Emotion regulation (ER) refers to the handling and modifying of emotional reaction intensity and duration. Individuals who struggle with ER have issues with aggression, meltdowns, or other problem behaviors (5:40) in response to an inability to regulate emotion. Generally, these problem behaviors are an attempt to alleviate distress from ER issues. ER treatments aim to develop a more adaptive and appropriate response to distressing situations via increased emotional awareness and understanding.  

The presenter makes two critical distinctions: 

1. ER issues occur when an individual does not have the regulatory capacity or skills to control emotional reactions. (8:15) — these are not temper tantrums or manipulative behaviors. 

2. ER is concerned with more than the “moment of meltdown” (30:00) 

Individuals on the spectrum are at high risk (9:45) of ER issues as many core autism symptoms and proven differences in brain function are understood to trigger challenges with emotional control (11:17). Further research has shown ER issues prove more reliable than autism symptom severity in predicting increased anxiety and depression (14:30) as well as hospitalizations and emergency room visits (15:30).  

Cognitive Behavior Therapy (CBT) is the most effective evidence-based ER treatment available and focuses on understanding the connection between emotions and thoughts. Although CBT is evidence-based, almost all studies focus solely on anxiety issues. By contrast, most individuals on the spectrum present with multiple conditions, making it challenging to apply CBT in real-time.