Sustainability of Cognitive Therapy Effects on Reducing Loneliness and Anxiety in Children with Autism: A Systematic Review and Meta-Analysis Based on Follow-up Periods

Background: Children with Autism Spectrum Disorder (ASD) frequently suffer from comorbid anxiety and chronic loneliness, which significantly impair their social development and quality of life. While Cognitive Behavioral Therapy (CBT) has shown efficacy in acute treatment, the long-term sustainability of these effects remains a critical area of investigation. Objective: This meta-analysis evaluates the sustainability of cognitive therapy effects on reducing loneliness and anxiety in children with autism, specifically focusing on follow-up periods ranging from ۳ to ۱۲ months, using data from recent scholarly publications (۲۰۲۰–۲۰۲۵). Methods: A systematic search of Google Scholar, PubMed, and ResearchGate identified relevant randomized controlled trials (RCTs) and longitudinal studies. Effect sizes (Hedges' g) were calculated for anxiety and loneliness at post-treatment and various follow-up intervals. Results: Analysis of nine key studies revealed that CBT produces large initial effects on anxiety reduction (Hedges' g = ۱.۰۳) and moderate to large effects on loneliness reduction (Hedges' g = ۰.۶۵). Crucially, these effects remained significant at ۱۲-month follow-up, although a slight decay was observed (Anxiety g = ۰.۸۵; Loneliness g = ۰.۴۸). Conclusion: Cognitive therapies provide sustainable benefits for children with autism, though booster sessions may be necessary to maintain maximum efficacy over time.

کلیدواژه ها:

Autism Spectrum Disorder ، Cognitive Behavioral Therapy ، Anxiety ، Loneliness ، Sustainability ، Meta-Analysis ، Follow-up