This document discusses signs of anxiety disorders in children and tips for parents and teachers. It outlines the most common forms of childhood anxiety such as generalized anxiety, social anxiety, and separation anxiety. Common symptoms are stomachaches, headaches, avoidance behaviors, and disruptions in sleep. The document recommends validating children's worries, teaching deep breathing techniques, and creating coping cards. It advises seeking professional help if anxiety is excessive or interfering with daily life, as cognitive behavioral therapy can help children learn relaxation and challenge worry thoughts.

1. This month, our expert Brooke Dooley offers help
with recognizing the signs of anxiety disorders in
children.
Dooley is the owner of Charleston Counseling
Center and has been a licensed professional coun-
selor for almost 20 years.
Howcanparentstellif
theirchildissimplya
worrier,orifhe/shehasa
seriousanxietyissue?
All children experience
anxiety, as fears and worries
in children are common
and can often be devel-
opmentally appropriate.
When a child’s worrying
becomes excessive or begins
to interfere with everyday
functioning, he or she may
be experiencing anxiety on
a clinical level.
Whatarethemostcom-
monformsofchildhood
anxiety,andwhatare
thesignsorsymptoms?
The most common forms
of childhood anxiety in-
clude generalized anxiety (i.e., the child has frequent
and excessive worries about many different things),
social anxiety (i.e., the child feels extremely nervous in
social situations and often engages in many avoidance
behaviors), separation anxiety (i.e., the child exhibits
significant anxiety when separated from parents or
caregivers), obsessive-compulsive behaviors (i.e., the
child has specific obsessive thoughts and creates rituals
to reduce anxiety), panic behaviors (i.e., the child has
unexpected episodes of intense anxiety that are accom-
panied by shortness of breath, sweating, increased heart
rate, etc.), specific phobias (i.e., the child has a specific
fear and avoids things or activities associated with that
fear), and selective mutism (i.e., the child only speaks
when around family members or select individuals, due
to severe social anxiety).
Common symptoms of childhood anxiety include
complaints of stomachaches and headaches, frequent
and repetitive reassurance-seeking, school refusal, ex-
cessive clinginess towards parents, avoidance of social
activities, disruptions in sleep or frequent nightmares,
significant people-pleasing behaviors and catastrophic
thinking.
Anger and irritability are also common in children
who are experiencing significant anxiety and are unsure
how to cope with the intense emotion. Symptoms of
childhood anxiety can begin as early as preschool, and
often change in nature and severity as the child moves
through transitions and encounters new experiences.
Whataresometipsforparentsandteachersto
helpchildrenfeellessanxious?
If your child is experiencing anxiety, it is important to
help them feel listened to and understood, even if their
worry seems irrational.
Validating a child doesn’t necessarily mean agreeing
with them; instead, you want to send a message of em-
pathy but also of encouragement that they can overcome
their anxiety. Help them to find activities that are relax-
ing and promote self-confidence, such as drawing/color-
ing, reading, creating artwork, etc.
It can also be helpful to teach your child “calm breath-
ing”, in which you take a deep breath in for 5 seconds
while making your stomach expand, and then slowly
breathing out for 5 seconds and feeling your stomach
return to normal. This type of breathing is very differ-
ent from rapid and shallow “chest” breathing that most
children engage in when they are anxious.
Repeating 10 calm breaths can help to reduce the
physical symptoms associated with anxiety as well as to
create an overall sense of relaxation. Practicing this cop-
ing skill with your child will not only help to normalize
it, but will also help them to feel more confident in using
it on their own.
Also, creating coping cards with your child can be a
fun and effective way to help them manage anxiety in
the moment. These cards can have positive statements
on them that challenge worry thoughts, as well as funny
pictures or images of your child’s favorite things.
Depending on the nature of the anxiety, specific
accommodations can sometimes be made within
the classroom, such as specialized seating, testing
accommodations,and taking small breaks to practice
calm breathing and work through specific worries using
their coping cards.
It is also helpful to have a “safe person” at the school
(a counselor, teacher or principal) who understands
your child’s worries and who your child feels comfort-
able with. When feeling anxious or worried, your child
can briefly check in with this “safe person” to challenge
worry thoughts, practice calm breathing, and return to
the classroom.
Whenachildissufferingfromanxiety,howdoes
aparentdecidewhetherit’stimetoseekprofes-
sionalhelpfromatherapistorcounselor?
If your child’s anxiety feels excessive or is interfering
with everyday activities, it may be time to seek profes-
sional help. If you are unsure as to whether your child’s
anxiety is normal or if professional help is needed, it
never hurts to meet with a therapist or counselor to re-
ceive an assessment as well as to learn tips and strategies
to apply at home.
Howcanatherapisthelpachildwithanxiety?
When helping an anxious child, a therapist often as-
sesses the child’s specific anxiety symptoms as well as
their individual strengths to create an individualized
plan for reducing anxiety symptoms and teaching cop-
ing skills.
Cognitive-behavioral therapy is a leading treatment
for childhood anxiety that is evidence-based, skills-
oriented, and engaging for the child. A cognitive-behav-
ioral therapist will help your child to learn relaxation
techniques (i.e., calm breathing, progressive muscle re-
laxation, visualization) for reducing physical symptoms
and enhancing body awareness.
Also, a cognitive-behavioral therapist will help your
child to play “detective” in assessing and challenging
worry thoughts. Specifically, your child will be taught
to look for “evidence” for and against a specific worry,
challenge it using coping thoughts, and replace it with a
more positive and rational thought.
If your child is struggling with a specific phobia, ob-
sessive-compulsive behaviors, social anxiety, or selective
mutism, small behavioral steps will also be created to
help your child become desensitized to the anxiety and
to gradually overcome fears and obstacles.
Whatelseshouldparentsknowaboutchildhood
anxiety?
While anxiety is often genetic or biological in nature,
some anxious behaviors are learned from parents or
those in the child’s social environment. Therefore, it can
be helpful for parents to recognize their own anxious
behaviors and model positive coping skills for their
children.
It is important to remember that overcoming anxiety
will not happen overnight or within a short period of
time, but often requires gradual steps and patience from
parents and teachers.
Learn more at CharlestonCounseling.org. Reach Brooke
Dooley at Brooke@CharlestonCounseling.org.
{ ask the expert }
Leanne Trudeau
Brooke Dooley
Serious
worries
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