Table 1 Session content
Session number | Content overview for children | Content overview for parents |
|---|---|---|
1. | • What are feelings • What is anxiety • Introduction to hand puppets Calvin & Austin • List of worries • Anxiety and my body • Rewards menu | • Nature of child’s anxiety, its development and its connection to ASD • Aim of program • Setting goals • Principles of using rewards effectively to reinforce child behavior |
2. | • Cool breathing • Relaxation • Feel-good activities • The worry scale | • Introduction and principles of the three relaxation methods • The importance of practice • Introduction and principles behind cognitive restructuring |
3. | • Helpful and unhelpful thoughts ▪ How to identify them ▪ A prepared list of helpful thoughts ▪ How to use helpful thoughts | • Realistic, helpful thinking for children with ASD • Avoidance and anxiety • Introduction to exposure • Principals and application of exposure hierarchies (stepladders) |
4. | • Fighting fear by facing fear • Stepladders | • Stepladders |
5. | • Review of stepladder progress • A small step first | • Parent’s anxiety traps • Alternative parental strategies, including encouraging greater child independence • Introduction and principles behind ‘A small step first’ |
6. | • Review of stepladder progress • Review of relaxation skills • Create a new stepladder | • Challenges to exposure • Overcoming barriers to stepladder practice • Planning in session exposure |
7. | • Review of stepladder progress • Review of helpful thinking • In-session exposure | • Social skills and assertiveness • How to train social skills • In-session exposure |
8. | • Review of stepladder progress • Review of a small step first • In-session exposure | • Creating creative stepladders • Reviewing alternative parental strategies • In-session exposure |
9. | • Review of stepladder progress • How can I help others | • Structured problem solving • Reviewing goals |
10. | • Review of stepladder progress • Setbacks and how to deal with them • What have Cool Kids ASD changed • Congratulation and reception | • Maintenance and setback • Reviewing goals and planning new ones • Planning strategies to use for future challenges of high-risk times such as changing school |