Abstract
Millions of youth who attend schools in the United States suffer from clinically significant anxiety. Left untreated, these students often experience significant disruptions in their academic, social, and family functioning. Fortunately, promising treatments exist for childhood anxiety that are amenable for delivery in school settings. However, educational law and new service delivery paradigms such as response-to-intervention (RtI) affect the delivery of anxiety interventions. In light of extant laws and practices that govern education, this article discusses the provision of supportive services to address childhood anxiety. Specifically, this article reviews how RtI, the Individuals with Disabilities Education Improvement Act, and Section 504 of the Rehabilitation Act guide service delivery and subsequently impact school-based anxiety treatments. Suggestions are provided to address childhood anxiety within a framework that allows for graduated and fluid service delivery.
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References
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.
Albano, A. M., & Kendall, P. C. (2002). Cognitive behavioral therapy for children and adolescents with anxiety disorders: Clinical research advances. International Review of Psychiatry, 14, 129–134.
Ballash, N. G., Pemble, M. K., Usui, W. M., Buckley, A. F., & Woodruff-Borden, J. (2006). Family functioning, perceived control, and anxiety: A mediational model. Journal of Anxiety Disorders, 20, 486–497. doi:10.1016/j.janxdis.2005.05.002.
Barnes, A. C., & Harlacher, J. E. (2008). Clearing the confusion: Response-to-intervention as a set of principles. Education and Treatment of Children, 31, 417–431. doi:10.1353/etc.0.0000.
Barrett, P. M. (1998). Evaluation of cognitive-behavioral group treatments for childhood anxiety disorders. Journal of Clinical Child and Adolescent Psychology, 27, 459–468. doi:10.1207/s15374424jccp2704_10.
Barrett, S., & Heubeck, B. G. (2000). Relationships between school hassles and uplifts and anxiety and conduct problems in grades 3 and 4. Journal of Applied Developmental Psychology, 21, 537–554. doi:10.1016/S0193-3973(00)00053-8.
Barrett, P. M., Lock, S., & Farrell, L. J. (2005). Developmental differences in universal preventive intervention for child anxiety. Clinical Child Psychology and Psychiatry, 10, 539–555. doi:10.1177/1359104505056317.
Beck, J. S., Beck, A. T., Jolly, J., & Steer, R. A. (2001). Manual for the Beck Youth inventories of emotional and social impairment (2nd ed.). San Antonio, TX: Harcourt Assessment.
Beidas, R., & Kendall, P. C. (2010). Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice, 17, 1–30. doi:10.1111/j.1468-2850.2009.01187.x.
Chavira, D. A., Stein, M. B., Bailey, K., & Stein, M. T. (2004). Child anxiety in primary care: Prevalent but untreated. Depression and Anxiety, 20, 155–164. doi:10.1002/da.20039.
Choudhury, M. S., Pimentel, S. S., & Kendall, P. C. (2003). Childhood anxiety disorders: parent–child (dis)agreement using a structured interview for the DSM-IV. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 957–964. doi:10.1097/01.CHI.0000046898.27264.A2.
Conners, C. K. (2008). Conners 3rd edition: Manual. Toronto, ON: Multi-Health Systems.
Connolly, S. D., & Bernstein, G. A. (2007). Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 267–283. doi:10.1097/01.chi.0000246070.23695.0.
Coplan, R. J., Girardi, A., Findlay, L. C., & Frohlick, S. L. (2007). Understanding solitude: Young children’s attitudes and responses toward hypothetical socially withdrawn peers. Social Development, 16, 390–409. doi:10.1111/j.1467-9507.2007.00390.x.
Costello, E. J., Egger, H., & Angold, A. (2005). 10-year research update review: The epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 972–986.
Cummings, J. R., Ponce, N. A., & Mays, V. M. (2010). Comparing racial/ethnic differences in mental health service use among high-need subpopulations across clinical and school-based settings. Journal of Adolescent Health, 46, 603–606. doi:10.1016/j.jadohealth.2009.11.221.
Durlak, J. A., Weissberg, R. P., Dymnicki, A. P., Schlinnger, K. B., & Taylor, R. D. (2011). The impact of enhancing students’ social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82, 405–432. doi:10.1111/j.1467-8624.2010.01564.x.
Farmer, E. M. Z., Burns, B. J., Phillips, S. D., Angold, A., & Costello, E. J. (2003). Pathways into and through mental health services for children and adolescents. Psychiatric Services, 54, 60–66.
Flannery-Schroeder, E. C., & Kendall, P. C. (2000). Group and individual cognitive-behavioral treatments for youth with anxiety disorders: A randomized clinical trial. Cognitive Therapy and Research, 24, 251–278. doi:10.1037/0022-006X.72.5.821.
Fletcher, J. M., & Vaughn, S. (2009). Response to intervention: Preventing and remediating academic difficulties. Child Development Perspectives, 3, 30–37. doi:10.1111/j.1750-8606.2008.00072.x.
Ginsburg, G. S., Becker, K. D., Kingery, J. N., & Nichols, T. (2008). Transporting CBT for childhood anxiety disorders into inner-city school-based mental health clinics. Cognitive and Behavioral Practice, 15, 148–158. doi:10.1016/j.cbpra.2007.07.001.
Gresham, F. M., & Elliott, S. N. (2008). Social skills improvement system: Rating scales. Bloomington, MN: Pearson.
Individuals with Disabilities Education Act of 1997. 20 U. S. C. § 1400 et seq.
Individuals with Disabilities Education Improvement Act of 2004. 20 U.S.C. § 1400 et seq.
Kamphaus, R. W., & Reynolds, C. R. (2007). Behavior assessment system for children—Second edition (BASC-2): Behavioral and emotional screening system (BESS). Bloomington, IN: Pearson.
Kazdin, A. E., & Weisz, J. R. (1998). Identifying and developing empirically supported child and adolescent treatments. Journal of Consulting and Clinical Psychology, 66, 19–36. doi:10.1037/0022-006X.66.1.19.
Kendall, P. C., Crawley, S. A., Benjamin, C. L., & Mauro, C. F. (2009). Brief Coping Cat: The 8 session Coping Cat manual. Unpublished treatment manual, Temple University.
Kendall, P. C., & Hedtke, K. A. (2006). Cognitive-behavioral therapy for anxious children: Therapist manual (3rd ed.). Ardmore, PA: Workbook Publishing.
Kendall, P. C., Safford, S., Flannery-Schroeder, E., & Webb, A. (2004). Child anxiety treatment: Outcomes in adolescence and impact on substance use and depression at 7.4-year follow-up. Journal of Consulting and Clinical Psychology, 72, 276–287. doi:2004-12113-012.
Kendall, P. C., & Suveg, C. (2006). Treating anxiety disorders in youth. In P. C. Kendall (Ed.), Child and adolescent therapy: Cognitive-behavioral procedures (3rd ed.). New York, NY: Guilford Press.
Khanna, M. S., & Kendall, P. C. (2008). Computer-assisted CBT for child anxiety: The coping cat CD-ROM. Cognitive and Behavioral Practice, 15, 159–165. doi:10.1016/j.cbpra.2008.02.002.
Khanna, M. S., & Kendall, P. C. (2010). Computer-assisted cognitive behavioral therapy for child anxiety: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 78, 737–745. doi:10.1037/a0019739.
Lazarus, P. J., & Sulkowski, M. L. (2011). The emotional well-being of our nation’s youth and the promise of social-emotional learning. Communiqué, 40, 1 & 16–17.
March, J. S. (1998). Multidimensional anxiety scale for children. North Tonawanda, NY: Multi-Health Systems.
Masia, C. L., Klein, R. G., Storch, E. A., & Corda, B. (2001). School-based behavioral treatment for social anxiety disorder in adolescents: Results of a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 780–786. doi:10.1097/00004583-200107000-00012.
Masia-Warner, C., Fisher, P. H., Shrout, P. E., Rathor, S., & Klein, R. G. (2007). Treating adolescents with social anxiety disorder in school: An attention control trial. Journal of Child Psychology and Psychiatry, 48, 676–686. doi:10.1111/j.1469-7610.2007.01737.x.
Masia-Warner, C., Klein, R. G., Dent, H. C., Fisher, P. H., Alvir, J., Albano, A. M., et al. (2005). School-based intervention for adolescents with social anxiety disorder: Results of a controlled study. Journal of Abnormal Child Psychology, 33, 707–722. doi:10.1007/s10802-005-7649-z.
Mendlowitz, S. L., Manassis, K., Bradley, S., Scapillato, D., Miezitis, S., & Shaw, B. E. (1999). Cognitive-behavioral group treatments in childhood anxiety disorders: The role of parental involvement. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1223–1229. doi:10.1097/00004583-199910000-00010.
Mychailyszyn, M. P., Beidas, R. S., Benjamin, C. L., Edmunds, J. M., Podell, J. L., Cohen, J. S., et al. (2011). Assessing and treating child anxiety in schools. Psychology in the Schools, 48, 223–232. doi:10.1002/pits.20548.
Mychailyszyn, M. P., Mendez, J. L., & Kendall, P. C. (2010). School functioning in youth with and without anxiety disorders: Comparisons by diagnosis and comorbidity. School Psychology Review, 39, 106–121. doi:10.1002/pits.20548.
National Association of State Directors of Special Education. (2008a). Response-to-intervention: Blueprint for implementation—district level. Alexandria, VA: Author.
National Association of State Directors of Special Education. (2008b). Response-to-intervention: Blueprint for implementation—school building level. Alexandria, VA: Author.
Neil, A. L., & Christensen, H. (2009). Efficacy and effectiveness of school-based prevention and early intervention programs for anxiety. Clinical Psychology Review, 29, 208–215. doi:10.1016/j.cpr.2009.01.002.
Nelson, L. J., Rubin, K. H., & Fox, N. A. (2005). Social withdrawal, observed peer acceptance, and the development of self-perceptions in children ages 4 to 7 years. Early Childhood Research Quarterly, 20, 185–200. doi:10.1016/j.ecresq.2005.04.007.
Office of Special Education and Rehabilitative Services, Department of Education (2006). Federal register: Part II Department of Education, 34 CFR Parts 300 and 301, Assistance to states for the education of children with disabilities and preschool grants for children with disabilities; Final rule. Author.
Ollendick, T. H., & King, N. J. (1998). Empirically supported treatments for children with phobic and anxiety disorders: Current status. Journal of Clinical Child and Adolescent Psychology, 27, 156–167.
Olweus, D., & Limber, S. (2000). Blueprints for violence prevention: Bullying prevention program. Denver, CO: Venture Publishing.
Pearson Education. (2008). AIMSweb. San Antonio, TX: Author.
Rapee, R. M., Kennedy, S., Ingram, M., Edwards, S., & Sweeney, L. (2005). Prevention and early intervention of anxiety disorders in inhibited preschool children. Journal of Consulting and Clinical Psychology, 73, 488–497. doi:10.1037/0022-006X.73.3.488.
Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior assessment system for children—second edition (BASC-2). Circle Pines, MN: AGS.
Reynolds, C. R., & Kamphaus, R. W. (2009). Behavior assessment system for children—second edition (BASC-2): Progress monitor. Circle Pines, MN: AGS.
Reynolds, C. R., & Richmond, B. O. (2008). The revised children’s manifest anxiety scale. Los Angeles, CA: Western Psychological Services.
Salloum, A., Sulkowski, M. L., Sirrine, E., & Storch, E. A. (2009). Overcoming barriers to using empirically supported therapies to treat childhood anxiety disorders in social work practice. Child and Adolescent Social Work Journal, 26, 259–273. doi:10.1007/s10560-009-0173-1.
Sattler, J. M., & Hoge, R. D. (2006). Assessment of children: Behavioral, social, and clinical foundations (5th ed.). San Diego, CA: Jerome M. Sattler Publisher Inc.
Section 504 of the Rehabilitation Act of 1973. 29 U.S.C. § 794.
Silverman, W. K., Kurtines, W. M., Ginsburg, G. S., Weems, C. F., Lumpkin, P. W., & Carmichael, D. H. (1999). Treating anxiety disorders in children with group cognitive-behavioral therapy: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 67, 995–1003. doi:10.1037/0022-006X.67.6.995.
Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putnam, F. W., et al. (2008). Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child and Adolescent Psychology, 37, 156–183. doi:10.1080/1537441070181829.
Spielberger, C. D. (1973). Manual for the state-trait anxiety inventory for children. Palo Alto CA: Consulting Psychologists Press.
Storch, E. A., Geffken, G. R., Merlo, L. J., Jacob, M. L., Murphy, T. K., Goodman, W. K., et al. (2007). Family accommodation in pediatric obsessive–compulsive disorder. Journal of Clinical Child and Adolescent Psychology, 36, 207–216. doi:10.1080/15374410701277929.
Storch, E. A., Ledley, D. R., Lewin, A. B., Murphy, T. K., Johns, N. B., Geffken, G. R., et al. (2006a). Peer victimization in children with obsessive-compulsive disorder: Relations with symptoms of psychopathology. Journal of Clinical Child and Adolescent Psychology, 35, 446–455. doi:10.1207/s15374424jccp3503_10.
Storch, E. A., Murphy, T. K., Bagner, D. M., Johns, N. B., Baumeister, A. L., & Goodman, W. K. (2006b). Reliability and validity of the child behavior checklist obsessive-compulsive scale. Journal of Anxiety Disorders, 20, 473–485. doi:10.1016/j.janxdis.2005.06.002.
Sulkowski, M. L., Jordan, C., & Nguyen, M. L. (2009). Current practices and future directions in psychopharmacological training and collaboration in school psychology. Canadian Journal of School Psychology, 24, 237–244. doi:10.1177/0829573509338616.
Sulkowski, M. L., Wingfield, R. J., Jones, D., & Coulter, W. A. (2011). Response to intervention and interdisciplinary collaboration: Joining hands to support children and families. Journal of Applied School Psychology, 27, 1–16. doi:10.1080/15377903.2011.565264.
Wheeler, J. J., & Mayton, M. R. (2010). Historical and philosophical changes in the education of students with exceptionalities. Advances in Special Education, 19, 175–195. doi:10.1108/S0270-4013(2011)0000021004.
Woodward, L. J., & Fergusson, D. M. (2001). Life course outcomes of young people with anxiety disorders in adolescence. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1086–1093. doi:10.1097/00004583-200109000-00018.
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Sulkowski, M.L., Joyce, D.K. & Storch, E.A. Treating Childhood Anxiety in Schools: Service Delivery in a Response to Intervention Paradigm. J Child Fam Stud 21, 938–947 (2012). https://doi.org/10.1007/s10826-011-9553-1
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DOI: https://doi.org/10.1007/s10826-011-9553-1