106 As pertains to psychosocial interventions,

unfortunately, there are few empirically supported treatments for peer problems in ADHD and related disorders implicating executive functioning.107 Crucially, however, there are empirically supported treatments to aid development of executive functioning that may also be appropriate settings to address social skills.108 These interventions, often delivered in school settings, may be readily combined with adjuvant SST or CBT interventions. There is fruitful work that may be done to directly examine the effects of such training on improved social functioning in this population, Inhibitors,research,lifescience,medical implicating a fairly easily testable change mechanism. Internalizing comorbidities Youth with ASD are also known to experience high rates of internalizing comorbidities, especially clinically significant elevations in anxiety and depressive disorders.103,109 Importantly, associations have been found between anxiety and social deficits in this population.’-110,111 Inhibitors,research,lifescience,medical Clinical and anecdotal observations suggest it may specifically be the awareness of social difficulties that enhances anxiety in adolescents with ASD.112 Additionally, research has implicated a relationship between greater cognitive and verbal abilities, and greater ASD severity, and elevated risk of depression.113

This emerging descriptive research suggests that internalizing Inhibitors,research,lifescience,medical disorders Inhibitors,research,lifescience,medical may play a role in predicting social dysfunction in this population. Promising INNO-406 interventions to specifically address anxiety using CBT in

this population have recently proliferated.114,115 Most of this clinical work has adapted CBT programs to primarily target anxiety reduction114,116,117,118 in children under the age of 14. Collectively, this body of research suggests that internalizing processes may be amenable to intervention in ASD. However, they do not explicitly examine the potential role of anxiety (or other internalizing problems, such as depression) as a mechanism of change in improving Inhibitors,research,lifescience,medical core ASD deficits. In a crucial recent step towards testing the possible mechanistic nature of anxiety in social dysfunction in ASD, White and colleagues119 produced and tested a manualized intervention to treat both of these old deficits in this population. Further exploration of this intervention will be essential in teasing out the degree to which decreasing anxiety may act as a mechanism of change in addressing social functioning in ASD. Other potential mechanisms As the consideration of common and unique mechanisms of change in psychosocial interventions for ASD is fairly new, we have focused above only on those that are most promising based on the available literature. We note, however, that there may be several more that are worthy of consideration, whose comprehensive exploration is beyond the scope of this overview.