This study examined the influence of maternal anxiety on the treatment outcome of anxious children. Forty-eight clinically anxious children (aged 6–14 years) were classified into two groups based on the presence of an anxiety disorder diagnosis in their mother. Diagnostic data at posttreatment showed that children with anxious mothers responded significantly less favourably to cognitive behavioural therapy (CBT) than did children with nonanxious mothers (28% vs. 58% improved, respectively). At 12-month follow-up, 68% of children with anxious mothers improved, compared to 79% of children with nonanxious mothers. This difference was not significant. Findings were not consistent across outcome measures. This study also investigated the changes in maternal anxiety across child treatment. Prior to treatment, diagnostic data showed that 60% of mothers met criteria for an anxiety disorder. At posttreatment, 21% of these mothers were free of their primary diagnosis. There was also a significant reduction in self-reported maternal anxiety across treatment that was maintained at follow-up. Theoretical and clinical implications of the findings are discussed.

The ACT (Acute Cognitive Therapy) Program was implemented as a patient follow-up initiative to respond to people presenting to emergency departments with suicidal behaviour or ideation, in a psychosocial crisis. Over 12 months 188 patients were referred to the program of which 160 attended at least one appointment and 109 completed the program. Pre- and postmeasures indicated that significant improvement occurred in those who completed the program, that improvements were maintained at 6 months and representation rates were reduced. Immediate short-term directed treatment appears beneficial in the short and medium term, and the rapidity and location of follow-up appears to promote compliance.

Four anxiety disordered 8- to 11-year-old children and their parents participated in a shortened version of an efficacious cognitive–behavioural program for anxiety in children, designed to reflect therapy conditions found in usual clinical practice. A modified multiple-baseline design was used that combined clinic setting pragmatics with a necessary level of methodological protection. For ongoing evaluation, weekly measures of the child's trait anxiety and coping ability were obtained from the child and parents. In addition, a battery of measures was used to evaluate outcomes following treatment and at two follow-up intervals. Emphasising increased parent involvement and earlier exposure sessions, the program was found to lead to marked changes in child functioning. In particular, all children showed improvement on self-report, parent report, and independent clinician's ratings over the course of treatment. Moreover, scores on relevant indices were all within a nondeviant range following intervention, and all four children no longer qualified for an anxiety diagnosis at posttreatment and at 3- and 12-month followup. Findings are discussed in terms of implementation and evaluation in practice settings (e.g., critical components of treatment, use of pragmatic single case designs). Suggestions for future research include testing the effectiveness of this brief program on a large and diverse sample of children. Additional research is also required to find out to what extent increased parent involvement and earlier exposure sessions enhance the impact of treatment in the larger context of addressing features of the research-practice gap. Overall, findings provide preliminary support for the effectiveness of a brief cognitive–behavioural program for treating anxiety disorders in children, along with an evaluation strategy, compatible with some of the needs of service delivery settings.

The limited communicative abilities of young children with autism and developmental disabilities may be enhanced by augmentative communication systems such as the Picture Exchange Communication System (PECS). Both children and adults can learn to use PECS, but research is inconsistent in establishing the degree to which PECS training transfers reliably from the training setting to other settings, for example, regular classrooms, and home. Three 5–6 year-old children, diagnosed as autistic and/or developmentally disabled, were given 1:1 PECS training at school, structured to enhance generalisation and transfer. Concurrent observations were made in their regular classroom and at home to probe the extent of generalisation. All three acquired the ability to request a preferred object or activity by exchanging a picture symbol with a communicative partner. In tests of transfer and generalisation, a multiple-baseline across subjects design showed no use of PECS symbols either in the classroom or at home prior to training, with spontaneous initiations of picture exchange (transfer) occurring to a slight to moderate degree in the classroom and to a slight degree at home. Even with PECS training structured to enhance transfer, functionally significant degrees of generalisation of training may be difficult to achieve, and cannot be assumed to occur.

The Picture Exchange Communication System (PECS) is a widely used intervention strategy designed to teach communication skills to children with developmental delays, including autism. The Picture Exchange Communication System incorporates the teaching of mand initiations that are thought to be pivotal response behaviours, and have been demonstrated to lead to generalised improvements in other nontargeted behaviours. The aim of the present study was to assess the acquisition of PECS with a 3-year-old boy with autism using the established PECS training program, and to evaluate concomitant changes in spoken language, social–communicative behaviours, and functional play. Results indicated that the participant rapidly acquired the criterion behaviours for Phases 1 to 3 of the PECS program. Although PECS exchanges were rarely observed in the generalisation settings, clear increases were evident in verbal mands and other initiations in both home and kindergarten generalisation settings. Increases in spoken vocabulary and in the length of comprehensible spoken utterances in free-play were observed as were gains in time spent in developmentally appropriate play. Implications of these results and directions for future research are discussed.