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Treating specific phobias in young people with autism and severe learning difficulties

Published online by Cambridge University Press:  22 December 2017

Phillippa Burton ,
Anna Palicka  and
Tim I. Williams Open the ORCID record for Tim I. Williams [Opens in a new window]
Phillippa Burton
Affiliation:
Priors Court School and University of Reading
Anna Palicka
Affiliation:
Priors Court School and University of Reading
Tim I. Williams*
Affiliation:
Priors Court School and University of Reading
*
*Author for correspondence: Tim I. Williams, Institute of Education, University of Reading, London Road Campus, 4 Redlands Road, Reading RG1 5EX, UK (email: timothy.williams@reading.ac.uk).
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Abstract

Animal phobias in young people with autism spectrum disorders (ASD) and intellectual disability (ID) can provoke behaviours that put them at risk and impede access to the community. Previous studies suggest that cognitive behavioural therapy including systematic desensitization and modelling are effective for people with ID, including those with comorbid ASD. Methods of adapting such treatment to people with little spoken language are not well described, and ethical issues concerning both young people and animals during treatment have not been addressed. The aim of this study was to describe, using a case series of consecutive referrals: (1) adaptations to systematic desensitization when communication of the young person is impaired, and (2) the ethics of involving animals in therapeutic interventions. Treatment was planned based on the use of systematic desensitization with a hierarchy of feared situations using visual symbols and schedules to communicate with the participants. Five young people with ASD, severe ID and minimal language were successfully treated for dog phobia. Modifications to treatment included both the use of non-verbal means of communication including printed symbols and graded activities such as jigsaw puzzles and picture matching to present information to clients in a more finely graded format. The treatment of specific phobias is possible with the use of minimal language provided that a variety of individualized stimuli approximating to the feared objects are developed and the safety of all participants is respected. Further work is required to develop sufficiently flexible treatment protocols, which in turn would enable a randomized controlled trial.

Keywords

animal phobiaintellectual disabilitysystematic desensitizationvisual communication
Type
Service models and forms of delivery
Information
the Cognitive Behaviour Therapist , Volume 10 , 2017 , e21
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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References

Further reading

May, AC, Rudy, BM, Davis, TE, Matson, JL (2013). Evidence-based behavioral treatment of dog phobia with young children two case examples. Behavior Modification 37, 143–160.CrossRefGoogle ScholarPubMed
McMurtry, CM, Noel, M, Taddio, A, Antony, MM, Asmundson, GJ, Riddell, RP et al. (2015). Interventions for individuals with high levels of needle fear: systematic review of randomized controlled trials and quasi-randomized controlled trials. Clinical Journal of Pain 31, S109–123.Google Scholar
Ollendick, TH, Cowart, MJ, Milliner, EL (2013). Specific phobias. In Pediatric Anxiety Disorders (pp. 113–128). Springer: New York.Google Scholar

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