Exploring Impacts of Play- and Humor-Infused Exposure on Parent-Reported Distress and Avoidance in Williams Syndrome: A Case Study

Jazmine Panganiban, “Exploring Impacts of Play- and Humor-Infused Exposure on Parent-Reported Distress and Avoidance in Williams Syndrome: A Case Study”
Mentor: Bonita Klein-Tasman, Psychology
Poster #139

Williams syndrome (WS) is a rare neurogenic disorder with a prevalence of 1 in 7,500. Specific phobia (SP) is among the most common anxiety disorders of children with WS, which poses challenges for the child and the family. Cognitive-behavioral therapy with elements of play and humor, based on the Replays approach, addresses the emotional and behavioral responses to SP through gradual exposure within a child-centered framework. Parents may inadvertently reinforce phobias by avoiding phobic stimuli in response to their child’s fear. The present study aims to investigate the impact of play- and humor-infused exposure therapy on parent-reported distress and avoidance in a case study with a 4-year-old with WS. Parent distress and avoidance ratings were measured on a 0 to 8 scale and collected over two timelines: (1) pre- to post-assessment and (2) weekly baseline to post-intervention. Parental distress and avoidance was considered improved when there was a decrease of at least 2 points. The family tracked 3 phobias: vacuum cleaners, blenders, and power tools; vacuum cleaners were the primary focus of intervention for the in-person sessions. From pre- to post-assessment there was no observed improvement in parent avoidance. From weekly baseline to post-intervention, there was modest improvement in parental avoidance with power tools, but not with vacuum cleaners or blenders. From pre- to 6-week post-assessment, improvement in maternal distress related to vacuum cleaners and blenders were observed; these improvements were not maintained at 3-month follow-up. Across most fears, the father’s distress levels showed no definable improvements. Although these preliminary findings of this case study do not conclusively demonstrate the effectiveness of this intervention in reducing parental distress and avoidance, they do suggest that greater avoidance may relate to less distress warranting further investigation of the bidirectional dynamic between child fear and parental distress and avoidance.