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Understanding anxiety in children

Jennifer Stanley and Lauren Thorne

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Today we aim to cover

What is anxiety
When is anxiety a problem
Causes of anxiety and what keeps it going
What we can do to help
Resources

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Phrases Kids Said That Were Code Words for “I’m Anxious.”

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What is anxiety?

A normal Response to stress
It usually passes
It can be protective and alert us to danger
It can enhance performance, e.g an exam, performance
Most children learn to cope with different fears or worries ( but not alone)

Anxiety is an unpleasant feeling of worry or nervousness that we all experience at some point in our lives. It is a normal reaction to stress in our lives. Everyday worry can cause us to experience unpleasant physical sensations, feelings and influence how we behave e.g. make us avoid situations. Usually these are linked to certain events or experiences e.g. exams and the feelings and associated symptoms go away after the event has occurred.

However, an anxiety difficulty is more than everyday worry, in that the feelings, sensations and way it makes us think and behave are more stable, intrusive and impact on our daily functioning. The intensity and length of time that anxiety difficulties are experienced for is stronger and longer than everyday worry and are often accompanied with other symptoms such as poor concentration, disconnection and feeling over-whelmed.

Anxiety is a feeling of worry or fear that is experienced as a combination of physical sensations, thoughts and feelings.

All children and young people feel worried sometimes, and this is a normal part of growing up. At certain points, such as on their first day of school or before an exam, young people may become more worried, but will soon be able to calm down and feel better.

Anxiety can become a problem when a young person feels stuck in it, or when it feels like an overwhelming, distressing or unmanageable experience. If this kind of worrying goes on for a long time, it can leave a young person feeling exhausted and isolated, and limit the things they feel able to do.

If your child is struggling with anxiety, there are things you can do to help them – including providing emotional support, working on practical strategies together and finding the right professional help if they need it.

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The stress response flight or fright

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Anxiety Worry

Fright

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Fears by developmental age:

Babies- stranger anxiety
Toddlers- separation anxiety
3 years old- afraid of dark, sleeping and dogs
4-6 years- anxiety is not based in reality (ie. monsters, ghosts)
7-12 years- more aware of real world issues like death and circumstances that can happen (bodily injury, natural disasters)

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When should you worry about anxiety:

When it is too strong for the child to bear
When it lasts once the threat has gone
When it leads the child to pull away from activities or school etc.
When it causes ongoing physical symptoms
When they keep seeking reassurance but it has no effect

What keeps anxiety going? Our thoughts, our reactions to situations and sometimes others reactions to us

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The anxiety cycle- Trigger = thoughts (I can’t do this)

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Group activity

Discuss in pairs- Individual responses to anxiety

How have you experienced anxiety?

Where in your body did you feel the physical sensations?

What thoughts were you having?

What did it make you want to do?

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Anxiety Curve

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Recognising Anxiety

Avoidance

Is your child avoiding situations that make theme anxious
Are they missing activities due to tummy aches headaches etc, which could be due to anxiety
Avoidance is an understandable reaction but makes things worse in the long term.
What helps? Encouraging them to face the situation in small steps

Remind your child to face it in small steps, there will be bumps along the way, aim to keep going and face the fear step by step

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Be aware of what contributes to anxiety

Genes and temperament
Anxious belief
Parent carer reaction
Avoidance
Life stressors

Moving home/school
An accident or serious illness
Parents fighting or arguing
School issues, e.g bullying/ exams
Loss of someone close to child
Being close to someone else who is anxious

A young person may feel anxious for a number of different reasons, depending on the individual. If your child is feeling unmanageable amounts of worry and fear, this is often a sign that something in their life isn’t right and they need support to work out what the problem is.

The following kinds of things can make some children and young people feel more anxious:

experiencing lots of change in a short space of time, such as moving house or school
having responsibilities that are beyond their age and development, for example caring for other people in their family
being around someone who is very anxious, such as a parent
struggling at school, including feeling overwhelmed by work, exams or peer groups
experiencing family stress around things like housing, money and debt
going through distressing or traumatic experiences in which they do not feel safe, such as being bullied or witnessing or experiencing abuse.

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How to help

It is really important for children to understand what is happening inside their bodies.

Tell them these symptoms are their bodies way of telling them how they are feeling.

Notice when they start to complain of headaches tummy aches etc.- remind them their bodies may be telling them that they are anxious

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Helpful and unhelpful thoughts

Examples of unhelpful thoughts

I am going to fail that exam

I have no friends

I am worried my family will get ill

I wish i was someone else

I am not going to like this

I cant talk in front of the class

Everything goes wrong because of me

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Support your child

Show them how to be successful

Understand

Patience

Prompt

Observe

Reward

Talk

Challenging unhelpful thoughts

“Is this thought helpful?”

“How do you know this is true?”

“Is your brain exaggerating here?”

“How can you make this unhelpful thought into a helpful one? What is realistic?”

“Are there any times this worked out differently?”

“What would your best friend say if they knew your thoughts?”

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How to support your child

Help your child feel safe and secure at home
Praise and reward for even small steps or effort
Give clear and firm limits (dont back down)
Try to be patient. Manage your reactions!!
Dont give too much reassurance - X1 only
Support your child to face their fears, small steps- (avoid avoiding) Coach them.
Be thoughtful about what you saher with your child.

Breathe slowly and deeply together.
You can count slowly to five as you breathe in, and then five as you breathe out. If this is too much, try starting with shorter counts. If it works for them, gradually encourage your child to breathe out for one or two counts longer than they breathe in, as this can help their body relax.
Sit with them and offer calm physical reassurance.
Feeling you nearby, or holding your hand or having a cuddle if it’s possible, can be soothing.
Try using all five senses together.
Connecting with what they can see, touch, hear, smell and taste can bring them closer to the present moment and reduce the intensity of their anxiety. You might think together about five things they can see, four things they can touch, three things they can hear, two things they can smell and one thing they can taste.
Reassure them that the anxiety will pass and that they will be okay.
It can be helpful to describe it as a wave that they can ride or surf until it peaks, breaks and gets smaller.
Ask them to think of a safe and relaxing place or person in their mind.
If you haven’t tried this before, agree with them when they’re feeling calm what this place or person is. It could be their bedroom, a grandparent’s house, a favourite place in nature or somewhere they’ve been on holiday. Sometimes holding a memento of a relaxing place, like a seashell or pebble, can help.
Encourage them to do something that helps them to feel calmer.
This could be running, walking, listening to music, painting, drawing or colouring-in, writing in a journal, watching a favourite film or reading a favourite book.

Remember that everyone is different, and that over time you and your child can work together to find the things that work best for them in these moments.

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Top tips for parents and carers

Provide brief, time limited reassurance and ignore as much of thei mildly anxious behaviour as possible.
Reward childrne for their efforts and doing their best (in tolerating their fears and being brave)
Model being calm and positive when facing you fears and worries.
Help children distract themselves from their worrying.

Outside of moments when your child is feeling particularly anxious or panicky, there are things you can do over time to help them manage their anxiety and feel better.

A lot of these strategies are about helping your child to understand themselves and find out what works for them. The more confident they feel about helping themselves when things are hard, the more they will believe in their ability to cope – helping to reduce feelings of panic.

In a calmer moment, talk with your child about their anxiety.

Think together about whether there’s anything in particular that’s making them feel anxious.

Help your child to recognise the signs that tell them they’re getting anxious.

Think together about the activities that help them to express themselves and reduce their anxiety.

Try activities that help them to relax, such as mindfulness, yoga or meditation.

Make a worry box or self-soothe box.

Help them do the daily things we know are important for our mental health.

Encourage them to cut out stimulants.

Spend quality time together and talk about other things.

Seek professional help if you’re worried about your child’s mental health and things aren’t getting better.

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Milkshake breathing

Get a plastic cup with a straw
Fill the cup a ⅓ full of water. Ensure child breathes in deeply through their noseand breathes out slowly through the straw. Encourage them to blow SMALL bubbles in the cup very gently.
Have your child practice at least 5 times.

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Tracing Fingers

Inhale through the nose & trace the outside of his thumb, then exhale through the mouth while tracing along the inside of the thumb. Inhale & trace the outside of his pointer finger, exhale while tracing the inside of his pointer finger…& so on and until all the fingers have been traced.

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Square Breathing

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Special Relaxing Place

Think about your relaxing place and draw or describe it. This could be a real place you

have been or a picture you may have created in your dreams.

_ Think about the colours and shapes of things.

_ Imagine sounds – seagulls calling, leaves rustling, waves crashing on the sand.

_ Think about the smell – the smell of pine from the trees, the salty sea, cakes baked

fresh from the oven.

_ Imagine the sun warming your back or the moonlight shining through the trees.

This is your special relaxing place. To practise using your relaxing place:

_ Choose a quiet time when you will not be disturbed.

_ Shut your eyes and imagine your picture.

_ Describe it to yourself in lots of detail.

_ As you think of your picture, notice how calm and relaxed you become.

_ Enjoy it and go there whenever you feel anxious.

Remember to practise.

The more you practise, the easier you will find it to imagine your picture

and the quicker you will become calm.

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Sensory Clamers

•Weighted/deep pressure/calming equipment

–Weighted blanket

–Weighted animals/shoulder snake

–Large ball

•Tactile equipment

–Rice/bean/corn flour

–Sensory ball

–Silly putty

–Moon sand

•Oral Motor

–Bubbles

•Some may need the opposite – quiet, space

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Self calming and relaxation strategies

walk, push a wall, slow breathing, stretch, foot massage

-drawing, colouring, calm music

-Visualising worry box

-Lotion smoothies

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The Worry Box

•Kleenex box, decorate it

•Write down worries put in box/ picture

•Everyday take out worries one by one

•Discuss them, problem solve.

•If still a worry go back into box

•If not rip it up and put it into a box

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What can we do?

• Learn to recognise these thought cycles and the thinking traps we are getting caught in • Learn how to challenge the evidence for our thoughts

• Use coaching conversations to make a plan

• Learn how to use relaxation strategies

• Use books, websites and apps to help

https://docs.google.com/document/d/1gNRoh0D9aeSZA4GKxHqSY4cGNTyxC1gD/edit

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Applying todays ideas and resources to your practice

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What are the signs of sensory processing disorder ?

Some of the symptoms of SPD are listed below:

Poor posture.
Difficulty controlling movements.
Poor handwriting.
Dislikes loud noises.
Difficulty making friends.
Difficulty dressing, eating or sleeping.
Frequently throws tantrums or gets upset.
Easily distracted.
Think clothing feels too scratchy or itchy.
Think lights seem too bright.
Think sounds seem too loud.
Think soft touches feel too hard.
Experience food textures make them gag.
Have poor balance or seem clumsy.
Are afraid to play on the swings.

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Can a child have sensory issues and not be autistic?

Fact: Having sensory processing issues isn't the same thing as having autism spectrum disorder.

But sensory challenges are often a key symptom of autism. There are overlapping symptoms between autism and learning and thinking differences, and some kids have both.

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Tops Tips when sensory processing becomes challenging

Sensory processing is our ability to take in information through our senses and organize it so that we are able to respond appropriately to particular situations and environmental demands. Some individuals may have major problems in handling the variety of sensations that we normally take for granted. Subsequently, they may find even common sensations confusing or frightening and have further difficulty comprehending and communication what they are experiencing.

To identify possible sensory impacts on behaviour, we need to carefully observe what is happening for that individual. Is there ….

Too little stimulation (Hyposensitivity): May feel bored, under stimulated, under aroused. When feeling underwhelmed, the person may end up seeking stimulation or attention.
Just enough: The person may present as happy, content and able to engage in activities without difficulty.
Too much stimulation (Hypersensitivity): May feel overwhelmed, overstimulated or overloaded. The person may eliminate or minimise sensory overload by avoiding. They may react with a ‘Fight’ response (responding with anger, irritability), or ‘Flight’ (responding with avoidance, fear or withdrawal) or ‘Freeze’ response (simply shutting down).
Consider the possible effects of the seven seas. These senses include touch, smell, taste and sound as well as hidden senses that enable us to detect movement and have an awareness of our bodies in space.
Have a good understanding of the individual’s sensory preferences and sensitivities.
Introduce sensory items/activities or approaches that are calming or alerting to help the situation.

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Link to Sensory Strategies for Parents and Teachers

Sensory Strategies for Parents and Teachers

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Support for parents

https://sensoryprocessingdisorderparentsupport.com/

https://sensoryprocessingdisorderparentsupport.com/tips-for-a-more-successful-sensory-christmas.php

https://sensoryprocessingdisorderparentsupport.com/tools-for-anxious-worrying-children.php