinically significant symptoms of anxiety are extremely common for youth with autism. Anxiety is often seen as co-occurring with autism, we have even started thinking of it as one of the symptoms of autism.

Question: How is research contributing to our understanding of ASD and Anxiety?

Response: A lot of research is being is done in this area, but there is still a lot to be done too. One area we are exploring is the overlap between autism and anxiety. The boundaries between the two become difficult to distinguish. Researchers are also trying to understand the biology of anxiety, and develop technologies that will help identify the biological signals of anxiousness, even when the children don’t identify as anxious themselves. These technologies will help for interventions and allow us to teach children how to identify their feelings.

Work is also being done to optimize treatment of anxiety. The RBC Anxiety Management Program is one of several treatments available. A variety of adaptations have been made to programs originally designed for typically developing children too. Work is also being done to integrate technologies like apps into programs.

Research suggests the physiological signals of anxiety are higher than normal for children with autism, even when they feel calm. So studies are exploring how to not only treat anxiety when a child is presented with a stressful situation, but also how to bring a child’s baseline level of anxiety down.

Question: What advice would you provide to parents of children with ASD who are reading this interview and may be concerned about anxiety?

Response: I would want parents to know that anxiety is a common problem for children with autism, and they should not feel inhibited about asking for help. Anxiety is a valid concern, and it is important to bring it to the attention of professionals. There are a variety of techniques that can be used to control levels of anxiety, and anxiety can be very amendable to treatment.

There is a lot of research supporting the use of CBT to treat anxiety in youth with autism, but less research about the use of medication for these youth. Ideally, most kids will have access to behavioural interventions for anxiety before medication treatment is sought out. We have successful ways of treating anxiety that do not necessarily involve medication. While CBT teaches children the important skills they need to manage feelings of anxiety, medication won’t teach skills. Medication is best seen as an augmentation to therapy. We understand there is often limited access to programs in the community for youth with autism, so medications sometimes become the first line of treatment. The RBC foundation grant will allow us to train therapists in community agencies, and increase the availability of programs.