2 - (SYM 38) Evaluating Trauma-focused Cognitive Behavioral Therapy for Puerto Rican Children with Autism Spectrum Disorder and Trauma: A Pilot Study

Trauma exposure and post-traumatic stress disorder (PTSD) are significant mental health concerns for children with autism spectrum disorder (ASD; Elizardo et al., 2025), yet evidence-based trauma interventions are understudied in this population. Although Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is the leading treatment for pediatric PTSD (Cohen et al., 2018), its effectiveness for children with ASD, particularly Hispanic youth in Puerto Rico, remains largely unexamined (Quinton et al., 2025; Roman-Hernandez et al., 2024). 

This presentation describes a pilot study examining the impact of TF-CBT on PTSD and trauma-related symptoms (TRS) in Puerto Rican children with ASD who experienced trauma. Conducted as part of a SAMHSA-funded project at the University of Puerto Rico, the study aimed to generate preliminary outcome data to inform trauma treatment for neurodivergent youth in diverse cultural settings.

Participants were three Puerto Rican males with ASD between the ages of 7 and 14. All received individual TF-CBT delivered according to standard protocols, as no validated ASD-specific adaptations currently exist. Treatment duration ranged from 27 to 30 sessions to accommodate individualized pacing needs. PTSD symptoms were assessed using the Child and Adolescent Trauma Screen (CATS), administered to children and their caregivers. Caregivers of children under age 11 completed the Child Behavior Checklist (CBCL), and the adolescent participant completed the Youth Self-Report (YSR). Measures were administered in Spanish at baseline, mid-treatment, and post-intervention. 

Results were mixed. Two participants showed consistent reductions in PTSD symptoms across child and caregiver reports and decreases in CBCL and YSR Total T scores at post-treatment. The third participant had caregiver-reported symptoms decrease while child self-report indicated increased PTSD symptoms, highlighting informant discrepancies and assessment complexity in ASD.

Findings indicate variable TF-CBT responses among children with ASD who have experienced trauma. Two of three participants demonstrated reductions in PTSD and trauma-related symptoms, while one case showed notable informant discrepancies. Differences in trauma exposure and assessment source may contribute to variability in response to treatment. Overall, TF-CBT shows promise for Hispanic children with ASD in Puerto Rico. This work can inform future efforts to refine treatment duration and develop individualized, culturally responsive, ASD-informed adaptations.