Peers' Emotionality and Children's Academic Achievement in Second Grade: Testing the Moderating Role of Children's Behavioral Self-Regulation.

Although there is interest in the role of peers in children's schooling experiences, few researchers have examined associations and related underlying processes between peers' emotionality, an aspect of temperament, and children's academic achievement. This study evaluated whether target children's (N = 260) own self-regulation, assessed with two behavioral measures, served a moderating function for associations between peers' emotionality and children's own academic achievement in second grade. There was a positive association between peers' positive emotionality and reading scores for children with higher self-regulation. Peers' negative emotionality was negatively related to target children's reading scores, particularly for children with higher self-regulation levels, but was unrelated to math scores. Peers' positive and negative emotionality did not predict math scores, and there was no strong evidence for the moderating role of target children's self-regulation in this association. This study highlights the potential role of children's self-regulation in modulating peer effects on academic achievement, particularly reading.

Streamlined pediatric anxiety program for school mental health services.

There needs to be serious transformation of evidence-based interventions (EBIs) into real-world solutions; otherwise, EBIs will never achieve the intended public health impact. In a randomized trial, we reported effects of a redesigned anxiety program. Herein, we described the redesign process that led to the program. Survey data revealed provider preferences for school mental health anxiety services. Focus groups and prototype feedback sessions revealed service barriers to uptake, implementation, and sustainability along with corresponding enabling strategies. Prototype feedback sessions also focused on refinement and fine-tuning of the redesign. In the end, traditional EBI strategies were transformed and packaged into six lessons, lasting 20-30 minutes each, and amenable to delivery in small-group format. The redesign achieved the intended purpose of retaining elements from cognitive and behavior therapy and social skills training for the target population of the intervention (e.g., 3rd to 5th graders with heterogeneous anxiety problems - identified and referred). The streamlined EBI is accessible from PBS LearningMedia™ - a service that hosts public, research-based, and school-ready materials.

Longitudinal relations between behavioral engagement and academic achievement: The moderating roles of socio-economic status and early achievement.

This study investigated developmental trajectories of observationally coded engagement across the early elementary years and whether these trajectories were associated with children's academic achievement. Furthermore, we evaluated if these relations varied as a function of children's family socio-economic status and early reading and math skills. Data were collected from 301 children who were studied from kindergarten (Mage = 65.74 months; 49% boys) to 2nd grade. Children's behavioral engagement was observed in kindergarten, 1st, and 2nd grade. Reading and math skills were assessed via standardized tests in kindergarten and 2nd grade. Growth mixture models identified two classes of behavioral engagement: most children (87.0%) displayed relatively high behavioral engagement in the fall of kindergarten and decreased significantly across time (referred to below as high-decreasing class), and other children (13.0%) exhibited moderate behavioral engagement in the fall of kindergarten that was stable across time (referred to below as moderate-stable class). After controlling for academic skills in kindergarten and demographic variables (i.e., child age, sex, ethnicity, and family socio-economic status), children in the high-decreasing class displayed higher reading skills, but not math skills, than children in the moderate-stable class. Additional analyses revealed that differences in reading skills between the two classes were present only for children from low socio-economic status families or for children low in kindergarten reading skills. The findings suggest that economically or academically at-risk students might benefit more than their peers from high behavioral engagement.

Brief, Non-Pharmacological, Interventions for Pediatric Anxiety: Meta-Analysis and Evidence Base Status.

In 1998, Ost published [One-session treatment of specific phobias-a rapid and effective method] [in Swedish] giving rise to the idea that brief, intensive, and concentrated psychosocial interventions could exhibit public health impact. At this juncture, and per criteria of the Society for Clinical Child and Adolescent Psychology, there are data supporting that brief, non-pharmacological intervention [prescriptions] for pediatric anxiety can be considered well-established or probably efficacious. In addition, data from 76 randomized controlled trials (N = 17,203 youth) yield an overall mean effect size of 0.19 on pediatric anxiety outcomes (pre-post). Note, however, that effect sizes vary significantly. These data point to the capacity for clinical change coming from in-vivo exposures for specific phobias (~3 h, one session), CBT with social skills training (~3 h, six sessions for indicated prevention and early intervention), and CBT-based parent training (~6 h, eight digital modules with clinician support). Given such evidence, we recommend efforts be made to establish ways to position such treatment innovations for rapid deployment facilitated by high-quality training, monitoring, technical assistance, and ongoing disclosures.

Streamlined Prevention and Early Intervention for Pediatric Anxiety Disorders: A Randomized Controlled Trial.

There is a need to optimize the fit between psychosocial interventions with known efficacy and the demands of real-word service delivery settings. However, adaptation of evidence-based interventions (EBI) raises questions about whether effectiveness can be retained. This randomized controlled trial (RCT) evaluated a streamlined package of cognitive, behavior, and social skills training strategies known to prevent and reduce anxiety symptom and disorder escalation in youth. A total of 109 youth (Mage = 9.72; 68% girls; 54% Latinx) at risk based on high anxiety were randomized to the streamlined prevention and early intervention (SPEI) (n = 59) or control (n = 50) and were assessed at pretest, posttest, and 12-month follow-up. A main objective was to determine whether our redesign could be delivered by community providers, with acceptable levels of fidelity, quality, and impact. In terms of process evaluation results, there was high protocol fidelity, excellent clinical process skills, few protocol adaptations, and high satisfaction with the SPEI. In terms of outcomes, there were no significant main or moderated effects of the SPEI at the immediate posttest. However, at the follow-up, youth in the SPEI reported greater self-efficacy for managing anxiety-provoking situations, greater social skills, and fewer negative cognitive errors relative to controls. Collectively, findings suggest that the redesigned SPEI might be an attractive and efficient solution for service delivery settings.

Prediction of Children's Early Academic Adjustment from Their Temperament: The Moderating Role of Peer Temperament.

The goal of the study was to examine whether target children's temperamental negative emotional expressivity (NEE) and effortful control in the fall of kindergarten predicted academic adjustment in the spring and whether a classmate's NEE and effortful control moderated these relations. Target children's NEE and effortful control were measured in the fall via multiple methods, academic adjustment was measured via reading and math standardized tests in the spring, and observations of engagement in the classroom were conducted throughout the year. In the fall, teachers nominated a peer with whom each target child spent the most time and rated that peer's temperament. Target children with high effortful control had high reading and math achievement (ps = .04 and < .001, respectively), and children with low NEE increased in engagement during the year (p < .001). Peers' temperament did not have a direct relation to target children's academic adjustment. Peers' negative emotion, however, moderated the relation between target children's effortful control, as well as NEE, and changes in engagement (ps = .03 and .05, respectively). Further, peers' effortful control moderated the relations between target children's NEE and reading and changes in engagement (ps = .02 and .04, respectively). In each case, target children's temperament predicted the outcome in expected directions more strongly when peers had low NEE or high effortful control. Results are discussed in terms of how children's temperamental qualities relate to academic adjustment, and how the relation between NEE and changes in engagement, in particular, depends on peers' temperament.

Evidence-Based Psychosocial Interventions for Ethnic Minority Youth: The 10-Year Update.

This is the official update on the status of evidence-based psychosocial interventions for ethnic minority youth. Compared to a decade ago, there has been expansion of well-designed intervention studies, growth in the number (not type) of interventions meeting evidence-based criteria, and greater focus on testing ethnicity/race moderator effects. In terms of standard of evidence, 4 psychosocial interventions are now well-established and 10 are probably efficacious or possibly efficacious, with most protocols drawing on cognitive and behavioral change procedures and/or family systems models. Yet the research literature remains mostly focused on testing interventions with European Americans (White Caucasians), and little to no progress has been made in testing the effects of interventions with Asian American or Native American youth. Knowledge of the effects of cultural tailoring on program engagement, outcomes, and mechanisms of change remains scant.

Trajectories of the Expression of Negative Emotion from Kindergarten to First Grade: Associations with Academic Outcomes.

We examined individual trajectories, across four time points, of children's (N = 301) expression of negative emotion in classroom settings and whether these trajectories predicted their observed school engagement, teacher-reported academic skills, and passage comprehension assessed with a standardized measure in first grade. In latent growth curve analyses, negative expressivity declined from kindergarten to first grade with significant individual differences in trajectories. Negative expressivity in kindergarten inversely predicted first grade school engagement and teacher-reported academic skills, and the slope of negative expressivity from kindergarten to first grade inversely predicted school engagement (e.g., increasing negative expressivity was associated with lower school engagement). In addition, we examined if prior academic functioning in kindergarten moderated the association between negative expressivity (level in kindergarten and change over time) and academic functioning in first grade. The slope of negative expressivity was negatively associated with first grade school engagement and passage comprehension for children who had lower kindergarten school engagement and passage comprehension, respectively, but was unrelated for those with higher academic functioning in kindergarten. That is, for children who had lower kindergarten school engagement and passage comprehension, greater declines in negative expressivity were associated with higher first grade school engagement and passage comprehension, respectively. The findings suggest that negative emotional expressivity in school is associated with academic outcomes in first grade and, in some cases, this association is more pronounced for children who had lower kindergarten academic functioning.

Reluctance to express emotion explains relation between cognitive distortions and social competence in anxious children.

Guided by social information processing and affective social competence models, the focal objective of this research was to examine the relations among anxious children's cognitive distortions, social skill competence, and reluctance to express emotion. In addition, we explored whether children's attention control played any meaningful role. Using a sample of 111 anxious children (Mage  = 9.63, SD = 0.73; 75.7% girls; 56% Hispanic/Latino), we found that cognitive distortions were negatively related to social competence. In addition, tests of moderated mediation showed that the negative association between cognitive distortions and social skill competence was indirect via reluctance to express emotion, but this only was the case for anxious children with high attention control and for distortions in the academic domain. The findings of this study may set the stage for new ways to conceptualize the role of higher attention control among anxious youth. Statement of contribution What is already known on this subject? Cognitive errors are prevalent in anxious youth Anxious children show socio-emotion deficits What does this study add? Cognitive errors are related to socio-emotion deficits in anxious youth Relations depend on attention control.

Control Over Anxiety and Dispositional Coping Tendencies Are Associated With Presleep Arousal Among Children Referred for Anxiety Problems.

Anxious youth typically experience sleep-related difficulties, but little is known about the role children's coping and perceived control over anxiety may play in these relations. We examined children's perceived levels of control over external anxiety-provoking events and internal anxious emotional reactions, as well as two dispositional coping tendencies (avoidant, support-seeking), and whether these were associated with anxious children's (N = 86) presleep arousal. Low perceived control over anxiety was significantly associated with high levels of presleep arousal. For children with low perceived control, higher avoidance was associated with greater presleep arousal, whereas lower avoidance was associated with lower presleep arousal levels. Findings suggest that efforts to avoid stressful life events may contribute to presleep arousal, especially under conditions where anxious arousal seems uncontrollable.

Observed emotion frequency versus intensity as predictors of socioemotional maladjustment.

The purpose of this study was to assess whether observed emotional frequency (the proportion of instances an emotion was observed) and intensity (the strength of an emotion when it was observed) uniquely predicted kindergartners' (N = 301) internalizing and externalizing problems. Analyses were tested in a structural equation modeling (SEM) framework with data from multireporters (reports of problem behaviors from teachers and parents) and naturalistic observations of emotion in the fall semester. For observed positive emotion, both frequency and intensity negatively predicted parent- or teacher-reported internalizing symptoms. Anger frequency positively predicted parent- and teacher-reported externalizing symptoms, whereas anger intensity positively predicted parent- and teacher-reported externalizing and parent-reported internalizing symptoms. The findings support the importance of examining both aspects of emotion when predicting maladjustment.

Assessment of anxiety symptoms in school children: a cross-sex and ethnic examination.

We evaluated the cross-sex and -ethnic (Hispanic/Latino, non-Hispanic White) measurement invariance of anxiety symptoms based on the Spence Children's Anxiety Scale (SCAS) as well as SCAS anxiety symptoms' correspondence with scores on the 5-item Screen for Child Anxiety Related Emotional Disorders (SCARED) and teacher ratings of child anxiety. Based on data corresponding to 702 children (M age = 9.65, SD = 0.70; 51.9 % girls; 55 % Hispanic/Latino), findings showed some sex and ethnic variations in SCAS measured anxiety at the item and scale levels. Moreover, SCAS correspondence to the 5-item SCARED was found across ethnicity and sex. SCAS correspondence to teacher ratings was found for non-Hispanic White boys and non-Hispanic White girls, marginally in Hispanic/Latino boys, and poorly in Hispanic/Latino girls.

Variations in the influence of parental socialization of anxiety among clinic referred children.

This study examined the relations between parental socialization of child anxious behaviors (i.e., reinforcement, punishment, modeling, transmission of information) and child anxiety and related problems at varying child sensitivity levels. Data corresponding to 70 clinic-referred children (M age = 9.86 years; 50% girls; 49% Hispanic/Latino, 51% Caucasian) showed that for children with low (but not high) anxiety sensitivity, anxiety-related parental socialization behaviors were associated with more child anxiety and depression symptoms. Findings also indicated that parental socialization of anxious behaviors and anxiety sensitivity functioned similarly in the prediction of anxiety and depression across Caucasian and Hispanic/Latino children. There were no significant mean level variations across child sociodemographic characteristics in general, but anxiety-promoting parenting behaviors were twice as high in Hispanic/Latino compared to Caucasian families.

Predictors of Initial Engagement in Child Anxiety Mental Health Specialty Services.

BACKGROUND: Child and family mental health services remain largely underutilized despite the relatively high rate of youth suffering from mental, emotional, and behavioral (MEB) disorders. As such, it is important to address challenges and examine factors related to child mental health service use and engagement, especially when it comes to children in need of services for anxiety. OBJECTIVE: Informed by the Behavioral Model of Health Services Use (BMHS), the present study sought to examine predictors of service use and engagement for families seeking assistance for their anxious children. Initial levels of engagement in culturally tailored services were predicted from predisposing characteristics (e.g., child age, ethnicity), enabling resources (e.g., Spanish services, transportation), and need characteristics (e.g., child clinical severity). METHOD: Participants included Latino (n = 126) and Caucasian (n = 116) families who presented to a specialty clinic due to child emotional and behavior problems related to anxiety. Initial service utilization and engagement was assessed along the following levels toward services care: (1) initiated contact and completed a clinical intake, (2) completed a home screen, and (3) completed an on-site diagnostic assessment. All procedures were culturally tailored to the presenting needs of families. RESULTS: Predisposing characteristics, enabling resources and need characteristics emerged as significant predictors of child mental health service use, with some variations. Child age, ethnicity, referral source, and enabling resources predicted completion of a home screen. Proximity to services predicted completion of the on-site diagnostic assessment. CONCLUSION: Knowledge of factors that predict engagement in child mental health services can help identify avenues to promote service utilization, especially among ethnic minority children and families. Our culturally tailored approach to serving families appears to be promising in bridging the cross-ethnic services gap and therefore has implications for practice.

A personalized and control systems engineering conceptual approach to target childhood anxiety in the contexts of cultural diversity.

In the child and adolescent anxiety area, some progress has been made to develop evidence-based prevention protocols, but less is known about how to best target these problems in children and families of color. In general, data show differential program effects with some minority children benefiting significantly less. Our preliminary data, however, show promise and suggest cultural parameters to consider in the tailoring process beyond language and cultural symbols. It appears that a more focused approach to culture might help activate intervention components and its intended effects by focusing, for example, on the various facets of familismo when working with some Mexican parents. However, testing the effects and nuances of cultural adaption vis-à-vis a focused personalized approach is methodologically challenging. For this reason, we identify control systems engineering design methods and provide example scenarios relevant to our data and recent intervention work.

Indicated prevention and early intervention for childhood anxiety: a randomized trial with Caucasian and Hispanic/Latino youth.

OBJECTIVE: This trial of a randomized indicated anxiety prevention and early intervention explored initial program effects as well as the role of ethnicity and language on measured outcomes. METHOD: A total of 88 youth (M = 10.36 years; 45 girls, 52 Latino) received 1 of 2 protocols with varying degrees of parent involvement, and response was measured at posttest and 6-month follow-up. RESULTS: Findings showed that child anxiety symptoms improved significantly across protocols, although additional gains were found for children in the child plus parent condition. Program effects did not vary by Latino ethnicity or Spanish language use in the intervention. CONCLUSIONS: The cognitive and behavioral strategies established for Caucasian children may be promising for Hispanic/Latino children when applied in a culturally responsive manner.

Pre-sleep arousal and sleep problems of anxiety-disordered youth.

The current study examined sleep problems and pre-sleep arousal among 52 anxious children and adolescents, aged 7-14 years, in relation to age, sex, ethnicity, and primary anxiety disorder. Assessment included structured diagnostic interviews and parent and child completed measures of sleep problems and pre-sleep arousal. Overall, 85% of parents reported clinically-significant child sleep problems, whereas 54% of youth reported trouble sleeping. Young children, those with primary generalized anxiety disorder, and Latino youth experienced the greatest levels of sleep disturbance. Additionally, greater levels of pre-sleep cognitive rather than somatic arousal were found and pre-sleep thoughts were associated with decreased total sleep duration and greater sleep problems. Findings suggest that attention to sleep should be part of assessment procedures for anxious children in both research and clinical settings.

Mediators and moderators of outcome in the behavioral treatment of childhood social phobia.

OBJECTIVE: The current study examined mediators and moderators of treatment response among children and adolescents (ages 7-17 years) with a primary diagnosis of social phobia. METHOD: Participants were 88 youths participating in one of two randomized controlled treatment trials of Social Effectiveness Therapy for Children. Potential mediators included changes in observer-rated social skill and child-reported loneliness after 12 weeks of Social Effectiveness Therapy for Children. Age and depressive symptoms were examined as potential moderators. RESULTS: Loneliness scores and social effectiveness during a role-play task predicted changes in social anxiety and overall functioning at posttreatment. Changes in social anxiety were mediated by child-reported loneliness. Outcomes were not moderated by age or depressive symptoms. CONCLUSIONS: Findings support the role of loneliness as an important mechanism of change during treatment for childhood social phobia.