Feeling anxious or fearful at times does not mean that a child has an anxiety disorder.
Whether or not a diagnosis is made, depends on how often, how easily and how intensely a child experiences the emotional symptoms of anxiety and how much it interferes with everyday living.
How are anxiety disorders diagnosed?
To make a diagnosis, mental health professionals usually talk to the child and to family members.
They may also ask teaching staff, parents, carers and children themselves to fill out questionnaires.
The child’s age is an important factor in deciding whether the anxiety is a serious difﬁculty. This is because having certain fears is normal for children. For example, if an infant cries when an unfamiliar person wants to hold him, his fear is judged as perfectly normal for his age. However, if a 12-year-old girl refuses to go to school because she fears something terrible will happen to her healthy mother, this may be signs of an anxiety disorder.
Common types of anxiety disorders
There are several common anxiety disorders in primary school-aged children.
- Separation Anxiety relates to fear and distress at being away from the family. There is commonly a fear that something bad will happen to a loved one while they are separated. Children with separation anxiety may complain about feeling sick. They may make frequent trips to the sick bay at school or sometimes refuse to go to school altogether.
- Social Phobia refers to extreme levels of shyness and fears of being seen in a negative light. Children with social phobia avoid a range of social interactions such as talking to new people, speaking up in class or performing in public. They are frequently self-conscious and will often have a limited number of friends.
- Generalised Anxiety Disorder is diagnosed when children have excessive and unrealistic worries about a broad range of possibilities. They may worry about things that might happen, about their own past behaviour, or about how good they are at their schoolwork or how popular they are. They often lack confidence and need a lot of reassurance.
- Post Traumatic Stress Disorder (PTSD) may develop following a traumatic event such as being in a serious accident, experiencing a life-threatening event or witnessing extreme violence. Symptoms include changes in sleep pattern, irritability and problems with concentration. There may also be mental flashbacks and re-experiencing of the event. Themes relating to the trauma may be seen in children’s drawings or in play.
- Obsessive Compulsive Disorder is where a child is affected by persistent unwanted thoughts, often about dirt or germs, or sometimes a need for symmetry. To try to stop the thoughts, the child feels compelled to repeat a particular action, such as washing his or her hands or repeated counting. Older children may recognise that the thoughts and behaviours do not make sense even though they are driven by them.
What professional help is available?
Getting an early assessment and professional psychological support for children’s anxiety difﬁculties is important.
For severe signs of anxiety, a referral to a mental health professional can be helpful for an assessment.
Psychological supports to help children cope
Psychological supports help children to cope with their current anxiety issues and can also prevent anxiety and depression occurring later on.
Psychological support works equally well whether it is run in groups or individually. It usually involves teaching children to reduce avoidance and use more effective coping skills, such as relaxation and learning how to replace unhelpful thoughts with helpful self-talk.
For phobias, professional support may involve the teaching of coping skills and gradually being exposed to the feared object or situation.
Families are often involved in professional support and the involvement of parents and carers has been shown to be especially important for younger children.
Parents and carers can provide critical support as children learn new coping skills and practise using them in situations they may have previously avoided.
As children are significantly influenced by the modelling of adults in their life, it can be helpful for parents and carers who experience anxiety to also seek support for themselves.
For children whose anxiety is less severe, school-based social and emotional learning programs that build resilience and coping strategies can be very helpful.
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