The Development of a School Based Cognitive-Behavioral Intervention Protocol for Young Children with Anxiety
Date of Award
Dissertation - Restricted
Doctor of Philosophy (PhD)
Educational Policy and Leadership
The effectiveness of a school based cognitive-behavioral intervention protocol was studied using a multiple baseline design across three subjects ages 6-10 with anxiety. The intervention was an adaptation of Kendall's (1992) cognitive-behavioral protocol for anxiety disordered children ages 9-13. The 16 session intervention made use of coping stories developed by the experimenter, puppets, and book making to assure that materials were developmentally appropriate for younger children. Dependent measures were continuous assessment Parent and Teacher Ratings of Severity/Interference, Fear Thermometer Ratings of three counseling goals, and self-report ratings of trait anxiety. Additional dependent measures were pre- and post parent, teacher, and self-ratings of anxiety, depression, and fears using the Child Behavior Checklist, the Revised Children's Manifest Anxiety Scale, the Children's Depression Inventory, the State-Trait Anxiety Inventory for Children A-Trait Scale, and the Fear Survey Schedule for Children-Revised The Diagnostic Interview Schedule for Children was also used for pre- and post assessment. Results were that two subjects receiving an anxiety disorder diagnosis at pretest no longer met diagnostic criteria at posttest. The three children receiving the intervention evidenced reductions in anxiety to criterion levels on a majority of measures of continuous assessment. Two of the subjects evidenced reliable improvement on parent- rated internalizing and externalizing behaviors. Two of the subjects experiencing somatic complaints showed reliable improvement on teacher-rated somatic complaints. Many self-report measures remained within normal limits from pre- to posttesting. The one self-report rating above clinical levels at pretest did not evidence reliable change at posttest. The study provides tentative support for a school based cognitive-behavioral intervention for young, anxious children. Developmentally sensitive materials for use with young, anxious children are discussed. Directions for future research are also discussed.