“My toddler is terrified of dogs”, “My 4 year old is struggling at drop off for Kindy”, “My 6 year old is having trouble going to sleep at night”. Sound familiar? These are common signs of anxiety in children.
Earlier this year my colleague, Katt Matthews, and I attended a two-day conference in Melbourne by Dr Chris Chapparo which explored the topics of Occupational Therapy for Anxiety and Helping Manage Stress and Resilience in Children.
What is Anxiety?
Anxiety, which is a feeling of worry, nervousness, or unease about something with an uncertain outcome; can present in children across all ages.
Anxiety can present in different ways. As parents/teachers/therapists, it is important that we detect signs of anxiety, so we can therefore implement strategies to build resilience, and reduce potential negative outcomes.
What does anxiety look like in children?
1) Being extremely well behaved and “flying under the radar”
2) Avoiding new things, even if it fun and safe
3) Becoming distressed by changes in routine
4) Identifying the worst case outcomes e.g. “Mum and dad could die”
5) Avoiding situations they don’t like e.g. parties
6) Asking unnecessary questions
7) Difficulty separating from parents
8) Displaying physical complaints (sickness, pain)
9) Being a perfectionist
10) Difficulty sleeping
11) Being argumentative
What can we do to help build resilience?
Resilience is an importance part of development for children, as it allows them to cope with the daily challenges of life. Resilience is the social, emotional and motivational capacity to engage in life. It allows a child to have confidence, be persistent, organised and to persevere. Resilience allows a child to have strategies to cope with anxiety.
Occupational Therapists can work closely with children to develop strategies to manage anxiety and improve resilience. The goal is to build capacity to make a child “resilient enough” to function. There are basic strategies parents can also implement to aid in building resilience including:
- Always pre-warn a child if a potentially anxiety inducing activity is too occur. Explain the process to the child, what they might feel and what you will do to help.
e.g. “Today we are going to the doctor to have a needle. The needle is really important because it will stop you from getting sick. The needle is going to hurt but we are going to come up with a plan for getting through it together. When they give you the needle you are going to sit in my lap, I’m going to hold your hand and you are going to look at my as we count to 10 and then it will all be done”
- Grade the exposure to the feared item. Slowly increasing expectations in a supportive environment can help a child to adapt and implement strategies to better manage the situation.
e.g. When learning to use the monkey bars, start by just holding the bar with you supporting majority of the child’s weight. Then complete moving to one bar with support. Slowly increase how far they need to move and reduced the level of physical support you provide.
- “Unlearn” anxious behaviours by replacing them with happy memories.
e.g. Find out what your child is scared of and replace this with something positive, for example if they were scared of a dog at a park and now refuse to go to the park, show the child the dog is no longer there and play a really fun game that the child enjoys.
- Provide a child with a safe space to talk about how they are feeling. Children benefit from parents modelling and to have “emotions normalised”. A great way is for you, as the parent to explain to the child how you are feeling in a particular moment, how it feels and why.
e.g. When in traffic saying “oh this traffic is making me feel frustrated and mad, I can feel my heart racing and I want to yell. I am going to take some deep breathes and think positive thoughts. There is nothing that we can do, it isn’t the end of the world if we are a few minutes late.”
- Use mindfulness and controlled breathing strategies to assist them to calm down.
e.g. Use mindfulness apps like Breathe Think Do with Sesame. Practise using these when the child is calm and make links to how this could be used during challenging scenarios.
If you identify any of these areas as a concern, please feel free to have a chat to one of us!