Function-Based Treatment of Separation Anxiety in a School Aged Child: A Case Study

Abstract

This case study summarizes the assessment and treatment of a nine-year-old girl, Layla, with separation anxiety and school refusal. The initial assessment indicated that challenging behavior served both to access and avoid stimuli from the environment, rather than to escape or avoid an aversive stimulus. Treatment consisted of teaching and then differentially reinforcing the use of appropriate behaviors that serve the same function as the challenging behaviors for which the family was seeking treatment. These strategies included functional communication training and differential reinforcement of other and alternative behaviors using a cumulative duration schedule of reinforcement and a habituation paradigm. The treatment was successful in reducing school refusal and increasing compliance with adult directions. We discuss treatment- and assessment-related recommendations for clinicians and students.