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

Abstract

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.

Keywords:

• Behavior therapy
• anxiety
• young children
• family accommodation

Declaration of interest

All Children’s Hospital Guild Endowed Chair supported this work.