Anxiety and fears in children

Anxiety, worries and fear: a normal part of childhood

It’s normal for children to show signs of anxiety, worries and fears sometimes. In most cases, anxiety in children and fears in childhood come and go and don’t last long.

In fact, different anxieties often develop at different stages. For example:

Babies and toddlers often fear loud noises, heights, strangers and separation.
Preschoolers might start to show fear of being on their own and of the dark.
School-age children might be afraid of supernatural things (like ghosts), social situations, failure, criticism or tests, and physical harm or threat.

Babies and young children don’t tend to worry about things. For children to be worried, they have to imagine the future and bad things that might happen in it. This is why worries become more common in children over eight years of age.

Children also worry about different things as they get older. In early childhood, they might worry about getting sick or hurt. In older childhood and adolescence, the focus becomes less concrete – for example, they might think a lot about war, economic and political fears, family relationships and so on.

Anxiety, worry or fear?
Worry and fear are different forms of anxiety. Worry usually happens when a child thinks about past or future situations. Fear usually happens in the present.

For example, a child might be fearful when a dog comes up to him in the park. The same child might also worry about visiting a friend with a pet dog.

Some anxiety, worry and fear is normal in childhood. But you know your child best. If you’re concerned that your child’s anxiety is interfering with her daily life, it’s a good idea to talk with your GP.

How to support your child with anxiety

If your child shows signs of normal childhood anxiety, you can support him in several ways:

Acknowledge your child’s fear – don’t dismiss or ignore it.
Gently encourage your child to do things she’s anxious about, but don’t push her to face situations she doesn’t want to face.
Wait until your child actually gets anxious before you step in to help.
Praise your child for doing something he’s anxious about, rather than criticising him for being afraid.
Avoid labelling your child as ‘shy’ or ‘anxious’.

Types of anxiety in children

Children experience several types of anxiety. A child might have only one type of anxiety, or she might show features of several of them.

Social anxiety in children
Social anxiety is fear and worry in situations where children have to interact with other people, or be the focus of attention. Children with social anxiety typically:

believe that others will think badly of or laugh at them
are shy or withdrawn
have difficulty meeting other children or joining in groups
have a limited number of friends
avoid social situations where they might be the focus of attention or stand out from others – for example, talking on the telephone and asking or answering questions in class.

Our article on social anxiety has information and tips on helping your child overcome this issue.

Separation anxiety in children
Separation anxiety is the fear and worry children experience when they can’t be with their parents or guardians. Children with separation anxiety typically:

protest, cry or struggle when being separated from mum or dad
worry about getting hurt or having an accident (they might worry about their parents or themselves)
refuse to go to or stay at day care, preschool or school by themselves
refuse to sleep at other people’s homes without their parents there too
complain of feeling sick when separated.

Our article on separation anxiety has information and tips on helping your child overcome this issue.

Generalised anxiety in children
Children with generalised anxiety tend to worry about many areas of life – anything from friends at playgroup to world events. Children with generalised anxiety typically:

worry about a variety of things – for example, health, schoolwork, school or sporting achievements, money, safety, world events and so on
feel the need to get everything perfect
feel scared of asking or answering questions in class
find it hard to perform in tests
are afraid of new or unfamiliar situations
seek constant reassurance
complain about feeling sick when worried.

Our article on generalised anxiety has information and tips on helping your child overcome this issue.

Read about the stepladder approach, a gentle behaviour technique that can be used to help children who experience different anxieties.

When to be concerned about anxiety in children

Most children have fears or worries of some kind. If you’re concerned about your child, the following points might help you decide whether you need to seek professional help.

Ask yourself whether your child’s anxiety is stopping him from doing things he wants to do. Is it interfering with his friendships, schoolwork or family life? If the answer is ‘yes’, consider seeking professional help.
Compare your child’s behaviour with other children of the same age. For example, it’s common for most children to have separation fears when going to preschool or school for the first time, but far less common over the age of eight years. If your child’s behaviour is very different from that of other children, consider professional help.
Consider how severe your child’s reaction is. If she’s extremely distressed and hard to settle when you leave her, for example, think seriously about professional help.

Severe anxiety can impact on children’s health and happiness. Some anxious children will grow out of their fears, but others will keep having trouble with anxiety unless they get professional help.

Finding professional help and treatment for children with anxiety

You can seek professional information and advice from several sources:

your child’s school counsellor
your child’s GP or paediatrician (who might refer you to a child psychologist)
your local children’s health or community health centre
a specialist anxiety clinic (present in most states).

Treatment
The first step for children with severe anxiety is usually treatment that focuses on their behaviour in situations that make them anxious. This is likely to include psychological therapies like cognitive behaviour therapy (CBT).

CBT helps children develop skills that change their thinking in anxious situations, and increases their ability to cope by themselves. This therapy involves gradually exposing children to things they’re anxious about so they can learn to manage their feelings. This approach has long-term benefits for the treatment of anxiety.

Medications are sometimes prescribed for children with severe anxiety. Some medications (particularly medications that target a neurotransmitter called serotonin) can successfully treat anxiety in children. They can work well when they’re combined with CBT.

Financial support for children with anxietyYour child might be able to get government funding to access a psychologist for individual or group sessions. Talk to your GP about the best option for your child.

Visit Australian Psychological Society – Find a psychologist to find professional services near you.

Causes of anxiety in children

Some people are more likely to be anxious because it runs in the family, just like eye colour, for example.

People can also learn to think and behave in an anxious way by watching others, or by going through scary experiences.

Certain things in a child’s environment might also increase the child’s chances of becoming anxious – for example, if a parent is overprotective of a shy child it might help the child in the short term, but can increase the child’s anxiety overall.