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TREATMENT EXPECTED TO HELP PARENTS COPE WITH SEPARATION-ANXIETY SITUATIONS
Most parents have faced the occasional heartbreaking wail of their child fearing separation from mom or dad. It's normal. But such children's fears may be eased using techniques being tested for the first time at Boston University on young children who have Separation Anxiety Disorder, which experts say is the most prevalent yet least studied of childhood anxieties. Funded by a National Institute of Mental Health grant, the BU researchers are embarking on the first controlled clinical study of childhood SAD in children ages 4-8. Sixty-four children will be participants, and together with their parents will undergo Parent Child Interaction Therapy, a treatment that has proved effective in treating young children with behavior disorders. "This is the first clinical trial conducted with very young children with separation anxiety, filling a significant gap in our knowledge of this at-risk population," said Professor Donna Pincus, director of the Child and Adolescent Fear and Anxiety Treatment Program at BU's Center for Anxiety and Related Disorders. "We know that these kids, if not treated, are at risk for other types of disorders later in life," she said, ranging from low self esteem to other anxiety disorders. Separation anxiety disorder is the most common anxiety disorder seen in children, Pincus said. Epidemiological studies report that as many as many as 41 percent of children experience separation concerns, with from 5 to 10 percent considered at a "clinical level" of separation anxiety. Symptoms may include the child screaming inconsolably when left by a parent, being incapable of staying in one room of the house while the parents are in another, being unable to sleep alone, or worrying obsessively that something bad will happen to mom or dad when they're away. Only children with clinical levels of separation anxiety are being recruited for the five-year Boston University study that will apply the proven PCIT therapy. PCIT incorporates essential skills that researchers say can be applied to teach parents how to reduce their child's anxiety. They include: (1) increasing parent/child warmth and attachment; (2) enhancing parent attention, so they are more effective monitors of the child's behaviors; (3) command training, so parents deliver clear, direct commands; (4) differential reinforcement, which teaches parents to ignore or minimize attention for inappropriate behavior, like fearful displays; and (5) shaping, where parents learn to positively reward children for appropriate behaviors. "We'll try to teach parents more appropriate ways to interact with their kids because having better relations with parents at a young age is a very good indicator that the child will be better adjusted," said Pincus. The child participants will be joined by at least one of their parents in the nine weekly sessions. Therapists behind one-way mirrors will coach parents, via microphone ear pieces, as they interact with their children. Each child will be assessed at three-, six- and 12-month intervals after treatment. In Professor Pincus' pilot study that led to the NIMH grant, all three children were free of SAD symptoms at the end of one year. "None of the children in the pilot study have a diagnosis of clinical-level separation anxiety any longer, and it seems to have helped their siblings as well. Parents reported using the skills with all of their children and improved the warmth in the family," Pincus said. "This full study is exciting because essentially any family can benefit from improved interactions, greater warmth and less discord. If we show that these skills are effective with these extreme cases, we can put the skills into a prevention-type of tool where we can teach parents early to possibly prevent the onset of this kind of disorder in childhood." BU's Center for Anxiety and Related Disorders has been researching and treating anxiety in adults for over 20 years. The Center's Child and Adolescent Fear and Anxiety Treatment Program offers clinical services to young people experiencing difficulty with fears, anxiety or shyness.
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