All little children experience numerous fears as they pass through the developmental phase of childhood. It is common for children to have fears abut the dark, insects, ghosts, kidnappers, and getting lost or abandoned. In most cases, these fears tend to disappear over time and are simply passing episodes. But, for some children, these fears persist and can develop into full-blown anxiety disorders. It is now widely accepted that as many as 8-11% of children and adolescents suffer from an anxiety that affects their ability to get on with their lives.
Research has shown that it is possible for anxious children, like adults, to develop specific phobias, social phobias, generalized anxiety disorders and obsessive behaviour. However, it is impossible for very young children to develop agoraphobia or experience panic attacks. Separation anxiety disorder and school phobia or refusals are two other anxiety disorders that are unique to children.
It is often very difficult for parents to determine whether their anxious child is displaying abnormal behaviour or just passing through a typical childhood phase. When does clinging, avoidant behaviour develop into separation anxiety disorder? Should parents be concerned if their 7 year old daughter seems to worry a lot about future events as well as her actions in the past?
Children can develop fears and phobias at any age, but they are particularly common during early childhood and, later on, during puberty. In young children, excessive clinging is often a warning sign that parents should look out for. In school age children, signs of anxiety could include children being extremely shy and timid, having real difficulties in mixing with other children, having difficulty going to sleep and staying asleep, experiencing repeated nightmares, continually complaining of headaches or stomach aches and constantly asking for reassurance.
Some of the anxiety disorders that occur in children can take on specific features, which make them easier to recognize.
Children with Social Phobia typically become extremely upset, embarrassed and timid in the presence of strangers and often cry, throw tantrums, freeze or withdraw from these situations.
Children with generalized anxiety disorder tend to be very self-conscious and to worry about future events, possible injuries, group activities and even past behaviour. Often they are pre-occupied with their competence in various tasks and others’ evaluations of their performance. They also worry a lot about meeting expectations and deadlines.
It has been estimated that about 4% of children and adolescents experience separation anxiety disorder. This disorder is characterized by children experiencing excessive anxiety, even panic, whenever they are separated from home or a parent. The children often fear that they will get lost when they are separated or that their parent will meet with an accident. This disorder can also be accompanied by somatic complaints such as headaches or nausea. Separation anxiety disorder sometimes takes the form of school phobia or refusal.
Children with anxiety disorders could also be experiencing severe problems in the home setting. Continual fighting between parents, recent parental divorce or parental illnesses are all factors that provoke anxiety in children. Furthermore, children are highly dependent on their parents for emotional support and guidance, and may be greatly influenced by parental inadequacies. If parents establish faulty communication with their children, for example constantly seeking reassurance from their children or using excessive threats to control their children, damaging patterns and anxious emotions could be reinforced.
Young children are exposed to a wide range of anxiety-provoking situations in the school setting. Problems with schoolmates, such as teasing, bullying or rejection, as well as difficulty with the workload can all lead to anxiety.
The Depression and Anxiety Support Group has a counselling line for parents or teachers open Mondays to Fridays from 8am to 7pm and Saturdays from 8am to 5pm where help is available and brochures can be sent to you free of charge. The group can be contacted from Monday to Saturday on (011) 783-1474/6.
There are a variety of therapeutic techniques that can be used to treat anxiety disorders in children. When dealing with younger children, many therapists make use of play therapy. This type of therapy involves children expressing their feelings indirectly by playing with toys, making up stories and drawing. The therapist then analyses these activities and encourages conflict resolution and insight through further play. In older children, exposure techniques, social skills training, relaxation therapy and cognitive behavioural therapy have all had good results.
A more controversial mode of treatment is drug therapy. Many experts argue that it is very risky to use drugs, such as antidepressants, on children due to the lack of empirical evidence in this field. However, there have been case studies suggesting that small doses can be effective in anxiety-ridden children.
What preventative measures can parents take to safeguard their children against the trauma of experiencing anxiety disorders? One idea is for parents to work on modeling a calm approach in their own lives, and setting a good example for their children. It also helps to ensure that children get a wide range of experiences and learn how to make their own decisions over small things.