This study provides evidence for differential response to broad-based CBT for children, based on type of anxiety diagnoses.

ANXIETY DISORDERS AMONG STUTTERING CHILDREN 2 Highlights Stuttering is a speech disorder that hampers communication in social situations  Roughly 22-60% of adults who stutter meet criteria for social anxiety disorder  No studies have evaluated the rate of anxiety disorders among stuttering children  Stuttering children demonstrated a significantly higher rate of anxiety disorders  Of note, 24% of stuttering children met criteria for social anxiety disorder AbstractPurpose: Stuttering during adulthood is associated with a heightened rate of anxiety disorders, especially social anxiety disorder. Given the early onset of both anxiety and stuttering, this comorbidity could be present among stuttering children.Method: Participants were 75 stuttering children 7-12 years and 150 matched non-stuttering control children. Multinomial and binary logistic regression models were used to estimate odds ratios for anxiety disorders, and two-sample t-tests compared scores on measures of anxiety and psycho-social difficulties.Results: Compared to non-stuttering controls, the stuttering group had six-fold increased odds for social anxiety disorder, seven-fold increased odds for subclinical generalized anxiety disorder, and four-fold increased odds for any anxiety disorder. Conclusion:These results show that, as is the case during adulthood, stuttering during childhood is associated with a significantly heightened rate of anxiety disorders. Future research is needed to determine the impact of those disorders on speech treatment outcomes.Keywords: Anxiety disorders; Social anxiety disorder; Diagnosis; Stuttering.ANXIETY DISORDERS AMONG STUTTERING CHILDREN 3 Prevalence of anxiety disorders among children who stutterFor some children who stutter, the negative social consequences of stuttering can begin as early as the preschool years, and continue across the lifespan. Non-stuttering preschool children have been found to negatively evaluate stuttering (Ezrati-Vinacour, Platzky, & Yairi, 2001) and may sometimes ignore, interrupt, mock, and walk away from stuttering children (Langevin, Packman, & Onslow, 2009). The communication difficulties and negative consequences of stuttering experienced by some children who stutter typically intensify during the school years, due to the increased importance of communication in social and classroom settings. Stuttering children have been rated as less popular, less likely to be considered leaders, and more likely to be considered bully victims, than their non-stuttering peers (Davis, Howell, & Cooke, 2002).Several studies have also confirmed that stuttering adolescents report a significantly higher rate of bullying than non-stuttering controls (Blood & Blood, 2004, 2007 Blood et al., 2011).Although negative consequences to stuttering may not occur for all children who stutter, these experiences have the capacity to adversely impact communication competence, selfesteem, social development, and even romantic attractiveness (Blood et al., 2011; Erickson & Block, 2013;Van Borsel, Brepoels, & De C...

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.

BackgroundAnxiety disorders are highly prevalent in adolescence, but access to health care services is limited and only few receive professional help. Internet-based cognitive behavioral therapy (ICBT) has been proposed to increase accessibility and reduce costs of treatment.ObjectiveThe study evaluated the efficacy of a Danish version of the guided ICBT program ChilledOut Online, developed at the Centre for Emotional Health, Macquarie University, Australia.MethodAt the Centre for Psychological Treatment of Children and Adolescents, Aarhus University, Denmark, a randomized controlled trial was conducted with 70 adolescents (13–17 years) with anxiety disorders according to DSM-IV. Participants were randomly assigned to a 14-weeks therapist-guided ICBT or to a waitlist condition. Outcomes were evaluated post-treatment and at 3- and 12-month follow-up.ResultsAt post-treatment, the ICBT group significantly outperformed the waitlist condition with moderate to large between-group effect sizes on diagnostic severity and anxiety symptoms rated by clinicians, and by adolescents and their parents. Forty percent of adolescents in ICBT were free of their primary diagnosis compared to 16% in the waitlist condition. Treatment gains were maintained at 3- and 12-month follow-up.ConclusionResults of the study provide support for the efficacy of guided ICBT for adolescents with anxiety disorders.Trial registrationClinicalTrials.gov: NCT02535403.

Initial internet-based cognitive behavioral therapy (iCBT) programs for anxiety disorders in children and young people (CYP) have been developed and evaluated, however these have not yet been widely adopted in routine practice. The lack of guidance and formalized approaches to the development and dissemination of iCBT has arguably contributed to the difficulty in developing iCBT that is scalable and sustainable beyond academic evaluation and that can ultimately be adopted by healthcare providers. This paper presents a consensus statement and recommendations from a workshop of international experts in CYP anxiety and iCBT (#iCBTLorentz Workshop Group) on the development, evaluation, engagement and dissemination of iCBT for anxiety in CYP.

Cognitive behaviour therapy (CBT) is an efficacious treatment for paediatric anxiety disorders, yet not all children improve following standard treatment protocols. Identifying pre-treatment predictors of poor treatment response is an important area of research to maximise outcomes for children with anxiety disorders. This paper presents a systematic review of pre-treatment predictors of child/adolescent anxiety treatment outcome, including child demographic, child diagnostic and parental factors. Results are based on 47 peer-reviewed articles and 4 dissertations. Results for each predictor are reported according to method of measuring outcome (e.g., endpoint or rate of change). No consistent and clear pre-treatment predictors of paediatric anxiety outcome were identified. Yet, it is worth noting that a number of trends emerged; some significant predictors were identified in more than one study including primary anxiety diagnosis, severity, comorbidity and parental anxiety/psychopathology. With regards to primary anxiety diagnosis, there was emerging evidence that Social Anxiety Disorder predicted poorer treatment response, while GAD predicted better outcome. Greater symptom severity and comorbid externalising symptoms/disorder were also associated with poorer treatment response but not dependably across studies. Some inconsistent evidence also emerged showing that presence of comorbidity, comorbid depression, parental psychopathology, parental anxiety and maternal anxiety were associated with poorer outcomes when outcome was assessed as an endpoint. There were a number of pre-treatment factors that were not related to treatment outcome: age, gender, ethnicity and socioeconomic status. Based on a small number of studies, comorbid anxiety, maternal depression, paternal anxiety and paternal depression also failed to predict treatment outcome. Further methodologically strong research is needed to clarify the conclusions made in this review and to investigate a range of predictors considered under preliminary investigation.

There is significant interest in the potential of Internet-delivered pain management programs for adults with chronic pain. Understanding the characteristics of people who do and do not benefit from Internet-delivered programs will help to guide their safe and effective use. Using a large sample from a previous randomised controlled trial of an established Internet-delivered pain management program, the Pain Course, this study (n = 463) examined whether several demographic, clinical, psychological, and treatment-related variables could be used to predict clinical response in levels of disability, depression, anxiety, or average pain. Multiple univariate and multivariate stepwise logistic regressions were used to identify unique predictors of clinical improvement, which, consistent with recommendations, was defined as a ≥30% reduction in symptoms or difficulties from baseline. Several unique predictors of clinical improvement were found. However, no particularly decisive or dominant predictors emerged that were common across time points or across the outcome domains. Reflecting this, the identified predictors explained only 18.1%, 13.7%, 7.6%, and 9.5% of the variance in the likelihood of making a clinical improvement in disability, depression, anxiety, and average pain levels, respectively. The current findings suggest that a broad range of patients may benefit from emerging Internet-delivered pain management programs and that it may not be possible to predict who will or will not benefit on the basis of patients' demographic, clinical, and psychological characteristics.

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