Category: Treatment - CBT


Multimodal Early Intervention Program for Behaviorally Inhibited Preschoolers

Friday, November 17
10:15 AM - 11:45 AM
Location: Sapphire Ballroom K & L, Level 4, Sapphire Level

Keywords: Child | Psychotherapy Outcome | Randomized Controlled Trial
Presentation Type: Symposium

Fifteen to twenty percent of young children can be classified with a behaviorally inhibited (BI) temperament. Stable BI predicts the development of later anxiety disorders (particularly social anxiety), but not all inhibited children develop anxiety. Parenting characterized by inappropriate warmth/sensitivity and/or intrusive control predicts the stability of BI and moderates risk for anxiety among high-BI children. For these reasons, we developed the Turtle Program: a multi-modal early intervention for inhibited preschool-aged children. In our treatment development study, 40 inhibited children between the ages of 42-60 months and their parent(s) were randomized to the Turtle Program or waitlist control condition (WLC). Participants randomized to the Turtle Program received 8 weeks of concurrent parent and child group treatment. Participants were assessed at baseline and post-treatment with parent and teacher report measures of child anxiety, diagnostic interviews, and parenting observations. The Turtle Program resulted in significant beneficial effects relative to WLC on maternal-reported anxiety symptoms of medium to large magnitude; large effects on parent-reported BI; medium to large effects on teacher-rated school anxiety symptoms; and medium effects on observed maternal positive affect/sensitivity. We are currently in the midst of a large RCT (projected n = 150) in which inhibited preschoolers are randomly assigned to the Turtle Program or Cool Little Kids (CLK) parent-only group, the best-established intervention for preschoolers with BI. Preliminary analyses based on 62 participants suggest that both Turtle and CLK led to similar declines in child anxiety across clinician, parent, and teacher ratings. Parent diagnosis of lifetime social anxiety disorder on the ADIS moderated the effect of treatment, such that children whose parents met lifetime criteria for social anxiety experienced greater social anxiety symptom improvement in Turtle relative to CLK. Our findings offer preliminary evidence that a more intensive, multimodal treatment program such as Turtle may be more effective for young children whose parents struggle with social anxiety themselves.

Andrea Chronis-Tuscano

Professor of Psychology
University of Maryland- College Park


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Multimodal Early Intervention Program for Behaviorally Inhibited Preschoolers

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