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Cognitive Behavioral Therapy as an Autism Treatment

Brooke Price with kids on cognitive behavioral therapy in Autism treatment

Cognitive Behavioral Therapy, or CBT, is one of the basic “go to” therapies in the Autism community. It’s based on how a person thinks, acts, feels and how their behavior affects those around them. The biggest positive in this type of Autism treatment is that it has no adverse side effects and no warnings associated with it. It also helps astoundingly with meltdowns and other behavioral issues.


Arguably, it helps so much because in Cognitive Behavioral Therapy the individual is asked to become more aware of themselves. They want your child to become aware of their own triggers and be responsible for how they react to said triggers. They help the individual develop their own methods of dealing with escalating emotions. They basically took cognitive therapies developed in the 1950’s and 60’s and evolved them into cognitive behavior therapy, as it is known today.

  1. So, who does CBT help the most and how does it work?

CBT is most effective in high functioning autistic individuals whom are over the age of 8, but it can be started at a younger age. It can also be used in lower functioning children and teens on the spectrum. My son is moderate-severe, depending on what area you are looking at, and CBT has helped him for years. During said therapy your child is taught to recognize their agitation by using a “Thermometer Drawing Chart.”

Essentially this is a bar of different emotional emojis that the child can use as a visual aid to rate their level of anger. It goes from “Very happy (smiling emoji)” all the way to “Rage (Extremely angry emoji)” and is especially useful in the younger children but is not limited to the use of just the younger kids. My son still uses this chart at the age of 14. Autism knows no age limits. Cognitive ability is not measured by physical age; therefore, this basic tool can be useful to any age individual with Autism.

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They also commonly use the Cognitive Behavioral Therapy model of reasoning for the older and higher functioning individuals. In this model, which forms a triangle. The first step is reminding oneself that your moods and emotions influence your thoughts and actions. The second step is reminding oneself that your thoughts and actions influence the quality of your life. The third step being to remind yourself that the quality of your life influences your mood and emotions. It’s a continuous triangle of steps to self-awareness. I use these steps with my son often when he is about to meltdown. I remind him of his steps and ask him to be aware of the decisions he is about to make before he makes them. Sometimes this actually stops the meltdown in it’s tracks.

If your child is lower functioning CBT can be for them as well. When my son started CBT he was extremely low functioning and nonverbal. Through many different therapies, a sensory schedule and years of research he is now verbal and higher functioning than he was. I contribute a lot of this to me starting Cognitive Behavioral Therapy with him at such a young age. As early intervention is key in the treatment of Autism, therapy is key. When working with a lower functioning individual they tend to go about therapy a little bit differently.

With lower functioning kids a lot of the therapy is done using social stories and cartooning. For those of you that do not know, social stories are stories devised as tools to help individuals on the spectrum better understand the degrees of interpersonal communication so that they can interact in an effective way and an appropriate manner with others. Cartooning is when they use a cartoon with blank bubbles and allow the child to fill in the blanks in whatever fashion they choose. They then go over the situation the child has created in the bubbles and talk about appropriate reactions.

If you decide to start your child in CBT and her/she is lower functioning keep in mind that a great deal of the time will be spent with the therapist speaking to you, not your child. Also, occasionally you may walk into a session that is purely an hour of board games, aimed at teaching your child self-control and helping ease them into trusting the therapist. When a child is lower functioning a lot of the therapy is about coping strategies for the families. They will teach you ways to cope with your child’s behaviors and how to treat them at home.

They may even teach you holds to use safely at home, in the case your child has a violent meltdown and you need to know how to restrain him/her properly; without anyone getting hurt. We’ve almost all been in the position where we have had to hold on to them or they are going to hurt themselves. CBT helps with those moments exceptionally. My child went from violently beating me- daily- to rarely being physically violent with me, in a matter of a few years with CBT. That may seem like a long time to work on something before seeing results; however, my child’s meltdowns were of epic proportion and it took a lot of work to make him self aware during them.

Cognitive Behavioral Therapy is just one of many different routes you can take with your child, I wrote about ABA therapy before this. That is another option, especially if your child has meltdowns, follow the link to read that article… CBT is commonly used and covered by most insurance companies, where ABA is not. Other options I will write about in the future so keep a look out for those.