The Anxious Child

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All children experience anxiety. Anxiety in children is expected and normal at specific times in development. For example, from approximately age 8 months through the preschool years, healthy youngsters may show intense distress (anxiety) at times of separation from their parents or other persons with whom they are close. Young children may have short-lived fears, (such as fear of the dark, storms, animals, or strangers). Anxious children are often overly tense or uptight. Some may seek a lot of reassurance, and their worries may interfere with activities. Parents should not discount a child’s fears. Because anxious children may also be quiet, compliant and eager to please, their difficulties may be missed. Parents should be alert to the signs of severe anxiety so they can intervene early to prevent complications. There are different types of anxiety in children.

Symptoms of separation anxiety include:

  • constant thoughts and intense fears about the safety of parents and caretakers
  • refusing to go to school
  • frequent stomachaches and other physical complaints
  • extreme worries about sleeping away from home
  • being overly clingy
  • panic or tantrums at times of separation from parents
  • trouble sleeping or nightmares

Symptoms of phobia include:

  • extreme fear about a specific thing or situation (ex. dogs, insects, or needles)
  • the fears cause significant distress and interfere with usual activities

Symptoms of social anxiety include:

  • fears of meeting or talking to people
  • avoidance of social situations
  • few friends outside the family

Other symptoms of anxious children include:

  • many worries about things before they happen
  • constant worries or concerns about family, school, friends, or activities
  • repetitive, unwanted thoughts (obsessions) or actions (compulsions)
  • fears of embarrassment or making mistakes
  • low self esteem and lack of self-confidence

Severe anxiety problems in children can be treated. Early treatment can prevent future difficulties, such as loss of friendships, failure to reach social and academic potential, and feelings of low self-esteem. Treatments may include a combination of the following: individual psychotherapy, family therapy, medications, behavioral treatments, and consultation to the school.

If anxieties become severe and begin to interfere with the child’s usual activities, (for example separating from parents, attending school and making friends) parents should consider seeking an evaluation from a qualified mental health professional or a child and adolescent psychiatrist.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry

The Child With Autism

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Most infants and young children are very social creatures who need and want contact with others to thrive and grow. They smile, cuddle, laugh, and respond eagerly to games like “peek-a-boo” or hide-and-seek. Occasionally, however, a child does not interact in this expected manner. Instead, the child seems to exist in his or her own world, a place characterized by repetitive routines, odd and peculiar behaviors, problems in communication, and a total lack of social awareness or interest in others. These are characteristics of a developmental disorder called autism.

Autism is usually identified by the time a child is 30 months old and always by three years of age. It is often discovered when parents become concerned that their child may be deaf, is not yet talking, resists cuddling, and avoids interaction with others.

A preschool age child with “classic” autism is generally withdrawn, aloof, and fails to respond to other people. Many of these children will not even make eye contact. They may also engage in odd or ritualistic behaviors like rocking, hand flapping, or an obsessive need to maintain order.

Many children with autism do not speak at all. Those who do may speak in rhyme, have echolalia (repeating a person’s words like an echo), refer to themselves as a He or She, or use peculiar language.

The severity of autism varies widely, from mild to severe. Some children are very bright and do well in school, although they have problems with school adjustment. They may be able to live independently when they grow up. Other children with autism function at a much lower level. Mental retardation is commonly associated with autism.

Occasionally, a child with autism may display an extraordinary talent in art, music, or another specific area.

The cause of autism remains unknown, although current theories indicate a problem with the function or structure of the central nervous system. What we do know, however, is that parents do not cause autism.

Children with autism need a comprehensive evaluation and specialized behavioral and educational programs. Some children with autism may also benefit from treatment with medication. Child and adolescent psychiatrists are trained to diagnose autism, and to help families design and implement an appropriate treatment plan. They can also help families cope with the stress which may be associated with having a child with autism.

Although there is no cure for autism, appropriate specialized treatment provided early in life can have a positive impact on the child’s development and produce an overall reduction in disruptive behaviors and symptoms.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry