TREATMENT OF SEPARATION ANXIETY DISORDER WITH GRADUATED EXPOSURE AND REINFORCEMENT TARGETING SCHOOL ATTENDANCE - A CONTROLLED CASE-STUDY

A six-year, nine-month old girl with school avoidance and a variety of other anxiety symptoms was diagnosed with Separation Anxiety Disorder (SAD). SAD was treated using graduated exposure with positive reinfor cement for approximations of independent school attendance. Treatment focused on systematically shaping increased duration of school attenda nce while fading mother's proximity and time spent in the classroom an d in transit to and from school. A changing criterion single-subject r esearch design was used to demonstrate functional control of the treat ment over the child's school attendance. Follow-up indicated that trea tment gains were maintained at two- and nine-months post-treatment. SA D is discussed as a childhood disorder involving fear and avoidance of separation from parents in a variety of situations, one of which may be attending school. The importance of differentiating SAD from school phobia and other anxiety disorders is discussed.