Internet-Delivered Parenting Program for Prevention and Early Intervention of Anxiety Problems in Young Children: Randomized Controlled Trial

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 56; no. 5; pp. 417 - 425.e1
• Main Authors: Morgan, Amy J., PhD, Rapee, Ronald M., PhD, Salim, Agus, PhD, Goharpey, Nahal, PhD, Tamir, Elli, BAppSc(Psych)(Hons), McLellan, Lauren F., PhD, Bayer, Jordana K., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2017; Elsevier BV
• Subjects: Anxiety; Anxiety disorders; Anxiety Disorders - prevention & control; Child; Child & adolescent psychiatry; Child psychology; Child Rearing; Child, Preschool; Children; Children & youth; Clinical trials; Control Groups; Coping strategies; Dissemination; Early intervention; Early Intervention (Education) - methods; Efficacy; Female; Humans; Inhibition; Internalization; Internet; Inventories; Male; Overprotection; Parenthood education; parenting; Parenting - psychology; Parents; Parents & parenting; Parents - psychology; Pediatrics; Personality; Phobia, Social - psychology; prevention; Prevention programs; Program Development - methods; Psychiatric Status Rating Scales; Psychiatry; Psychologists; Questionnaires; Randomized Controlled Trials; Risk assessment; Self report; Temperament; Young Children; anxiety disorders; children; internet; prevention; parenting; Internet
• ISSN: 0890-8567; 1527-5418
• DOI: 10.1016/j.jaac.2017.02.010

Abstract Objective The Cool Little Kids parenting group program is an effective intervention for preventing anxiety disorders in young children who are at risk due to inhibited temperament. The program has 6 group sessions delivered by trained psychologists to parents of 3–6-year-old children. An online adaptation (Cool Little Kids Online) has been developed to overcome barriers to its wide dissemination in the community. This study tested the efficacy of Cool Little Kids Online in a randomized controlled trial. Method 433 parents of a child aged 3-6 years with an inhibited temperament were randomized to the online parenting program or to a 24-week waitlist. The online program has 8 interactive modules providing strategies parents can implement with their child to manage their child’s avoidant coping, reduce parental overprotection, and encourage child independence. Parents were provided telephone consultation support with a psychologist when requested. Parents completed self-report questionnaires at baseline, and 12 and 24 weeks after baseline. Results The intervention group showed significantly greater improvement over time in child anxiety symptoms compared to the control group (d = 0.38). The intervention group also showed greater reductions in anxiety life interference (ds = 0.33-0.35) and lower rates of anxiety disorders than the control group (40% vs 54%), but there were minimal effects on broader internalizing symptoms or overprotective parenting. Conclusion Results provide empirical support for the efficacy of online delivery of the Cool Little Kids program. Online dissemination may improve access to an evidence-based prevention program for child anxiety disorders. Clinical trial registration information— Randomised Controlled Trial of Cool Little Kids Online: A Parenting Program to Prevent Anxiety Problems in Young Children; http://www.anzctr.org.au/ 12615000217505