Early Intervention for Children at Risk for Anxiety

Inclusion criteria

• The child is at risk for anxiety disorders, as indicated by at least one of the following:
• the child has behavioral inhibition (as determined by observed behavioral assessment);
• the child meets criteria for a DSM-IV or IIIR anxiety disorder (as determined by Kiddie-Schedule for Affective Disorders and Schizophrenia, Epidemiologic Version [K-SADS-E] with the mother); or
• the child has both a parent with lifetime history of anxiety disorder (as determined by direct Structured Clinical Interview for DSM-IV [SCID-IV] with both parents) and the child has anxious symptomatology, as indicated by Child Behavior Checklist [CBCL] scale scores (T-scores) on Anxious/Depressed or Withdrawn of 55 or higher.
• The child is between the ages of 4 and 7 years
• The child and parent(s) have a working command of English

Exclusion criteria

• Psychosis in parent or child
• Suicidality in parent or child
• Current alcohol or substance abuse in a parent
• Mental retardation or pervasive developmental disorder in parent or child
• Child in current psychiatric treatment
• Child judged too uncooperative or distractible to take part in intervention
• (In the controlled trial): Child judged clinically unable to wait six months for treatment. The following criteria are used in determining whether the child can wait for 6 months before receiving treatment:
• Suicidal Ideation
• Serious impairment in eating or sleeping habits
• Severe social isolation
• Severe impairment in school functioning or attendance
• Severe symptoms of obsessive-compulsive disorder (OCD)
• Clinical judgment based on the child's overall severity of symptoms and family functioning.
• All judgments of severity of symptoms/impairment are based on a clinician review of the Kiddie-SADS-E and a clinical evaluation with the family.