Social Anxiety and Pragmatics in Autism Spectrum Disorders: Cognitive Behavioral Therapy and Its Relation to Speech-Language Pathology

Abstract

In this review of basic principles of cognitive behavioral therapy, application to treatment of anxiety in autism spectrum disorders (ASD) is outlined and evidence for effectiveness presented. The links between social anxiety disorder and social communication impairment are explored, and the issues raised by applying principles drawn from psychology to clinical practice in speech-language pathology are discussed. Suggestions for clinical practice are offered, along with reflections on the potential for increased collaboration between cognitive behavioral therapists and speech-language pathologists (SLPs) to better serve individuals with ASD. Outcomes for individuals with autism spectrum disorders (ASD) can be impacted by many factors, including co-morbid psychiatric factors. In working on clinical pragmatics with individuals on the autism spectrum, it is not uncommon to come across clients who have a clinical diagnosis of anxiety disorder. Often, the symptoms of that disorder are present primarily in social situations. The social piece creates a direct interface between speech-language pathologists (SLPs), as experts on pragmatic language and social communication, and psychologists, with expertise in psychological functioning and treatments for its disorders. Awareness of current literature and best practice in handling anxiety is relevant to our practice as SLPs, because social anxiety and communicative competence are logically connected, in that both deal with managing social situations. Effective treatments for anxiety exist within the psychiatric and psychological professions. In this review of recent cognitive behavioral therapeutic approaches for treatment of social anxiety in ASD, the strength of the evidence for effectiveness will be described and implications for clinical practice in speech-language pathology discussed.