Anxiety is a normal part of life, and for children, it often plays a developmental role in building resilience. However, when anxiety becomes persistent and interferes with daily life, it can indicate an anxiety disorder. For child and family specialists, recognising the signs of anxiety is critical in providing timely and effective support to families.
Recognising anxiety in children
Children experience and express anxiety differently based on their age, developmental stage, and personality. Specialists should look for the following signs:
Physical Symptoms: Complaints of headaches, stomach aches, or muscle tension without a clear medical cause. Other indicators may include excessive fatigue, restlessness, or changes in sleep patterns.
Behavioural Changes: Avoidance of certain activities, places, or people is a key behavioural indicator. Children might resist going to school, refuse to engage in social situations, or avoid tasks that seem challenging.
Emotional Responses: Look for heightened emotional reactivity, such as frequent crying, irritability, or disproportionate fear responses. Children may struggle to articulate their feelings, instead expressing their anxiety through mood swings.
Cognitive Patterns: Anxiety often manifests in negative thought patterns. Children might express excessive worry about future events, perfectionism, or fear of failure.
Age-specific presentations
Understanding age-related manifestations of anxiety can help specialists tailor their approach:
Early Childhood: Separation anxiety is common in younger children, often presenting as clinginess or distress when separated from caregivers. Fear of imaginary threats (e.g., monsters) is also typical.
Primary School Age: Social anxiety may emerge, with children fearing judgement or rejection by peers. Generalised anxiety disorder might present as excessive worry about academic performance or safety.
Adolescence: Anxiety during this stage often centres on social relationships and identity. Panic attacks or symptoms resembling them can also begin to appear in some adolescents.
How anxiety differs from typical worry
It is important to differentiate between age-appropriate worry and clinically significant anxiety. While transient worry is a normal part of development, anxiety disorders are characterised by persistent and disproportionate fear that lasts beyond typical durations. Additionally, clinically significant anxiety often causes functional impairment, disrupting daily life through behaviours such as school refusal or an inability to participate in family activities, signalling the need for intervention.
Engaging families in identification
Child and family specialists play a vital role in helping families identify and address anxiety. Effective strategies include using a combination of observations and open-ended questions to gently explore a child's feelings and behaviours. Educating parents about the signs of anxiety and encouraging them to share observations from home and school settings is equally important. Additionally, collaborating with teachers and caregivers provides a holistic view of the child's emotional and behavioural patterns, enabling a comprehensive assessment and tailored support plan.
Practical strategies for support
Specialists can equip families with tools to address anxiety effectively. This includes teaching emotional awareness by helping children and parents recognise and label emotions, normalising anxiety as a natural part of life. Building coping skills is also essential, with techniques such as deep breathing, mindfulness exercises, problem-solving, and gradual exposure to feared situations. Creating predictable environments through consistent routines can reduce uncertainty and foster a sense of safety. Additionally, empowering parents with guidance to maintain a calm, supportive approach allows them to model adaptive responses to stress, reinforcing resilience in their children.
When to seek professional help
While many children can manage anxiety with support from their families and schools, some may require additional intervention. Red flags that indicate a need for further assistance include persistent anxiety that does not improve with initial strategies, severe avoidance behaviours that disrupt daily functioning, and physical symptoms such as chest pain or difficulty breathing that are related to anxiety. Encourage families to seek professional help, such as therapy or counselling, if these signs persist.
Conclusion
Identifying and addressing anxiety in children is a collaborative process that involves understanding, empathy, and evidence-based strategies. By recognising the signs of anxiety and empowering families with the right tools, child and family specialists can help.
Resources
Healthdirect Australia: Anxiety in children
Royal Children’s Hospital Melbourne: Recognising anxiety in children
RWA Psychology: What Does Anxiety Look Like in Children
ScienceDirect: Genetic basis of anxiety-like behaviour: a critical review
Cambridge Journals: The Importance of Behaviour in the Maintenance of Anxiety and Panic: A Cognitive Account
Cleveland Clinic: Anxiety in Children