The development, reliability, and validity of a new instrument, the Social Phobia and Anxiety Inventory for Children (SPAI-C), is described. The results indicate that the SPAI-C has high test-retest reliability and internal consistency. In addition, an assessment of concurrent and external validity indicates statistically significant correlations with commonly used self-report measures of general anxiety and fears and parental reports of children's anxiety and social competence. The results of a factor analysis indicate that the scale consists of three factors: Assertiveness/ General Conversation, Traditional Social Encounters, and Public Performance. Finally, scores on the SPAI-C successfully differentiate socially anxious and non-socially-anxious children. The instrument appears to be a reliable and valid measure for childhood social anxiety and fear and may prove useful for improving clinical assessment and documenting treatment outcome.

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Sixty-seven children (ages 8 and 12) with social phobia were randomized to either a behavioral treatment program designed to enhance social skills and decrease social anxiety (Social Effectiveness Therapy for Children, SET-C) or an active, but nonspecific intervention (Testbusters). Children treated with SET-C were significantly more improved across multiple dimensions, including enhanced social skill, reduced social fear and anxiety, decreased associated psychopathology, and increased social interaction. Furthermore, 67% of the SET-C group participants did not meet diagnostic criteria for social phobia at posttreatment compared with 5% of those in the Testbusters group. Treatment gains were maintained at 6-month follow-up. The results are discussed in terms of treatment of preadolescent children with social phobia and the durability of treatment effects.

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Future research should ensure adequate assessment for symptoms of anxiety and depression when examining sleep disturbance in children. Likewise, research on anxiety and depression should include assessment for symptoms of disturbed sleep. Bridging the gap between these literatures should provide further insights into the etiologies of these disorders, increase symptom detection, and improve the clinical care of children and their families.

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The structural, descriptive basis of the diagnostic categories outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) is contrasted to a system of functional analysis, with regard to (a) clinical diagnosis, (b) target behavior identification, (c) treatment design, (d) treatment evaluation, and (e) clinical research. It is noted that structural classification is a useful starting point for these activities but that functional analysis has greater utility for target behavior identification and treatment design by giving consideration to antecedent and consequent events, skills repertoires, response interrelations, and support systems. Examples of melding structural classification and functional analytic systems are provided with reference to certain childhood disorders: mental retardation, disruptive behavior disorders, and anxiety disorders. Recommendations are made for an elaboration of the DSM axes to include (a) psychosocial and environmental resources and deficits, and (b) idiographic case analysis. It is suggested that these axes will assist in systematizing functional analysis and making it more accessible to all clinicians and researchers.