Little Children with Big Worries: Addressing the Needs of Young, Anxious Children and the Problem of Parent Engagement
- 1.6k Downloads
Anxiety disorders in preschool-age children represent an important clinical problem due to high prevalence, substantial impairment, persistence, and associated risk for later emotional problems. Early intervention may mitigate these problems by capitalizing on a strategic developmental period. Elevated neuroplasticity, availability of screening tools, and the potential to modify parenting practices position anxiety as a good candidate for early intervention and preventive efforts. While some novel interventions show promise, the broad success of such programs will largely depend on parent engagement. Since parents are less likely to identify and seek help for anxiety problems compared to other childhood behavior problems, especially in a preventive manner, methods for understanding parents’ decisions to participate and enhancing levels of engagement are central to the success of early childhood anxiety prevention and intervention. Understanding these processes is particularly important for families characterized by sociodemographic adversity, which have been underrepresented in anxiety treatment research. This review summarizes the developmental phenomenology of early emerging anxiety symptoms, the rationale for early intervention, and the current state of research on interventions for young, anxious children. The roles of parent engagement and help-seeking processes are emphasized, especially among economically disadvantaged and ethnic minority communities who are acutely at risk. Evidence-based strategies to enhance parent engagement to facilitate the development and dissemination of efficacious programs are offered.
KeywordsAnxiety Preschool Early childhood Parent engagement Prevention Early intervention
I would like to thank Dr. Alice S. Carter for her guidance and support of this project.
- Allen, J. L., Rapee, R. M., & Sandberg, S. (2008). Severe life events and chronic adversities as antecedents to anxiety in children: A matched control study. Journal of Abnormal Child Psychology: An official publication of the International Society for Research in Child and Adolescent Psychopathology, 36(7), 1047–1056.CrossRefGoogle Scholar
- Barlow, D. H., Chorpita, B. F., & Turovsky, J. (1996). Fear, panic, anxiety, and disorders of emotion. In D. A. Hope (Ed.), Nebraska symposium on motivation, 1995: Perspectives on anxiety, panic, and fear (pp. 251–328). Lincoln, NE: University of Nebraska Press.Google Scholar
- Benham, A. L., & Slotnick, C. F. (2006). Play therapy: Integrating clinical and developmental perspectives. In J. L. Luby (Ed.), Handbook of preschool mental health: Development, disorders, and treatment (pp. 331–371). New York, NY: Guilford Press.Google Scholar
- Biederman, J., Petty, C. R., Hirshfeld-Becker, D. R., Henin, A., Faraone, S. V., Fraire, M., et al. (2007). Developmental trajectories of anxiety disorders in offspring at high risk for panic disorder and major depression. Psychiatry Research, 153(3), 245–252.PubMedCentralPubMedCrossRefGoogle Scholar
- Briggs-Gowan, M. J., Carter, A. S., Moye Skuban, E., & McCue Horwitz, S. (2001). Prevalence of social-emotional and behavioral problems in a community sample of 1- and 2-year-old children. Journal of the American Academy of Child and Adolescent Psychiatry, 40(7), 811–819.PubMedCrossRefGoogle Scholar
- Briggs-Gowan, M. J., & Mian, N. D. (in press). Trauma and violence exposure in young children. In P. Clements, & S. Seedat (Eds.), Mental health issues of child maltreatment. Saint Louis, MO: STM Learning, Inc.Google Scholar
- Cartwright-Hatton, S., McNally, D., Field, A. P., Rust, S., Laskey, B., Dixon, C., et al. (2011). A new parenting-based group intervention for young anxious children: Results of a randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 50(3), 242–251.PubMedCrossRefGoogle Scholar
- Costello, E. J., Egger, H. L., & Angold, A. (2004). Developmental epidemiology of anxiety disorders. In T. H. Ollendick & J. S. March (Eds.), Phobic and anxiety disorders in children and adolescents: A clinician’s guide to effective psychosocial and pharmacological interventions (pp. 61–91). New York, NY: Oxford University Press.Google Scholar
- Day, J. C. (1996). Population projections of the United States by age, sex, race, and Hispanic origin: 1995 to 2050. US Bureau of the Census, Current Population Reports, P25-1130. Washington, DC: US Government Printing Office. http://www.census.gov/prod/1/pop/p25-1130.pdf.
- Egger, H. L., & Angold, A. (2006a). Anxiety disorders. In J. L. Luby (Ed.), Handbook of preschool mental health: Development, disorders, and treatment (pp. 137–164). New York, NY: Guilford Press.Google Scholar
- Godoy, L., Mian, N. D., Eisenhower, A. S., & Carter, A. S. (2013). Pathways to service receipt: Modeling parent help-seeking for childhood mental health problems. Administration and Policy in Mental Health and Mental Health Services Research. doi: 10.1007/s10488-013-0484-6.
- Hirshfeld-Becker, D. R., Masek, B., Henin, A., Blakely, L. R., Pollock-Wurman, R. A., McQuade, J., et al. (2010). Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 78(4), 498–510.PubMedCrossRefGoogle Scholar
- Kennedy, S. J., Rapee, R. M., & Edwards, S. L. (2009). A selective intervention program for inhibited preschool-aged children of parents with an anxiety disorder: Effects on current anxiety disorders and temperament. Journal of the American Academy of Child and Adolescent Psychiatry, 48(6), 602–609.PubMedCrossRefGoogle Scholar
- Marakovitz, S., Wagmiller, R. L., Mian, N. D., & Carter, A. S. (2011). Lost toy? Monsters under the bed? Contributions of temperament and family factors to early internalizing problems in boys and girls. Journal of Clinical Child and Adolescent Psychology, 40(2), 233–244.PubMedCrossRefGoogle Scholar
- McCabe, K. M., Yeh, M., Garland, A. F., Lau, A. S., & Chavez, G. (2005). The GANA program: A tailoring approach to adapting parent child interaction therapy for Mexican Americans. Education & Treatment of Children, 28(2), 111–129.Google Scholar
- McDonald, R., Jouriles, E. N., Briggs-Gowan, M. J., Rosenfield, D., & Carter, A. S. (2007). Violence toward a family member, angry adult conflict, and child adjustment difficulties: Relations in families with 1- to 3-year-old children. Journal of Family Psychology, 21(2), 176–184.PubMedCrossRefGoogle Scholar
- Mrazek, P. J., & Haggerty, R. J. (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, DC: National Academy Press.Google Scholar
- Ollendick, T. H., Öst, L.-G., Reuterskiöld, L., Costa, N., Cederlund, R., Sirbu, C., et al. (2009). One-session treatment of specific phobias in youth: A randomized clinical trial in the United States and Sweden. Journal of Consulting and Clinical Psychology, 77(3), 504–516.PubMedCrossRefGoogle Scholar
- Pincus, D. B., Eyberg, S. M., & Choate, M. L. (2005). Adapting parent–child interaction therapy for young children with separation anxiety disorder. Education and Treatment of Children, 28(2), 163–181.Google Scholar
- Rapee, R. M., & Coplan, R. J. (2010). Conceptual relation between anxiety disorder and fearful temperament. In H. Gazelle & K. Rubin (Eds.), Social anxiety in childhood: Bridging developmental and clinical perspectives New directions for child and adolescent development. San Francisco: Jossey-Bass.Google Scholar
- Szapocznik, J., Perez-Vidal, A., Brickman, A. L., Foote, F. H., Santisteban, D., Hervis, O., et al. (1988). Engaging adolescent drug abusers and their families in treatment: A strategic structural systems approach. Journal of Consulting and Clinical Psychology, 56(4), 552–557.PubMedCrossRefGoogle Scholar
- Wu, P., Hoven, C. W., Bird, H. R., Moore, R. E., Cohen, P., Alegria, M., et al. (1999). Depressive and disruptive disorders and mental health service utilization in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 38(9), 1081–1090.PubMedCrossRefGoogle Scholar