When do children have fear and anxiety?

• Anxiety, worry or fear can be normal and often it does not last long in children
• Stranger anxiety and separation anxiety are two common fears that young children will experience. It is part of normal development.
• Stranger Anxiety
  • Refers to the fear reactions infants experience when approached by unfamiliar adults.
  • Occurs by age 4 – 5 months and intensifies at age 12 months
• Separation Anxiety
  • Refers to the child’s reaction to the departure of the main care-giver
• Factors affecting stranger and separation anxiety:
  • Child’s age
  • Nature of situation
  • Past experiences and
  • Quality of the child-carer attachment

When should help be sought?

• It is advisable to get help when anxiety, worry or fear:
  • Causes marked distress
  • Affects the child’s functioning at home or school
  • Is prolonged

What are the types of anxiety disorders found?

Common types of anxiety disorder include:

• Separation Anxiety Disorder
• Generalised Anxiety Disorder
• Phobic Disorder
• Social Anxiety Disorder
• Post Traumatic Stress Disorder
• Panic Disorder

How can fear or anxiety be manifested?

1. Unusual Behaviour. For example:
   • Avoidance of activities e.g. family outings
   • Avoidance of place e.g. playground
   • Avoidance of person e.g. teacher
   • Distress behaviour e.g. before going to sleep
   • Unusual clinging behaviour
   • Change in habits e.g. starting to have thumb sucking
   • Fidgeting
2. Depressed Mood / Emotion / Thinking :
   • Feeling worried or fearful
   • Excessive anticipation of negative events or disaster, e.g.
     • Rejection
     • Ridicule
     • Accident
     • Injury
     • Examination failure
3. Physical complaints :
   • Headache
   • Stomachache
   • Choking sensation
   • Shortness of breath
   • Sweating
   • Tremors

Why should we be concerned?

Fear and anxiety may lead to :

• Interference with normal progress of growing up
• Interference with functions, for example in learning and adversely affecting relationship with family members, friends or teachers.
• May lead to more serious behavioral problems e.g. conduct disorder
• May lead to substance abuse to get comfort e.g. tobacco, alcohol, drugs
• Risk of self harm
• Risk of suicide

What can be done to help the child?

• Listen to the child and understand his behavior
• Give encouragement and praise
• Help the child see his personal strength
• Help the child accept his weaknesses and how to deal with them
• Help the child use relaxation technique e.g. breathing exercises, visualization of calming scenery
• Provide psychological support so the child can :
  • Learn to think positively
  • Deal positively with changes, fear, anger, frustrations etc
  • Develop positive social skills e.g. assertiveness
• Provide counseling to the :
  • Individual child
  • Child’s family members
  • School – inform the school about his/her problems so the school staff is supportive
• Give medication as advised by a psychiatrist

What can be done to prevent excessive fear or anxiety?

• Help the child develop necessary emotional and social skills
• Help the child deal with life events positively
• Provide a warm, responsive and trusting relationship
• Provide child with warm, harmonious environment
• Ensure predictable failures

Where shall one go for further support?

The following professionals may be helpful

• School counselor
• Doctors at local health centres
• General practitioners