early treatment to tackling anxiety behaviors in childrenEarly Intervention for Children dealing with abnormal Anxiety is effective Treatment for Short Term and Long-Term Success
Child Psychologist agree that early treatment is key to tackling anxiety behaviors in children and adolescents. Behaviors such as trouble sleeping, excess worrying, and separation anxiety are symptoms of anxiety. A child experiencing anxiety will have problems socially, interacting with family and school activities. Melbourne Child Psychology states "children will become more worried about natural events, and [adolescents will be anxious about classwork]and socializing. These fears become worse in adulthood." Treatment such as relaxation exercises, meditation, and intervention programs with psychologist are some options available. The first step to getting help for children with anxiety is recognizing the symptoms.
Primary Care Provider visits can assist with detecting anxiety in children and adolescents. During routine annual visits is a great time to determine if a child needs further evaluation to determine if anxiety is present. Providers questions regarding school performance, social and home life may uncover information to indicate if anxiety if present. Williams and Pearman states "These disorders often have distinct clinical presentations, and easily accessible diagnostic criteria should facilitate evaluation for childhood anxiety disorders during routine office visits".
There are online questionnaires available to screen for child anxiety. Screen for Child Anxiety Related Emotional Disorders (SCARED), Multidimensional Anxiety Scale for Children (MASC), are both child and parent screenings. The Pediatric Anxiety Rating Scale (PARS), is used by clinicians to determine the severity of the anxiety.
Child Anxiety can be difficult to identify at times. Sometimes children have trouble concentrating in school or they are being disruptive. Feeling anxious can make you feel out of control, or upset, which can make children aggressive, causing them to act out, or fight. They also have trouble paying attention in class because they are anxious and attempt to avoid being called on in class. These behaviors are sometimes mistaken for something else. Ehmke states "at times anxiety is easy to identify (...), other times anxiety in the classroom [looks different, manifesting as physical illness, or appearing like a child has a learning disorder]. If teachers can somehow engage the child one-on-one, away from a group, they may better assess the learning and needs of the child.
There are potential barriers to receiving early intervention for anxiety in children at the onset. There is a stigma associated with mental health treatment. Williams and Pearman states "Reduced access or lack of access to mental health specialists and the stigma associated with the use of mental health services increase the likelihood that anxious children will present in a primary care setting." (8). Negative stereotypes that people with mental illness are dangerous and prejudice associated with receiving treatment is a barrier. People feel shame in admitting they have been treated for anxiety. Another potential barrier is being able to recognize the symptoms and determining when a child may need intervention. Melbourne Child Psychology states "It is time to consider (...) steps to help [when worry impacts] daily life".
Any symptom such as separation anxiety, not wanting to attend school, withdrawal from social activities, or any behavior that impacts daily routines are warning signs.
Working as a community with parents, caregivers, educators, and doctors will help to identify and determine appropriate treatment for childhood anxiety. Parents and caregivers participating in prevention programs can assist with anxiety symptoms. There was an analysis completed by the National Center for Biotechnology Information (NCBI), U.S. National Library of Medicine assessing anxiety risk for those exposed to trauma, or child or parent anxiety. It concluded that those who received enhanced recruitment (ER), consisting of outreach, parent preferences, and community endorsements, were more likely to participate in prevention treatment. PubMed article states "Results highlight the need to improve strategies for engaging parents in preventive, community-based interventions." There is a need to form special groups involving community partners to conduct recruitments, to assess the needs of both parents and children impacted with anxiety. Determine early if a child needs help if there is a change in normal daily activities in school and social settings. Teachers/educators may detect behaviors such as children having difficulty focusing on their work, problems with attendance, or manifesting into physical symptoms of anxiety like stomach aches or nausea. Keeping parents and caregivers informed of any ongoing and consisting behaviors can assist with determining when to receive prevention treatment. "Ehmke states "Sometimes kids get so anxious that they freeze. They might have been paying attention to the lesson and they might even know the answer, but when they're called on their anxiety level becomes heightened..." Children suffering with worry and anxiety will struggle more in a group or social setting.
Since children with anxiety will likely see a pediatrician or family doctor, providers should be familiar with the signs or symptoms of anxiety. Childhood fear, such as clinging, crying, freezing or angry outburst is an indicator of anxiety. Social phobia, such as panic attacks, or shrinking from social situations is another indicator that can be screened during routine office visits. These phobias fall into categories described by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Williams and Pearman states:
"DSM-IV diagnostic criteria specify that children must experience symptoms-possibly including "crying, tantrums, freezing, or shrinking from social situations with unfamiliar people" (l0) -for at least six months to be diagnosed with social phobia."
Diagnostic Tools used in the primary care setting includes questions regarding academic performance, family and social activities, along with the online screening questionnaires, has been effective in detecting anxiety in children.
Despite the possible barriers associated with receiving mental health care, such as the stigma, or prejudice for those impacted, there are ways to improve access to children afflicted with anxiety. Educating the public on mental health issues is one step to improving. We can advocate for events with community partners such as educators, mental health care providers, and law enforcement. The more transparent we become about the need for mental health services for anxiety, the more familiar and comfortable we become with addressing these issues. It is vital that we work together with parents, caregivers, educators, and the mental health community to provide a network of resources readily available to address this ongoing issue.
Melbourne Child Psychology, "Anxiety in Younger Children - Why Early Intervention Matters."
Williams, Lindsey, and Catherine Pearman. "Childhood anxiety disorders: recognition and diagnosis in the primary care setting.", Clinician Reviews, Jan 2010, p 8+. Health & Wellness Resource Center,
Ehmke, Rachel, Child Mind Institute, "Anxiety in the Classroom"
Association for Psychological Science. "Stigma as a barrier to mental health care."
Mian, ND, Eisenhower, AS, Carter, AS, "Targeted prevention of childhood anxiety: engaging parents in an underserved community." National Center for Biotechnology Information. U.S National Library of Medicine Mar 2015