(PS7-47) Reductions in Parental Avoidance and Distress with Intervention for Child Fears and Phobias in Williams Syndrome

Abstract Text: Children with Williams syndrome, a rare neurogenetic disorder, are diagnosed with specific phobias (SPs) at a rate estimated to range from 37-56% (Pitts et al., 2016). In the general population child fear or anxiety may result in elevated parental anxiety and contribute to parental avoidance of feared stimuli, which serves to inadvertently further reinforce and perpetuate child anxiety (Ginsburg & Schlossberg, 2002). In the current study, we were interested in whether child participation in a developmentally attuned play-based exposure therapy for fear (Klein-Tasman et al., 2022) is associated with changes in parent-reported avoidance and distress related to their child’s fears, which could disrupt the cycle that maintains anxiety.

Participants were parents of five 4- to 9-year-old children with WS (4 girls and 1 boy) who experienced strong emotional responses to specific stimuli (e.g., hair brushing, brushing teeth, vacuums) and participated in a play- and humor-infused developmentally attuned play-based exposure therapy. Questions to assess parental avoidance and parental distress related to the child’s fears were added to the Specific Phobia section of the Anxiety Disorders Interview Schedule Parent (ADIS-IV-P; Silverman & Albano, 1996) and administered pre-intervention, post-intervention, and three months following the intervention. On an 8-point scale, a 2-point reduction in parental avoidance and/or parental distress level from the pre-intervention rating was considered to reflect improvement.

All parents experienced an improvement in ratings of their own distress levels from pre-intervention to post-intervention, with four of the five parents maintaining this reduction at the 3-month follow-up. Two parents indicated that they did not engage in avoidance of their child’s feared stimuli at pre-intervention leaving no room for calculable improvement, two parents experienced improvement in avoidance at both timepoints, and the remaining parent experienced an increase in avoidance post-intervention.

This study provides new evidence that a child’s participation in therapy for SPs may have positive secondary effects on parents’ distress and avoidance. Study limitations include the small sample size and the case series design, which restrict the generalizability of results. Nevertheless, the findings highlight how targeted child therapy may indirectly influence parental behaviors and emotions, which may be important for reductions in child fear.