Autism & Developmental

Family Accommodation in Autism Spectrum Disorder.

Feldman et al. (2019) · Journal of autism and developmental disorders 2019
★ The Verdict

Most parents quietly rearrange their lives around their child's repetitive behaviors, and this hidden work increases with symptom severity.

✓ Read this if BCBAs doing parent training or family-centered ABA with kids who have repetitive behaviors.
✗ Skip if Clinicians working only in center-based programs without parent involvement.

01Research in Context

01

What this study did

Researchers asked 80 parents of kids with autism about their daily routines.

They wanted to know how often parents change their own behavior to avoid upsetting their child's repetitive actions.

Parents filled out a simple survey about things like lining up toys or hand-flapping.

02

What they found

Four out of five parents said they accommodate these behaviors at least once a month.

The more severe the repetitive behaviors, the more parents reported changing their own routines.

This means parents aren't just noticing the behaviors - they're actively working around them.

03

How this fits with other research

Shepherd et al. (2018) found that advocacy tasks stress parents more than daily care.

This study shows daily care actually involves lots of hidden work - parents are constantly adjusting to avoid meltdowns.

Sim et al. (2017) found that couples who cope well together have less stress.

These accommodating behaviors might be one way parents try to reduce stress, even if it creates more work.

Dai et al. (2025) showed parent-coached DTT can reduce stress.

Understanding these accommodation patterns could help design better parent training programs.

04

Why it matters

When you see a parent 'giving in' to repetitive behaviors, you're watching accommodation in action.

Track these patterns during parent interviews - they reveal both stress levels and intervention opportunities.

Start conversations about which accommodations help versus which ones might maintain problem behaviors.

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→ Action — try this Monday

Ask parents to list three things they changed this week to avoid triggering repetitive behaviors - use this as your starting point for parent training goals.

02At a glance

Intervention
not applicable
Design
survey
Sample size
86
Population
autism spectrum disorder
Finding
positive

03Original abstract

Family accommodation occurs frequently among families of children with OCD and anxiety disorders, with higher levels of accommodation repeatedly associated with greater symptom severity, lower functioning, and poorer treatment outcomes for children. This is the first examination of family accommodation of restricted and repetitive behaviors (RRBs) in children with autism spectrum disorder (ASD). Parents of children with ASD (N = 86) completed questionnaires assessing their children's RRBs and parental accommodation of these symptoms. Most participants (80%) reported engaging in accommodation at least once a month and family accommodation was significantly positively correlated with RRB severity. These results suggest accommodation of RRBs follows a pattern similar to that reported in obsessive compulsive and anxiety disorders, and highlight avenues for potential parent-based interventions.

Journal of autism and developmental disorders, 2019 · doi:10.1007/s10803-019-04078-x