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Monday, November 9, 2009

Types of Anxiety Disorders in Children

By Chaim Packer

Like all human beings, children experience anxieties, many of which are perfectly normal developmental stages or responses to things they encounter in their everyday lives. Very young children often show intense anxiety at being separated from their parents or primary caretakers-a common sight (and sound) on the first day of daycare or the first time parents leave their child with a babysitter. And of course many children go through stages where they develop a temporary fear of strangers, or the dark, or dogs, or any number of external stimuli. But anxiety can also persist and develop beyond what is "normal" even in very young children.

Six distinct types of anxiety disorder have been identified: generalized anxiety disorder, panic disorder, phobias, social phobia, post-traumatic stress disorder and obsessive-compulsive disorders. Every one can strike children and teenagers as well as adults. There are some significant differences between children and adults, however, in the particular symptoms they exhibit, in how the disorder can be recognized or diagnosed, and in the prevalence of certain sub-types of anxiety.

Diagnosing anxiety disorders in children (as in adults) is often a matter of degree. How often, how severe, how persistent are likely to be the determining factors. But children are often not analytical or articulate enough to communicate their feelings directly, which can make understanding their problems a challenge. Parents and teachers need to learn to recognize certain types of behaviors as warning signs that merit further attention. Some of the symptoms that can be warning signs in children are extreme clinginess, tantrums, unwillingness to go to school or to friends' houses, nightmares, wanting to sleep with parents, signs of panic when they are separated from their parents, inability or unwillingness to speak audibly, and a need for constant approval and reassurance.

Experts have given labels to some of the particular forms anxiety takes among children.

Separation anxiety is usually a brief phase for young children between the ages of 18 months and 3 years. When it continues after the age of 4, it may signal a more serious problem. It most often recurs between the ages of 6 and 9 and can take the form of extreme homesickness, excessive worry about a parent's safety or health, and resistance to attending school. A child who is reluctant to go to school or camp or social activities like sleepovers, who clings to his or her parents particularly at bedtime and who experiences nightmares when apart from parents may be suffering from separation anxiety.

Social phobia and social anxiety disorders often first appear in the teenage years, the prime period for learning and negotiating peer interaction. It's important to distinguish this problem from mere shyness, since it can have a major impact on a child's total social development and future ability to function. Children with this problem will have difficulty speaking or performing before a class or other group, and may avoid eye contact and speak very softly or indistinctly. They are likely to sit alone and be highly sensitive to embarrassment and criticism.

Social anxiety disorder can sometimes lead to an extreme symptom called selective mutism, where children refuse to speak in certain situations they find uncomfortable-like school-even though they may be quite talkative when at home.

School avoidance or school refusal is also sometimes treated as a distinct issue that is related to separation anxiety but also can arise from or lead to the development of social phobias and social anxiety. The stomachaches and headaches that children often complain about on school mornings are classic signs, as are tantrums.

It's extremely important to spot and address anxiety disorders in children, because they can seriously interfere with the child's school performance and the ability to form social and peer relationships-problems that have lifelong consequences.

Chaim Packer is passionate about helping others with this debilitating condition. For more great information on anxiety disorder children visit

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