Adapting Cognitive Behaviour Therapy for children with intellectual disabilities

Dr Anastasia Hronis1

1University Of Technology Sydney, Sydney, Australia

Children with intellectual disabilities have high rates of mental health disorders, with anxiety being the most prevalent mood disorder. Recent research has begun to examine how Cognitive Behaviour Therapy can be adapted for the learning needs of children and adolescents with intellectual disabilities. As such, the Fearless Me! © program was developed. It was designed for children aged 8 to 18 with mild to moderate intellectual disability. The aim of research was to develop and evaluate CBT for children with mild to moderate intellectual disabilities and anxiety.

A review of the literature was conducted considering the neuropsychological profiles of children with intellectual disabilities, and suggestions for adaptations for therapy were proposed. Feedback was gathered from both parents of children with a mild to moderate intellectual disability, and clinicians, as to how therapy could be adapted for their needs.

The Fearless Me! program was created as a multimodal program for children with intellectual disabilities experiencing clinical or subclinical anxiety. It involves ten face to face therapy sessions with a psychologist, and an online program which allows the practice of CBT skills. There are three modules in the program; Keep Calm (which teaches relaxation), Stop and Think (which teaches cognitive restructuring) and Facing Fears (which uses exposure hierarchies). Children who participated in evaluations showed significant improvements in anxiety.

It is hoped that the program will enable children to engage in CBT and provide an alternate treatment path other than behavioural strategies and medications.


Dr Anastasia Hronis (B Psych Hons, M Clin Psych, AMusA, LMusA, Ph.D.) is a clinical psychologist and founder of the Australian Institute for Human Wellness. Anastasia is also an Honorary Associate at the University of Technology Sydney. She conducts research in adapting therapy for children with intellectual disabilities.