Preliminary study of family accommodation in 4-7 year-olds with anxiety: frequency, clinical correlates, and treatment response.

Background: Childhood anxiety disorders are common in early childhood and are associated with marked impairment. Family accommodation, which contributes to the maintenance of child anxiety, has only been minimally examined in children under the age of 7 years with anxiety disorders. Aims: This study aimed at examining the frequency and clinical correlates of family accommodation in anxious children under the age of 7 years, as well as changes in family accommodation following cognitive-behavioral treatment. Method: Twenty-six children between the ages of 4 and 7 years diagnosed with at least one anxiety disorder participated in this study. A subsample of these children (n = 23) participated in 10 sessions of parent-led exposure therapy or treatment-as-usual (TAU). Results: Family accommodation occurred in 100% of the sample and was positively correlated with children's externalizing behavior, but not with anxiety severity or parental distress. Family accommodation decreased following cognitive behavioral therapy but not TAU. Conclusions: Reductions in family accommodation were associated with greater improvements in child anxiety symptoms following treatment.

Preliminary study of family accommodation in youth with autism spectrum disorders and anxiety: Incidence, clinical correlates, and behavioral treatment response.

Anxiety symptoms are common in youth with autism spectrum disorders (ASD) and directly associated with symptom severity and functional impairment. Family accommodation occurs frequently among individuals with obsessive-compulsive and anxiety disorders; to date, no data exist on the nature and correlates of family accommodation in youth with ASD and anxiety, as well as its relationship to cognitive-behavioral therapy outcome. Forty children with ASD and a comorbid anxiety disorder participated. Clinicians administered measures of ASD and anxiety disorder caseness, anxiety symptom severity, and family accommodation; parents completed questionnaires assessing social responsiveness, internalizing and externalizing behaviors, and functional impairment. A subsample of youth (n = 24) completed a course of cognitive-behavioral therapy. Family accommodation was common and positively correlated with anxiety symptom severity, but not functional impairment, general internalizing symptoms, externalizing behavior, or social responsiveness. Family accommodation decreased following cognitive-behavioral therapy with decreases in family accommodation being associated with decreases in anxiety levels. Treatment responders reported lower family accommodation frequency and lower parent impact relative to non-responders. Clinical implications of this study in assessing and psychotherapeutically treating youth with ASD and comorbid anxiety are discussed.