Anxiety disorders in older children and adolescents have long been acknowledged as impairing, persistent and predictive of future anxiety and mood-related disorders. Until recently, however, anxiety in preschoolers and younger children has been regarded as relatively uncommon and within normal developmental parameters. Increasing evidence is suggestive that symptoms of anxiety in preschoolers parallel those in older children (Hirshfeld-Becker, Micco, Mazirsky, Bruett, & Henin, 2011) with this under-investigated area attracting increasing interest from researchers and clinicians alike. The present review summarises the empirical literature on early intervention and prevention programs for anxiety in young children (aged 3–7 years) with a specific focus on the application of such programs in the school context and implications for guidance counsellors, an improved understanding of which is critical for informing effective intervention. The studies reviewed demonstrate promising outcomes for anxiety; however, there is still a significant amount of work to be done in terms of our understanding of developmentally appropriate, family-focused and child-led models of anxiety and early intervention and prevention protocols.

We present an integrative review of the development of child anxiety, drawing on a number of strands of research. Family aggregation and genetic studies indicate raised vulnerability to anxiety in offspring of adults with the disorder (e.g. the temperamental style of behavioural inhibition, or information processing biases). Environmental factors are also important; these include adverse life events and exposure to negative information or modelling. Parents are likely to be key, although not unique, sources of such influences, particularly if they are anxious themselves. Some parenting behaviours associated with child anxiety, such as overprotection, may be elicited by child characteristics, especially in the context of parental anxiety, and these may serve to maintain child disorder. Emerging evidence emphasizes the importance of taking the nature of child and parental anxiety into account, of constructing assessments and interventions that are both disorder specific, and of considering bidirectional influences.