We met at a dinner recently and I was fascinated by her and her work. She has generously agreed to share some of her pearls of wisdom on recognizing anxiety in children and for coping with it. Thank you, Dr. Ledley!
Although we are nearing the end of October, school-related anxiety actually seems to peak just about now in the offices of anxiety specialists like myself. The initial euphoria of new notebooks, cute new clothes, and fresh faces seems to dwindle…leaving kids with lots of worries.
Here is a sampling of the kinds of worries that seem to hit kids at this time of year:
- Separation anxiety – Not wanting to leave mom and dad to go to school, activities, birthday parties, and sleep-overs.
- Social anxiety – Worries about making new friends, being a good friend, and how others are judging us.
- Performance anxiety – Doing well in school, getting homework done, making a good impression on teachers and friends in the classroom setting. These worries can be particularly strong for kids who have learning differences. And, of course, performance anxiety can extend to activities that are supposed to be fun, like sports, music, and other activities.
- Health anxiety – Worries about getting ill (particularly with tummy related ailments) when away from mom and dad. At this time of year, we hear lots from our kids about tummy aches (and the dreaded vomit!), headaches, and about all the illnesses going around school.
Here are some tried and true tips for dealing with childhood anxiety:
- Establish (and stick to!) good routines: I often begin my work with families by examining their evening and morning routines (or lack thereof). Kids feel comfortable with routines and little tweaks to the routine can go a long way to reducing anxiety.
- Make sure your child gets enough sleep. I am amazed by how late kids go to sleep these days. Kids are not little adults. Children still need 10-12 hours of sleep per night. Make sure to get homework and physical activity done early in the evening. Watch out for subtle sources of caffeine like iced tea and hot chocolate. Discontinue all screen time an hour before bed and if at all humanly possible, do not put a TV in a child’s room. Make sure kids are watching age-appropriate TV, because even if they don’t seem distressed by adult content, they might very well be. Use the hour before bed to wind down by reading, drawing, listening to music, listening to a book on tape — anything that introduces the brain to the idea that it is time to sleep!
- Examine the morning routine. When does anxiety hit? Is it when your child is still lying in bed? Is it because the morning is rushed? Do you find your child talking incessantly to you about all the things she is concerned about for the day ahead? If so, re-tool the morning. Make sure that the pace is calm and that no one is rushing (even if this means waking up at bit earlier). Have your kids hop right out of bed (laying in bed for too long is a recipe for out of control worry!), get dressed, eat a healthy breakfast (even with a nervous tummy), and teach them to get their brains busy with something besides worry. Again, reading, drawing, playing with the dog are all good things. Although discussing all those worries might feel like the right thing, doing so often feeds anxiety and makes worse. So, if a child is really swamped with worry, a better idea is to have them write their worries down on slips of paper and put them in a worry box. At the end of the day review the worries with your kids and help them to sort their worries into a box of “worries that came true” and a box of “worries that didn’t come true”. Kids will be amazed to see that the vast majority of their worries do not come true. When kids start seeing the recurring data, they are more able to “boss back their brain” and say, “Not going to happen, brain” and move on with their day!
- Exposure: Our inclination as parents is to shield our kids from things that frighten them. In the short-run, this approach makes sense. Our kids feel better and we don’t have to deal with the gamut of emotions that come with exposure to feared situations. In the long-run, however, we are teaching our kids that objectively safe things (school, play-dates, puppies) are dangerous. So, the best strategy for anxious kids is to help them confront the exact things that they fear (we call this “exposure”). If they fear school, make them go each and every day even if it feels terrible (for both of you!). If they are afraid of going to play-dates without you, set up a plan with your child to first play at a friend’s house with you there, then with you leaving for a very brief time, and with you then leaving for a longer time. Ask your child, “What do you think is going to happen?” Together, be scientists and see if the predictions come true. If they fear you are not going to come back to get them from a play-date, the best way to see that their anxiety is telling them lies is to go on said play-date and have mom arrive back at the exact time that she said she would!
- Don’t Provide Too Much Reassurance – Another trap we well-meaning parents fall into is providing our kids with too much reassurance about the things that worry them. If kids fear getting sick at school, parents might find themselves taking their kids’ temperatures every morning, discussing aches and pains, and reassuring their kids that they will be fine. This level of reassurance feeds anxiety. Here is a better approach. Tell your kids once – “I am your mom and each morning, I am going to send you to school even if your tummy hurts because I am pretty sure that once you get there, you are going to be fine. I can’t promise this, but I do trust my instincts and I don’t want you to miss out on learning and fun with your friends. So, in the mornings, we are no longer going to talk about health.” When kids ask about their worries on subsequent mornings, we are doing a much better job as parents to help their brains get busy with something else. As adults, we do this all the time – life can’t stop if we have a headache or a stomachache or even if we are suffering from a serious illness. So, if kids are worrying in the morning, say, “Hey, what can we do to change the channel in your brain? Want to help me pack the lunch boxes?” At a calm time, have kids make a list of things they can get busy with at stressful times that easily fit into the morning routine so that when they are given the cue to change the channel in their brains, they can do so with increasing independence.
- Don’t Let it Go for Too Long: All kids feel anxious at the beginning of the school year. For most kids, that anxiety fades as they settle in to school and they see that they can handle the schoolwork, the teacher is nice, and they have been able to make some friends. For other kids, it is not so easy. I encourage parents to do everything they can for their kids (besides helping them avoid, of course!).
- When little kids talk about hating school, or being bored in school, give it some deeper thought. Similarly, if your child behaves well at home but is acting up at school, don’t just shrug it off. Could they have a learning difference? Could they be particularly gifted? Speak to their teacher and discuss the possibility of having them tested. It is your right to have your child evaluated within the school system and receive any services that he or she needs.
- Educate yourself: There are many excellent books available for parents of anxious kids. Check out worrywisekids.org for suggestions.
- If your child’s anxiety is becoming more heightened as the year progresses, consider seeing an expert in child anxiety. Check out the Find a Therapist function for the Association for Behavioral and Cognitive Therapies to find a therapist in your area.