This is a long overdue answer to a question written in to BehaviorBandAid:

I have a problem.  My son is 4.5 and has a twin sister. He is now scared to go in any room of our house alone.  This is now affecting his sleep. He now wakes up between 5:15 and 5:45 because he is scared. His sister is in the room, but…he can’t go to the bathroom alone or to get his clothes from his room without one of us going with.

Interestingly, the experiences this mother has are not uncommon. I recently posted an article written about “fear of the dark” that I feel was interesting and helpful in terms of getting through different “fears” kids often have.   My answer is a little more in depth, so see what you think.

I believe the answer lies in practice outside the event when it usually occurs (you don’t want to practice hitting a baseball only at the times when the bases are loaded and there are 2 out) and a bit of work up front when the occasion is likely to occur.  Make sense?  Lets attack this one area at a time.

Calming agent: It seems the “calming agent” is you or your husband (a good think if you time it correctly).  We need to arrange this from the beginning to make sure you are initially present and slowly fade that presence instead of putting him out there, crossing your fingers, then going to him once he gets more and more fearful.  This is likely not a “sink or swim” situation in which you can say “you do it this time” because you might be setting up a situation where you are contributing to his experiences of getting scared and having that fear relieved by you guys. 

Play it out:  Find opportunities to “play games” where he can practice being alone for short periods of time and experience fun around those events.  I quickly begin to think of “hide and go seek.”  Play games with getting dressed up (independently).  The idea is to find ways to make these behaviors fun, so they are likely to occur then you can reward them and use them as a reference in the future…”see you can do it!”

Set the alarm:  As for the nighttime thing, does this happen every night (having to wake up to use the restroom then calling for you guys to go with)?  If so, (and this might be initially painful) I would set my alarm for 4:00 AM, go in to get him before he wakes and take him.  Don’t make this very entertaining, but do reinforce this with praise, “good job…I knew you could do it. Well done.”  Send him back to bed and tell him you will come to wake him up later, but he needs to be in his bed.  Make sure you get there (again…initially painful) a bit before he is likely to wake on his own (given you have already toileted…if that is a nightly thing).  If that is too early to be up and about, you should give him things to do when he is awake, but in bed.  I am trying to make sure he does not need you at these times and at the very least has a lesser opportunity to gain access to you by screaming or calling out for you and “being scared.”

Slowly back away:  Slowly fade your presence from the bathroom (assuming this occurs throughout the day).  Begin by going with him before he asks.  Over time, slowly fade out (“O.K., I will be right here outside the door” – “O.K. I am going to step into the kitchen” — “O.K. I will be in the living room”).  Praise and maybe even have some other reward (see this post and this one).  The idea is to do this slowly enough that he will be likely to succeed and less likely to get fearful and then get access to you.  This applies to the nighttime thing too.  If he can go overnight without you…there needs to be some positive effect of that.  Whether that is solid praise and high fives or something more tangible is up to you guys (consider what it would be like not to have to wake up at 5:00 in the morning when considering this).

Timing is everything:  Same idea with the clothes.  You essentially want to begin with what you would do after he gets scared, but do it before he gets scared and tries to get access to you guys.  So, if you go collect the clothes for him when he says he is scared, then I would do that before he gets scared (go with him) and then fade back from that after you have gotten some momentum with him doing it without getting scared.  Again…not a “sink or swim” behavior because you know he needs to get dressed and you will ultimately help him if he gets scared.  So, my idea is to go back to where his success can be rewarded then slowly and predictably move back and let the effects of the success take hold.

Main ideas: a) the recognition that it is your attention and help that is likely the “calming agent,” b) this attention and help can be used to your advantage before the fear behavior occurs, c) “sink or swim” won’t likely apply, d) praise, reward, praise as you slowly back away.  Fear is reduced initially by reducing the opportunity for the fear to occur (you are there from the get-go) and is less likely to occur as you reward the independent behavior and back away.