title: Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial.
abstract: OBJECTIVE
  To examine the feasibility, acceptability and preliminary efficacy of family-based exposure/response prevention therapy (E/RP) versus treatment as usual (TAU) in a cohort of very young children with early onset obsessive-compulsive disorder (OCD).
  
  
  METHODS
  Thirty-one children ages 3-8 years (M = 5.8 years) with a primary diagnosis of OCD were randomized to E/RP or TAU. The E/RP condition received 12 sessions of family-based E/RP twice weekly over 6 weeks. Families were assessed at baseline, post-treatment, 1-month and 3-month follow up. The Children's Yale Brown Obsessive Compulsive Scale and Clinical Global Impression served as primary outcome measures.
  
  
  RESULTS
  A large group effect emerged in favor of the E/RP group (d = 1.69). Sixty-five percent of the E/RP group was considered treatment responders as compared to 7% in the TAU group. Symptom remission was achieved in 35.2% of the E/RP group and 0% of the TAU group. There was no attrition and satisfaction was high; gains were maintained at 3 months.
  
  
  CONCLUSIONS
  Even amongst children as young as 3 years, developmentally tailored E/RP is efficacious and well-tolerated in reducing OCD symptoms. Key adaptations for younger children include extensive parent involvement, targeting family accommodation, and frequent meetings while delivering a full course of E/RP.
  
  
  BACKGROUND
  NCT01447966 http://clinicaltrials.gov/ct2/show/NCT01447966?term=ocd+and+st+petersburg&rank=1.
authors.affiliation: Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA. Electronic address: alewin@health.usf.edu.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Lewin
authors.affiliation: Department of Psychology, University of South Florida, USA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Park
authors.affiliation: Department of Psychology, University of South Florida, USA.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Jones
authors.affiliation: Department of Pediatrics, University of South Florida, USA.
authors.forename: Erika A
authors.initials: EA
authors.lastname: Crawford
authors.affiliation: Department of Psychology, University of South Florida, USA.
authors.forename: Alessandro S
authors.initials: AS
authors.lastname: De Nadai
authors.affiliation: Department of Psychology, University of South Florida, USA.
authors.forename: Jessie
authors.initials: J
authors.lastname: Menzel
authors.affiliation: Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA.
authors.forename: Elysse B
authors.initials: EB
authors.lastname: Arnold
authors.affiliation: Department of Pediatrics, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA.
authors.forename: Tanya K
authors.initials: TK
authors.lastname: Murphy
authors.affiliation: Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
mesh_terms: D000367:Age Factors; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005196:Family Therapy; D005260:Female; D006801:Humans; D007171:Implosive Therapy; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales
keywords: Accommodation; Cognitive therapy; Exposure-response prevention; OCD; Preschool; Very young children