Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, Maryland.
Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Am Acad Child Adolesc Psychiatry. 2020 Aug;59(8):914-917. doi: 10.1016/j.jaac.2020.01.021. Epub 2020 Jul 28.
Family involvement in routines that exacerbate and maintain child anxiety is referred to as family accommodation. Family involvement is also related to maintenance of severe problem behavior (SPB) demonstrated by children with intellectual and developmental disabilities (IDD). Family members may deliver attention, tangible items, or remove aversive task demands that produce temporary cessation, or avoidance of SPB, but long-term maintenance. This Clinical Perspectives article describes parallels between the treatment of family accommodation in child anxiety and the assessment and treatment process for SPB. Suggestions are described for borrowing the concept of family accommodation to help caregivers of children who demonstrate SPB begin to approach previously avoided contexts. A case vignette is provided to illustrate strategies for targeting family accommodation as an expansion of function-based treatments for SPB.
家庭参与加剧和维持儿童焦虑的日常生活被称为家庭迁就。家庭参与也与智障和发育障碍（IDD）儿童表现出的严重问题行为（SPB）的维持有关。家庭成员可能会给予关注、有形物品，或免除会产生暂时停止或回避 SPB 但长期维持的厌恶任务要求。这篇临床观点文章描述了儿童焦虑症中家庭迁就的治疗与 SPB 的评估和治疗过程之间的相似之处。本文还描述了借用家庭迁就概念的建议，以帮助表现出 SPB 的儿童的照顾者开始接近以前回避的情境。提供了一个案例片段来说明将家庭迁就作为基于功能的 SPB 治疗的扩展来靶向的策略。
