childworriesWorries are a normal part of life. Fear is actually one of our basic emotions. Even less intense fears can still feel powerful because, just like all our other emotions, there are multiple parts to it. There are the thoughts that accompany fear (“Oh no, the fire alarm went off and there might be a fire in the building”), the physical sensations (butterflies in your stomach, fast and shallow breathing, heart beating fast, etc.) and also behavioral urges (to escape or avoid the situation that could case harm).

It is completely normal to feel anxious or worried at times. In fact, it’s actually helpful—fear is our body’s alarm system, which alerts us to danger and mobilizes us to act quickly to stay safe. Worries in kids vary by developmental level.

Typical worries of toddlers and preschoolers include separation from parents and monsters in their rooms at night. Younger children have a harder time differentiating imagination from reality, which makes their fears seem very real and scary. The good news is that younger kids are easily reassured, so they usually feel better when their parents explain that a nice babysitter is coming over for the night or that Dad did a monster check and there are none anywhere in the house.

During middle childhood—the time between the preschool and teenage years—kids usually do not have difficulty separating from their parents, but they haven’t yet hit puberty and don’t feel as self-conscious about their bodies. Sometimes this is called the “latency phase” of development because there is a lull in physical development. But while there is a temporary break in drastic physical changes, there are lots of new tasks to master during this phase of childhood.

Around this age, kids tend to feel worried or stressed about meeting new challenges, like riding the school bus alone, doing more independent projects for school, managing disagreements with friends and sometimes doing well at extracurricular activities, like an upcoming soccer game.

For parents who are wondering if a child’s fears are healthy, there are some factors to consider. Normal worries do not last very long, are not too intense and do not negatively affect kids’ day-to-day functioning. Worries become a cause for concern when they are so persistent and intense that they interfere with what we call the job of being a kid, and this is when parents should seek professional help. Kids’ jobs are to go to school and do the best they can, to make and keep friends, to love their families and to engage in activities that they enjoy and do well at. When kids feel anxious about doing these things they might experience the urge to avoid them, which can cause functional impairment.

For example, some kids might feel so worried about going on the bus alone that they would avoid going to camp and miss out on fun activities with friends. Other kids might feel so scared about entering the cafeteria at school and having other kids look at them that they fake being sick to stay home or go to the nurse’s office.

Other things that we look for when differentiating normal worries from more concerning worries include:

  • Persistent worries about lots of things, like world events, parents getting sick and being “perfect”
  • Having so many worries that they cause grouchiness, body tension and difficulty sleeping
  • Fears of humiliating oneself by doing everyday things, such as eating in front of others or saying the wrong thing
  • Refusal to be separated from parents or refusal to go to school
  • Intrusive thoughts or images that kids can’t seem to control and get out of their heads, such as being contaminated by germs

If your child is exhibiting any of these behaviors, or if worries are interfering with your child’s functioning, I recommend contacting your pediatrician or school counselor for a referral for Cognitive Behavioral Therapy (CBT). In CBT, kids learn to identify unhelpful thoughts that trigger worries, practice relaxation strategies to decrease the physical sensations that accompany anxiety and engage in helpful actions to approach safe situations. Basically, kids learn to identify when their body has sounded a false alarm, and they learn how to turn off that alarm system and feel better.

There are also some things parents can do at home to help kids with their worries:

  1. It’s important to remember that your children are paying careful attention to you, and they are likely to pick up on your emotions and reactions. If you are anxious, your kids are more likely to believe that something dangerous is about to happen and then they feel more anxious themselves. I recommend that parents try to appear calm and vocalize realistic thoughts for their kids to overhear, e.g., “I’m going to miss you when you start a full day of school, but I know this is a really important, interesting and safe place for you to be!”
  2. Parents can teach relaxation skills to their kids, such as belly breathing, stretching and imagining a safe place in their imagination.
  3. Parents should be mindful of what we call “parental accommodation,” which happens when well-intentioned parents inadvertently help kids to avoid the things they’re scared of. It’s important for kids to continue facing their fears, often gradually, so they get used to them and no longer feel so afraid.
About Dr. Jamie Howard

Jamie M. Howard, PhD, is Child Mind Institute's Director of the Stress and Resilience Program; Clinical Psychologist, Anxiety and Mood Disorders Center.

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