OBJECTIVE To date, no one-on-one psychotherapy protocol for elementary and middle school-aged children with autism spectrum disorder (ASD) has been found to be efficacious for treating autism-related symptoms such as failure to initiate social interactions. This study compared modular cognitive behavioral therapy (CBT) with enhanced standard community treatment (ESCT) in terms of impact on the severity of autism-related symptoms. METHOD Children with ASD (N = 107; aged 6-13 years) were randomly assigned to a treatment condition (CBT or ESCT). Both treatments provided 32 therapy sessions. The CBT condition utilized a modular design, matching specific evidence-based treatment elements to each child's clinical needs (e.g., social-communication symptoms). The ESCT condition provided social skills training and cognitive behavioral training in a structured and linear group therapy format. The primary outcome measure was independent evaluator ratings of peer engagement during school recess using a structured and validated observation system. Parents also made session-by-session ratings on personalized autism-related symptom profiles throughout treatment. RESULTS CBT outperformed ESCT on the primary outcome measure (p < .001; d = .50; 95% CI [.06, .93]) and the secondary outcome measure (p = .003; d = .87; 95% CI [.45, 1.27]). CONCLUSIONS The modular one-on-one CBT program evaluated in this study may be beneficial for reducing the severity of autism-related symptoms in some children with ASD. Further research is needed to clarify the extent of the treatment effect and the feasibility of implementation for therapists in the community. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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儿童自闭症相关症状的模块化认知行为疗法：一项随机对照试验。

目的 迄今为止，尚未发现针对患有自闭症谱系障碍 (ASD) 的中小学生的一对一心理治疗方案可有效治疗自闭症相关症状，例如无法开始社交互动。本研究比较了模块化认知行为疗法 (CBT) 与增强标准社区治疗 (ESCT) 对自闭症相关症状严重程度的影响。方法 患有 ASD 的儿童（N = 107；6-13 岁）被随机分配到治疗条件（CBT 或 ECT）。两种治疗都提供了 32 次治疗。CBT 条件采用模块化设计，将特定的循证治疗要素与每个孩子的临床需求（例如，社交交流症状）相匹配。ECT 条件以结构化和线性的团​​体治疗形式提供社交技能训练和认知行为训练。主要结果测量是使用结构化和经过验证的观察系统在学校课间休息期间对同伴参与的独立评估者评级。父母还在整个治疗过程中对个性化的自闭症相关症状概况进行逐次评分。结果 CBT 在主要结果测量 (p < .001; d = .50; 95% CI [.06, .93]) 和次要结果测量 (p = .003; d = .87; 95% CI) 上优于 ECT [.45, 1.27]）。结论 本研究中评估的模块化一对一 CBT 项目可能有助于减轻一些 ASD 儿童的自闭症相关症状的严重程度。需要进一步的研究来阐明治疗效果的程度以及在社区治疗师实施的可行性。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。