Abstract
Background & Objectives: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by significant impairment of social interaction, communication impairment, and restricted/repetitive patterns of behavior, interests, and activities. In addition to the challenges caused by the main symptoms of this disorder, maladaptive behaviors such as anxiety and aggression can be associated with ASD and further impair performance and quality of life. Because most people with ASD spend the majority of their lives with ASD in adulthood, there is a compelling need for effective treatments for these incompatibilities. One of the psychological problems found in children with ASD is anxiety. This intense emotion is accompanied by an unpleasant state and internal turmoil that affects the individual, including feelings of low confidence, helplessness, and physiological arousal. Despite the various treatments that have been done for these children so far, there are few studies to investigate the effect of transcranial Direct Current Stimulation (tDCS) on the anxiety of children with ASD. Therefore, the present study aimed to examine the effectiveness of tDCS on anxiety in children with high–functioning autism spectrum disorder.
Methods: This quasi–experimental research employed a pretest–posttest design with a control group. Among children aged 8 to 12 with autism spectrum disorder referred to the rehabilitation clinics of Yazd City, Iran, 30 qualified volunteers were included in the study using available sampling; 15 were randomly assigned to the intervention group and 15 to the control group. The inclusion criteria were as follows: having autism spectrum disorder as diagnosed by a psychiatrist, having an IQ greater than 80, being between 8 and 12 years of age, and not using other treatment methods such as medication and psychotherapy. The exclusion criteria were missing one tDCS session and failure to complete the questionnaire during the study. Each subject completed a consent form to participate in the study. In the present study, a Taiwan–made iOMED device (2011) was employed. It consisted of two electrodes (anode and cathode), each with a surface area of 35 cm². The electrodes were embedded in saline–soaked pads to facilitate electrical conductivity and ensure effective current delivery to the scalp. Anxiety variable scores were compared using Spence Children's Anxiety Scale–Child Version (SCAS–Child) (Spence, 1997) at two time points, before and after tDCS. Data analysis was done using SPSS version 17 software and covariance analysis. The significance level of the tests was 0.05.
Results: Data analysis revealed that the anxiety variable score in children with autism spectrum disorder in the intervention group and after receiving tDCS was significantly reduced compared to the control group (p<0.001). The effect size also showed that 66% of the difference between the intervention group and the control group in the anxiety variable was due to the implementation of tDCS.
Conclusion: The results of the present study showed that 10 sessions of 20 minutes of 1 mA tDCS of the left anodic/right cathodic region of the dorsolateral prefrontal cortex led to the improvement of anxiety in children with ASD. So, tDCS can be used as a complementary treatment to improve the anxiety of children with ASD.
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