Anxious Child, Ages 6 to 12

Anxiety is a normal part of children's behavioral and emotional development, and as children get older, their concerns grow broader. Your child may be worried about a spelling test, a soccer match, or riding the school bus for the first time. These anxieties are common, even signs that your child's development is on track.

Why is my child so anxious?

As children get older, they subject themselves to more scrutiny. This, in turn, can give rise to a good deal of anxiety. Typically, children of this age worry about performing well in school, impressing their peers, and living up to their parents' expectations. Anxiety can result when a child feels she may be failing at any of these things. Your child might fret that she doesn't have the "cool" brand of jeans or drag her feet getting ready for school one morning because she has to make a presentation in science class.

In addition, your child may react to stresses and issues within the family as well as the world beyond: A divorce, a parent's losing a job, a car accident, even a story on the evening news can trigger feelings of distress, fear, and helplessness. At this age, children begin to think more about death, realizing that it's real and happens to everyone -- not only the bad guy on TV, but parents and children as well. Consequently, your child may have trouble falling asleep after watching a movie in which someone dies or refuse to go to school if you're ill. Provide your child plenty of opportunities to discuss specific fears, especially if they've arisen from events in your household.

Are there specific kinds of anxiety that children experience?

Yes. Here are some types of anxiety that children between the ages of 6 and 12 commonly experience, along with possible causes:

• Separation anxiety. Although typically associated with toddlers, this nervousness about being apart from you can reappear as your child embarks on experiences that take her away from home, such as summer camp or a trip to visit relatives. As she struggles to establish autonomy, she naturally becomes aware of how much she needs you.
• Phobias. Your child is terrified of certain things or situations, such as being bitten by a pit bull or riding in the car. The fear may have its root in an actual incident, such as being cornered by a neighbor's dog or being involved in a car accident.
• Shyness. Your child may become fearful in new situations, such as her first girl scout troop meeting or school dance.
• School phobia. Your child refuses to go to school, pleading with you not to make her or insisting that she's ill. This may be a manifestation of separation anxiety, or it may derive from a more specific fear, such as that of not knowing the answer when her teacher calls on her or of being teased or bullied on the playground.
• Fears of natural disasters. Children in this age range often have fears that are grounded in events they've witnessed or heard about. Your child might start worrying that your house will catch fire after a school fire drill, or develop a fear of flying after seeing an airplane accident on the evening news.

These anxieties are normal, and they will diminish or disappear in time.

How can I tell if my child is overly anxious?

Ask yourself whether your child has spells of anxiety linked to particular events, or if she is anxious day in and day out. While all children are anxious before having to do certain things, such as perform in a piano recital or take a math test, some become apprehensive even when going about their daily routines. If that's the case with your child, it's possible that her worries are overwhelming her ability to cope.

Generally speaking, you should be concerned if your child's fears or constant worrying begin to hamper her ability to participate in school, family or social activities. She may also need some special help if you've repeatedly reassured her, yet her fears are as strong as ever.

When should I get help for my child's anxiety?

According to the American Academy of Pediatrics, you should consult your pediatrician if your child's anxiety is:

• Interfering with family activities
• Making it hard for her to find or keep friends
• Becoming an excuse for her to stay home from school
• Disrupting her sleep habits
• Resulting in compulsive behavior such as repeatedly washing her hands or counting
• Resulting in attacks of intense fearfulness or panic, with physical symptoms such as heart palpitations; excessive sweating; cold, clammy hands; dizziness; trembling; nausea; and hyperventilation. Known as panic disorder, this problem rarely affects children under 12.

Your child's doctor will examine your child to see if an underlying physical problem such as poor hearing or vision, could be causing her anxiety. He may also refer you to a family counselor or child psychiatrist, who can look for a behavioral, emotional or learning disorder. If necessary, the doctor may prescribe medication to calm your child and ease any compulsive behavior.

What can I do?

When your child becomes anxious, follow your instincts and comfort her. But don't stop there: Use your imagination to find ways to help your child overcome specific fears and worries. These tips can help:

• Talk it out. Some of your child's fears are entirely normal and denying them would be denying reality. A typical one for this age is apprehension about doing badly in school. (Perhaps you still have that dream about going to class only to find that it's exam day and you never cracked a book.) Pretty much everyone experiences fear of failure, and empathizing with your child can help. However, if your child is worrying obsessively or convinced she won't succeed, try to help her see that if she has studied for tests and done her homework, this fear isn't grounded in reality.
• Write or act it out. School-age kids often keep journals, and writing down fears and worries can do wonders to dissipate them. If your child has become concerned about something outside her own life, such as the plight of dolphins or children going hungry, don't dismiss her fears, but give her tools to confront them. She might write a letter to Greenpeace about the dolphins or to UNICEF asking about ways to aid needy children. Acting out fears is another way to diminish them.
• Practice short separations. Encourage your shy child to stay overnight at a friend's house or spend a weekend with a favorite aunt and uncle. Such temporary separations will give her practice in adjusting to different situations and interacting with people outside the family.
• Lower the pressure. Your anxious child may be trying to tell you that she's doing too much -- that the demands of school, music classes, sports, and friendships have mushroomed out of control. Consider whether you're pushing too hard in terms of grades or chores. Offer some guidance on how she might better manage her schedule, or suggest that she cut back a little --maybe the tennis lessons could wait a few months, for example. You can also help your child feel secure and well rested by keeping mealtimes and other routines as regular as possible.
• Use your sense of humor. Laughter goes a long way towards resolving anxiety. If your child is worrying about an upcoming piano recital, tell her the old trick of imagining the audience in their underwear. Or describe the time you bombed while making a toast at your sister's wedding. Funny stories put things in perspective, and if your child learns to laugh at herself when she occasionally flops, she'll have an easier time throughout life.
• Don't demand toughness. Your child already is tough, in ways you probably don't appreciate. How many times a day does she hear that she's done something wrong, and must try again? How many rules is she expected to follow? How many activities compete for her attention? Forcing your child to do something that makes her anxious will only make her fear you and doubt herself. Give her time, don't fret if her progress is gradual, and praise her for each small step she takes.

References

American Academy of Child and Adolescent Psychiatry. Facts for Families: The Anxious Child. http://aacap.org/cs/root/facts_for_families/the_anxious_child

American Academy of Child and Adolescent Psychiatry. Facts for Families: Children Who Won't Go to School (Separation Anxiety). http://aacap.org/cs/root/facts_for_families/children_who_wont_go_to_school_separation_anxiety

Nemours Foundation, KidsHealth. Anxiety, Fears, and Phobias. http://kidshealth.org/parent/emotions/feelings/anxiety.html