Anxiety in Children

Anxiety is the fastest growing disorder in children from elementary school to college. Anxiety interferes with learning, socializing, and inhibits social-emotional growth. Due to the systemic changes in education, the perennial threat from school violence (and its media coverage), our increased reliance on technology and the intensifying pressure students put on themselves to achieve, we are growing a problem that district leaders need to appreciate.

 

What is Anxiety?

Anxiety is different from worry, fear, and panic. The simplest way to differentiate between them is using the following vignettes: If a bear knocks on your door, that elicits fear. If you hear a radio broadcast of a located in your area, that is worry. If there is no indication a bear is present, yet are consumed with the idea, that is anxiety.

With anxiety, we become preoccupied with what may be, often to the point of creating disruption to our wellness, our relationships, or our work/school performance. Anxiety can be general, meaning it touches on multiple areas, or it can be concentrated into one area, such as a phobia. Anxiety can also be concentrated in panic attacks, which is essentially the fear of fear. Anxiety can also manifest in more enduring conditions such as obsessive- compulsive disorder.

There are two primary modes of anxiety, ruminative and anticipatory. Ruminative is when you spend time dwelling on the past and anticipatory is looking forward into what may be. Often times people have a combination of the two and in children the future oriented version is more prevalent.

 

What Causes Anxiety?

We are a society of overthinkers, which is the short answer. We analyze, judge, debate and a whole other set of processes using our brain. We tend to deemphasize our bodies in Western culture, ignoring our needs. Our body lets us know what needs are unmet or threatened, through signals we often label as symptoms. In doing so we use prescriptive measures to turn down the volume of the message in order to alleviate the symptom.

As we learn to increase our tolerance for discomfort, we can tune into what our body is trying to tell us, so that we can take action that gets our needs met, instead of alleviating the ‘symptom’. With children, it’s our job to help them tune into their bodies and understand their needs. If they aren’t able to communicate their needs, by expressing feelings, they will likely have a compounded effect which amplifies their frustration generating additional anxiety.

Anxiety is more common with perfectionists, people who are more rigid in their thinking, and those who isolate and/or avoid conflict. If we imagine anxiety as trapped energy, anything that internalizes feelings as opposed to acting upon them has the potential to create anxiety.

Some children develop existential anxiety early in their lives. This amounts to the fear of death, which less communicative or sensitive children may describe as a fear of the dark. At night, children may lie awake imagining their own or their parent’s death. Those children who haven’t yet mastered abstract thinking are more at risk, due to the harsh finality the concept of death presents.

Separation anxiety is a combination of insecurity and mistrust of the world. A child may latch onto a parent, sometimes out of their struggle to face the world alone or perhaps out of a deep- seated fear for the parent. Parents with anxiety often install cautionary tales with their children or model hesitancy, which can influence a child toward their own anxiety.

In families where trauma is present, chaos is frequent, or disruption to the family peace occurs, anxiety can result. Since the family serves as the anchor for attachment, any threat to that anchor stirs up fear that left untreated, can morph into anxiety.

Our increased reliance on technology has also had an impact on the prevalence of anxiety. As students emphasize more cognitive based activities that promote isolative problem solving, they lessen their contact with their bodies and their environments. As reliance and dependency on technology grows, children grow more intolerant of distress and have increased difficulty holding feelings in abeyance. Delayed gratification suffers and their trapped energy grows, a foundation for growing anxiety.

 

Not ADHD

There was a period of many years where the rates of attention deficit/ hyperactivity disorder surged in diagnosis. The number of children placed on medication grew as educators searched for ways to contain unruly students within a larger classroom. What’s better understood by educators and clinicians are the growing number of conditions that mirror ADHD, creating attentional problems.

Anxiety is high on that list, often times difficult to distinguish for pediatricians and other health care providers. Both conditions can show up as restlessness, distractibility, and poor concentration, making it easy to mistake. A risk is that ADHD medication of the stimulant variety, can exacerbate anxiety, so it’s important to have an evaluation by a psychologist before medication is attempted

 

How Does Anxiety Impact Learning?

For some children who are anxious, they may excel in school. In fact, some of your most diligent and conscientious students may be anxious, which would mean missing the underlying turmoil that drives their obsessive need to succeed.

For others, disruption to focus and memory can impede both processing and recall. Motivation may be diminished and agitation may adversely influence peer relationships. Younger students may seem like pests to the teacher but it’s also possible you won’t notice any overt signs to indicate anxiety is present. For some bright children who suffer with anxiety, they are private and withhold their struggle, to avoid embarrassment.

In short, anxiety can take on many different forms that you can’t look for any one thing. The most effective way to assess for anxiety is to have children write or talk about the things that worry them. Given the opportunity for catharsis, children will gravitate toward transparency. Remember that you may be put in a position where you now have information you aren’t sure what to do with or whether you can share. Having some early ground rules may help avert this problem.

 

What Can Teachers Can Do?

What hinders:

  • Reassurance may be more effective in the short term but not in the long term
  • Applying logic or reason to irrational thinking can sometimes help a child feel more frustrated
  • Telling a child there is nothing to worry about can cause them to withhold sharing
  • Not rushing to medication which interferes with recognition of sensations (needs)
  • Over reliance on technology in the classroom

 

What helps:

  • Understanding feelings and thoughts without judgment is comforting
  • Telling a child, you are impressed or proud of their willingness to share something so personal
  • Sharing your own struggles with worry or stress can help them feel less alone
  • Creating a classroom and school environment where expressing differences is encouraged
  • Bulling and intimidation is dealt with firmly but not through punitive measures
  • Helping adjust for realistic expectations
  • Celebrating inequities as human beings ought not be perfect
  • Modelling directness with sensitivity
  • Integrate social-emotional learning into curriculum (tolerance for distress)
  • Use of mindfulness in the classroom

 

For more information on anxiety, please visit www.teachercoach.com and search the marketplace for our series on anxiety & children. Our software allows you to make this training available to both faculty and parents.

This is Your Child’s Brain on Screen Time. Any Questions?

CaptureAt least once a week in my office I will witness a child completely breaking down when asked to turn over an ipad or other device.  The tears and outbursts seem more than just a tantrum and have many features of an anxiety or panic attack.  Parents often confirm that the battle over computer and video games is so great they have thrown in the towel rather than endure their child’s distress.

In full disclosure, I am also the parent of a teenage boy with whom I regularly find myself negotiating screen time.  I know all too well the frustration and helplessness a parent might feel as my teen tries to have me understand how vital his group chats and social media accounts are to his well-being.

As a therapist, however, I see an increasing number of children who are experiencing increased moodiness, impulsivity and difficulty paying attention. Parents and teachers refer children to me who are finding it difficult to organize themselves, complete tasks and make and maintain friendships. Often these symptoms are viewed as indicators for a diagnosis of ADHD or Oppositional Defiance Disorder (ODD) and pharmaceutical treatment becomes the de facto treatment, before any exploration of screen habits is considered.

While the activity may provide them with short-term relief (and keep car rides and long office and restaurant waits quieter for parents), new medical research shows that extended screen time is changing the structure of children’s brains with serious impact on cognitive and emotional processing.

Shrinkage or loss of brain tissue in the frontal lobe has been documented in numerous studies of those addicted to internet and video gaming. The pre-frontal part of the brain is responsible for executive functioning and impulse control. Other brain damage associated with screen usage has been documented in the areas responsible for empathy and in the paths that connect the higher function brain to the emotional response center, resulting in a lower ability to regulate emotional responses – hence the tumultuous melt-downs.

During action-based games, the brain’s fight or flight response is triggered just as it would be in a real-life threat.  This causes the release of stress hormones which have an adverse effect on the body.

Suggesting that your child is addicted to their tablet isn’t just hyperbole.  Research also shows that playing video games releases dopamine in the brain, a chemical associated with reward processing and addiction.  Your child may be experiencing cravings similar to what is experienced in drug and alcohol addiction.

California psychiatrist Victoria Dunckley suggests before accepting a diagnosis of an attention or mood disorder, parents may want to try a media/screen fast to rule out screen time as a culprit.  Two weeks without computer, phone or television may seem like the equivalent of a strict gluten/dairy/sugar fast and nearly as difficult.  However, it does offer a chemical-free way of isolating problematic behaviors and their potential causes.

If cold-turkey fasting feels impossible, consider a two week period during which screen time is not permitted during the week and for no more than two hours a day on the weekend.  Engage your child in tracking moods, sleep, and physical symptoms like headache and stomach aches.  Replace the screen time with at least 30 minutes a day of outdoor play and exercise.

At the end of two weeks, review with your child everything you and they have noticed.  Compare results with classroom teachers to see if there are improvements there as well.  If little has changed after two weeks, this will be valuable information for your child’s pediatrician or therapist as you pursue other causes.

Even if, in the end, you decide that that it’s unrealistic to completely eliminate screen time from your child’s life, you will have taught them to pay more attention to signals their body sends them about their needs, wants and desires.  And you may find they discover a renewed interest in some forgotten pastimes as well.

 

Parenting is Not For the Faint of Heart

CaptureThis kind of thing happens in my house at least once a week.  It’s the price I pay for encouraging independence in my 7th grader.  The list of damages is long, a burnt chair, broken mugs, lamps, pictures…arms….but the inventions are equally exciting.  On his own he’s taught himself to play the guitar, design and sew a replica of a medieval knight’s costume, and make  very  lifelike scars and wounds out of latex and make up.  At 5 he was making one meal a week for the family.  Sometimes we ate peanut butter and candy bar sandwiches but we’ve also enjoyed chilled cucumber soup and grilled pineapple over saffron rice.

I believe that if he’s going to be ready for challenges in his future, he’s going to have to, quite literally, break a few eggs.  Children and teens need to be given the chance to struggle and sometimes fail so they can gain the skills for coping with and recovering from challenges.  This is how they develop resilience, the ability to weather setbacks and the belief that they are capable of surviving the hardships that will inevitably come.

Children become resilient through opportunities to connect with their abilities, sense of self and to the world at large.  As parents and teachers, the more we can help foster these connections, the more resilient our children can become.

Connecting with abilities: Children learn what they are capable of through decision making and problem solving.  “I’m not sure, what do you think needs to happen?” and “How are you going to solve this?” not only take the pressure off of adults to have and provide the ‘right’ answer, but send the message that children are competent and can find solutions.

Connecting to sense of self: “Trophies for everyone” is a common attempt at boosting children’s self-esteem but without specific and authentic praise children don’t learn what it is that they do well and where their areas for improvement are.

Connection to family and friends: Children who know that they are safe and accepted in their families and communities know they can take risks and try new things.  Open communication and the encouragement to express all emotions (even frustration!) lets children know that they don’t need to be perfect, especially the first time.

Connection to the larger world: A key component of resiliency is the knowledge that you make a difference, that you have a place in the world.  Volunteer activities connect children to the adult world and provide them with a sense that they are not alone and that they have the power to make a difference in someone else’s life.

As parents it is our nature to want to protect children from harm, from disappointment and from failure.  Watching them struggle can bring up our own feelings of shame and fear.  But it is through engaging in struggle that we become aware of the impact of our own actions and choices and we learn exactly what we are capable of achieving.

Get more support for the challenges of parenthood through our online classes here.

Helping Children Take Responsibility

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“It’s not my fault! You MADE me do it!!!”

Arguments like these are likely no stranger to parents of children who seem to find it impossible to take responsibility for their own actions.  To be fair, in some ways, they truly can’t.  The ability to reflect on one’s actions and manage emotions is governed by the pre-frontal cortex, a part of the brain that is still developing in young people. Fortunately, activating the functions of this part of the brain helps it develop – meaning the more you help them through the process of reflecting, the more easily it will come to them in the future.

Young children learn rapidly and effectively through observation.  And guess who they’re observing most?  Helping children move past blaming others takes modeling and support.  Just like us, children blame others to avoid disapproval, negative consequences and the discomfort of feeling ‘wrong’.  When children hear us make comments that blame our cranky neighbor or the selfish lady in the checkout line for our bad behavior, they are taking notes.

How easy is it for your child to tell you if she’s done something wrong?  Will she be met with anger or understanding?  Will he be punished immediately or helped to recognize the consequences of his actions? Children are more likely to confide in adults who remain calm and approachable and help them understand what they could do differently next time.

One way to help children practice reflection is to help them understand cause and effect.  Playing games, using stories and finding teachable moments to demonstrate ‘what happens if..” can make it seem less threatening when it comes time to looking at their own behavior and helps them set up an inner dialogue to evaluate on their own.

Here are a few examples to get you started:

“Oh, I was talking on the phone when I put those keys down and now I can’t find them”

“I got up late this morning and then was so rushed I forgot to thaw the chicken.”

You may just find your own stress level going down when you do this and realize you have more control over what happens to you than you thought.

It’s as Easy as Falling Off a Bike

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A father was describing to me how he recently taught his daughter to ride her bike.  The kickstand was off and she was exploring her balance as she tentatively placed her foot on the pedal and inched forward.  Without the speed needed to keep the bike upright she tipped over and hopped around a bit to stabilize herself, frustrated and fearful.  Her father knew that if she could just apply a little more pressure to the pedal she would get the bike moving and would soon see what it felt like to glide smoothly down the road.

The temptation in moments like this, when we can see the answer that the person in front of us hasn’t yet had the experience to understand, is to push them forward.  Likely, if he had lost his patience and told her to ‘just pedal’, she would have become more upset herself, might have given up, certainly the experience would be less pleasant for both of them.  Instead, this father recognized his daughter’s fear and asked her about it, met her where she was.  She described her fear of falling off, of not being able to stop, of going too fast.  And he listened.  And he remembered when he first learned, and when he had been afraid.  He agreed that, yes, learning to ride a bike is scary and that he would be there to do what he could to help her until it wasn’t scary any longer.

My own son was not happy with my announcement that this was the day he would learn to ride.  “Will I fall?” he asked.  “Most certainly.” I replied.  “Will I bleed?” he asked.  “It is very possible that you will,” I said and showed him the BandAids I had packed in his pack.  “I’ll be right back,” he announced and ran back up to his room.  He emerged a few minutes later with three pairs of pants on to protect his knees and off we went to the park.

When we let go of our urge to protect and instruct children at our pace and instead, pay attention to their processes for learning, we can teach them self-confidence and the ability to tolerate their fears long enough to risk mistakes and failure.  I am happy to report that both of these children are happy riders now and both parents may have learned a little something along the way.

For more tips on navigating parenthood, visit the parent classes at Teacher Coach here 

 

 

Getting Kids to Eat Healthy

A family came into my office this week excited to share their plan to get their child to eat new foods and increase his intake of fruits and vegetables.  They have created J’s Taste Kitchen which stars their youngest son who currently lives mostly on chicken fingers and pancakes.  The Taste Kitchen will be a special event weekly during which the child will taste and review one new food.  The family plans to make a video of the tasting each week in the spirit of popular cooking and food programs. J’s parents will work with J to choose each week’s tasting.  Foods he likes will be added to the family dinner rotation.  J will earn points for every food he tastes which he will cash in for a variety of rewards including extra screen time, 10 extra minutes of staying up before bedtime and extra bedtime stories.

What I love about this plan is that it is fun, incorporates technology, involves the whole family and can be kept within the family food budget. It also puts J in charge of some of the decisions about the food he eats which is likely to cut down on family feuds.

Getting children involved in cooking and shopping for food is a wonderful way to expand their interest in healthy eating.  There are a number of television shows cropping up that feature young chefs and bakers to inspire your picky eater.  Cookbooks with bright pictures and simple to follow instructions can help you involve your child in the weekly meal prep and cooking utensils designed especially for young people can help you feel comfortable turning your child loose in the kitchen.  A quick internet search can lead you to many recipes that substitute or add in fruits and vegetables to current family favorites.  Planting and growing vegetables can help you and your family feel more involved with the food you put on the table.

The following resources are just a tiny sample of what’s available to help you in your effort to inspire healthy eating.  Involving the family in fun and easy options might just end the dinner-time wars.  I’m sure hoping that happens for J!

Kid Cookbooks

Chop Chop: The Kids’ Guide to Cooking Real Food with Your Family ; Chop Chop also publishes a magazine and website featuring child cooks and recipes.

My A to Z Recipe Box: An Alphabet of Recipes for Kids: includes brightly colored and easy to follow recipes on cards that can be taken to the grocery to pick out ingredients.

Kid Cooking Supplies

www.GrowingCooks.com offers many kid-friendly utensils and kitchen items made for small hands.

www.CuriousChef.com offers recipes, blogs and utensils including safe cooking knives for small chefs at affordable prices.

Websites and Apps

www.thesneakychef.com includes recipes and products for adding fruits and vegetables in your family’s diet.

Nicolas’ Garden is a mobile app developed by 8 year old Nicholas that can be used by children and adults to find, plan and save healthy recipes and share them with others.

 

Please add to this list by posting some of your favorite ways to encourage children to eat healthy and check out our two-part course How to Get Children to Eat Healthy

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The Grades are In

grades“You are FAILING the sixth grade!!!” It wasn’t just hyperbole, my son’s progress report this week does show four Fs and getting him to complete and turn in work has been a struggle since the fall.  I was angry.  I was frustrated.  I expected more from him.  But the truth is, I was afraid. I was afraid he’d be tracked as a poor student, I even worried that his sixth grade transcript would keep him from college.  And as he cried and told me about class changes, block schedules, losing things in his locker and work getting lost in his backpack, I thought about the family not far from us who would never again get to be exasperated with their son or reprimand him about his work.  Their 13 year old boy took his life after receiving an email from his school about a failing grade.

Suicide is currently the leading cause of death among kids my son’s age, killing more young people than cancer.  This frightens me. Stress, anger, frustration and depression are all common in children who consider suicide. They are also necessary and normal feelings of teens  as they figure out who they are, what their goals are and how they decide they measure up. A 2011 (Hansen, B., & Lang, M) study of suicide rates in students found that suicides increase during the school year but dramatically decrease during the summer and school holidays.  The researchers controlled for seasons and weather and differences in ethnicity, race, gender and income.  In all groups, the trend remained; suicide rates increase when school is in session. Let that sink in for a moment. Suicide rates go up when our kids go back to school.

We are creating environments where our children feel unvalued, uncared for, and incapable of managing stress and disappointment.  We are narrowing the definition of success to discrete, measurable outputs, and forgetting to consider all that is gained through building relationships with peers and teachers and through trial and error.

My lovely boy is funny, creative and kind.  He is a talented singer and artist, he stands up for others when they are being treated unfairly.  He can cook.  He can design costumes and build machines out of paper and cardboard. He makes me laugh daily and for a little while, I forgot that those are grades I care about most and that is the curriculum I’ve been using to raise him.