The Anxious Child: How to Identify and Help
By Lorna Jansen, Psy.D
Anxiety is among the most prevalent mental health concerns for children. Between 15 and 20% of children and adolescents will meet criteria for anxiety disorders before the age of 18. Anxiety affects children in many ways, including:
- Academically—when a child has anxiety about performance situations such as tests or public speaking, or about being separated from a caregiver, which can lead to school refusal.
- Socially – when a child struggles to read aloud in the classroom, he may not be understood by fellow peers, or he may have trouble maintaining friendships if he is constantly absent from school.
- Emotionally – often anxious children perceive ambiguous stimuli as threatening, and they have decreased sense of self-efficacy regarding feelings of anger, sadness, etc. They are more likely to self-blame, ruminate, and/or catastrophize.
Various anxiety disorders manifest differently in children. For example, a kid with separation anxiety disorder often looks sad, she may have difficulty concentrating and a variety of fears. This child may feel homesick, may exhibit school refusal behavior, and can become aggressive when forced to separate. A child with generalized anxiety disorder is usually concerned with academics, health problems, disasters, and harm to others. For those with social anxiety disorder, their top two fears are giving formal presentations and being in unstructured social situations (which could include talking to authority figures). These children also dislike: reading aloud, performing on a stage, athletic events, attending parties, talking with strangers, ordering food in a restaurant, and answering a question in class. Obsessive-compulsive disorder includes obsessions which are repeated and persistent thoughts that cause distress and/or compulsions, which are repetitive behaviors that the child feels he must perform. A child with specific phobia has a fear of a specific object or situation, which he may express by crying, tantrums, freezing or clinging. Kids with a panic disorder experience panic attacks and may describe feeling sick, but may not know how or why.
The following is a list of strategies for parents and teachers who are helping anxious children:
- Recognize that anxiety is the most prevalent mental health concern for children and adolescents.
- Ask yourself: What are you seeing in the child that seems different from what you observe in other children? Or, why does this child stand out to you?
- Where are you seeing impairment?
- Check with the family – any recent changes to the family structure? Divorce? New jobs for the parents? Recent move? Loss of a pet?
- Consider using the nurse’s office – some children need to call home occasionally to make sure everything is ok.
- Write directions on the board or another visible place.
- Try to provide opportunities for the child to answer a question—either aloud or on the board—that he or she may know, as a way of building confidence.
- Offer the opportunity for the child to do presentations in front of smaller groups (just teacher?).
- Help connect child to other students in the class.
- Offer other seating options during school assemblies.
- Prepare for change – substitute teachers, field trips, fire drills, etc.
- Limit amount of time spent on homework.
If you need additional help, please contact The Center for Neuropsychology and Counseling or another mental health professional for assistance from a child psychology expert. The Coping Cat is a program designed to help treat anxious children aged 7 to 13, and it can be implemented in schools or with a therapist. Worry Wise Kids is a helpful website for parents and teachers alike.
To work with one of our child psychology Bucks County professionals, please request an appointment.
What is a Pediatric Neuropsychologist?
Neuropsychology is a specialty within the field of Psychology that focuses on brain-behavior relationships. A Pediatric Neuropsychologist uses standardized tests and observes behavior to define a child’s pattern of brain functioning and overall development. The child’s performance is compared to what is expected at the child’s age-level or compared to a specific group of children. The child’s individual pattern of strengths and weaknesses is defined based on these comparisons. The pediatric neuropsychologist uses his/her knowledge of brain development, organization and functioning and their effects on development to guide the assessment, interpret the results and guide the recommendations. Continue reading