Preventing anxiety problems in children with Cool Little Kids Online: study protocol for a randomised controlled trial

Abstract

BackgroundAnxiety disorders are the most common type of mental health problem and begin early in life. Early intervention to prevent anxiety problems in young children who are at risk has the potential for long-term impact. The ‘Cool Little Kids’ parenting group program was previously established to prevent anxiety disorders in young children at risk because of inhibited temperament. This group program was efficacious in two randomised controlled trials and has recently been adapted into an online format. ‘Cool Little Kids Online’ was developed to widen and facilitate access to the group program’s preventive content. A pilot evaluation of the online program demonstrated its perceived utility and acceptability among parents. This study aims to evaluate the efficacy of Cool Little Kids Online in a large randomised controlled trial.Methods/DesignParents of young children who are 3–6 years old and who have an inhibited temperament will be recruited (n = 385) and randomly assigned to either immediate access to Cool Little Kids Online or delayed access after a waiting period of 24 weeks. The online program contains eight modules that help parents address key issues in the development of anxiety problems in inhibited children, including children’s avoidant coping styles, overprotective parenting behaviours, and parents’ own fears and worries. Intervention participants will be offered clinician support when requested. The primary outcome will be change in parent-reported child anxiety symptoms. Secondary outcomes will be child internalising symptoms, child and family life interference due to anxiety, over-involved/protective parenting, plus child anxiety diagnoses assessed by using a new online diagnostic tool. Assessments will take place at baseline and 12 and 24 weeks after baseline.DiscussionThis trial expands upon previous research on the Cool Little Kids parenting group program and will evaluate the efficacy of online delivery. Online delivery of the program could result in an easily accessible evidence-based resource to help families with young children at temperamental risk for anxiety disorders.Trial registrationAustralian New Zealand Clinical Trials Registry 12615000217505 (registered 5 March 2015)Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-1022-5) contains supplementary material, which is available to authorized users.

Psychometric properties of the Child Anxiety Life Interference Scale – Preschool Version

“…Full details of the study procedures are reported in the CLK trial protocol (Bayer et al, 2011) and the CLK-Online trial protocol (Morgan et al, 2015). In both trials, primary caregiving participants were recruited on the basis of a child score above 30 (approximately 1.15 standard deviations above the age-adjusted norm) on the Approach-Inhibition Subscale of the parent-report Short Temperament Scales for Children (Pedlow, Sanson, Prior, & Oberklaid, 1993;Prior, Smart, Sanson, & Oberklaid, 2000).…”

“…The present study sample included 443 parents who completed 12-month follow-up assessments for a trial of the original group-based program (CLK; Bayer et al, 2011), and 341 parents who completed 24-week follow-up assessments for a trial of a new online adaptation of the group program (CLK-Online; Morgan et al, 2015). Follow-up data from the CLK and CLK-Online trials were used in the present study because this was the only time point to include the CALIS-PV and a diagnostic assessment of anxiety.…”

“…Thus, Kennedy et al's (2009) preschool version of the CALIS (CALIS-PV) assessed impacts of a child's "anxiety or shyness" on the parent and child's life. The CALIS-PV showed good internal consistency and sensitivity to treatment effects in the original trial sample (Kennedy et al, 2009) and continues to be used as a treatment outcome measure in anxiety prevention trials for at-risk preschoolers (Bayer et al, 2011;Fisak, 2014;Morgan, Rapee, & Bayer, 2016;Morgan et al, 2017). However, the CALIS-PV has yet to be validated for use with preschool-aged children and, to our knowledge, no alternative measure has been developed to assess the various daily life impacts of anxiety during the preschool period.…”

Supporting Carers of Children and Adolescents with Eating Disorders in Austria (SUCCEAT): Study protocol for a randomised controlled trial

“…There is online support for patients with other mental disorders that shows positive effects: for parents of children with autism spectrum disorders (Clifford & Minnes, 2013), for parents of socially anxious youth (Reuland & Teachman, 2014), for parents to prevent anxiety problems in young children (Morgan et al, 2015), and for bipolar parents of young children (Jones et al, 2015).…”

Parental Involvement in Remotely Delivered CBT Interventions for Anxiety Problems in Children and Adolescents: A Systematic Review

“…Other studies bring evidence that iCBT treatments for children can be as effective as golden standards, i.e., face-to-face CBT delivered in a clinic [16]. Online-delivered CBT is also efficient in anxious preschool children, albeit it is delivered mostly as a parenting intervention [17,18].…”