The importance of parents and caregivers acting in warm, loving, caring and interested ways towards their children might seem obvious towards us as health/education professionals today, but it has only been in the last 50 or 60 years that these concepts have been discussed by researchers interested in child development in any depth.

This article examines the concepts of warm and responsive parenting and loving, “securely attached” child/parent relationships, how they have developed over time and the research behind with them…

How long are you able to read something or think carefully about a topic without being distracted by something else? Do you feel satisfied with the length of time you can do this? Does it depend on the time of day or what you are doing? Has it changed over the years for you?

The questions above are about “attentional control” – in other words, our ability to keep our attention and thoughts focused on a chosen task, object or idea for a set period of time…

Have you looked directly into someone’s eyes today when you spoke with them? Did it help you understand them? Or connect with them? Or did it make you feel uncomfortable? And (perhaps more interestingly) have you consciously thought about using this eye contact or have you just done so automatically?

As health and educational professionals we may spend more a little more time thinking about eye contact (usually in relation to young people we are working with) than others in the general population, but even for us, it is a concept which doesn’t occupy much of our thinking. Most of us use appropriate eye contact without much thought and it also may be very far down the list of topics we discuss with our clients, given the other significant needs they present to us with…

Imagine you have been unwell for several months - intermittent, low level but unpleasant symptoms – stomach pain, headaches and dizziness. A GP can’t find anything wrong with you and so you try diet changes, vitamins and getting more sleep – none of which makes a difference. You start to worry about whether you have a serious illness, - and feel frustrated about having to take time off work/social activities.

Eventually a specialist diagnoses you with a particular medical condition. Unfortunately it can’t be “cured” – but you now know how to manage it, what triggers it and how to make symptoms less severe. Almost immediately, even though you still don’t feel well, your overall suffering eases. Knowing causes of problems often makes us feel significantly better and helps us manage them more effectively - even if the problems themselves don’t disappear...

Many children and young people we will work with have grief and loss experiences. One data source estimates 1 in 15 children experience the death of a parent or sibling by the age of 16, and another study found 80% of 11-16 year olds say they have experienced the death of a “close” family member or friend. Many children also experience other significant losses – for instance the “loss” of the family unit through parental separation, sudden loss of a family home (house fire/disaster), the death of a pet, loss of some aspect of health/mobility, or the loss of a favourite or treasured activity or possession.

Given bereavement is such a common experience for young people and as professionals it is helpful to be aware of how we can support children and teens through grief and loss experiences.

There is a significant body of research showing that children and teens with symptoms or diagnoses of anxiety disorders have been shown to “think in different ways” compared with children who do not have these challenges.

For instance, studies have found children with anxiety are more likely to remember negative or threatening information in their environment, interpret ambiguous situations as potentially dangerous, and be able to identify a greater number of threats in any given situation. Other studies have found that the degree or amount of “negative thinking” a young person regularly does/has (catastrophizing, black and white thinking, mind reading) is correlated with the severity of anxiety they experience. Finally, studies have also found that children with anxiety disorders spend significantly more time “worrying” (thinking repeatedly about fearful thoughts repeatedly) than children without anxiety disorders. A note for interest – although these effects have been found in children of all ages, they are more pronounced in older children/teens than in younger kids.

Given these differences in the way anxious children think compared to non-anxious children, it is not surprising that there is a long history of psychologists trying to help anxious young people to either think differently, or to think differently about their thinking.

There are at least three models of psychological treatment which outline strategies for how children/teens with anxiety might manage, respond to or view thoughts and beliefs - cognitive behaviour therapy, metacognitive therapy and acceptance commitment therapy. Each of these models of treatment have slightly different views about the way worried thoughts or beliefs contribute to anxiety. I have briefly summarized these below. Please note that each of these therapy models include other important components in their treatment protocols – in this summary however I have just focused on how these different treatment models view thoughts and beliefs.

Tina is in year 1, lives with her Mum and her older brother, and is very anxious about going to school. This issue has been a challenge for Tina and her Mum for some time – from kindergarten onwards.

However since starting year 1, Tina has become even more anxious. Every school morning, while Mum tries to convince her that she will be okay at school, she cries, yells, says she is sick, throws things, says “I hate you so much” and hits her Mum. Sometimes she vomits. Tina gets a stomach ache and headache most afternoons when she thinks about school the next day.

Tina is now only going to school once a week and has missed over 50 days of school this year.

As well as being anxious about going to school, Tina also feels uncomfortable staying with her grandparents when Mum goes out on the weekend, and does not want her Mum to leave when she goes to other children’s houses to play.

As I’m sure you have guessed, Tina (not a real person) is a child with separation anxiety, the most common anxiety disorder diagnosed in childhood – and school anxiety.

I’ve recently been undergoing physiotherapy rehabilitation after having tendon surgery. At my first visit, the physio had me download an “app” which lists my daily exercises, uses an alarm notification to remind me to complete them and has a “tick off” function for each exercise after I complete them daily. I’m an old hand at rehab and so am generally committed to doing it consistently, but having a visual record of exercise completion over a week in this app has provided extra incentive make sure I don’t miss any days.

This app is of course, encouraging self-monitoring behaviour. In case you need a refresher, self-monitoring within education and psychology fields is defined as the paying of attention to a specific aspect of our life – usually a behaviour or a mood - and regularly recording whether or when that behaviour or mood happened (Korotitsch, 1999).

As you are no doubt aware, self monitoring has been used for decades by psychologists and teachers to help people change something about their life or emotions. For example, we might ask people to record – on a daily basis - their mood on a scale of 1-10, how often they used a helpful or unhelpful coping strategy, what they ate, how often they got angry, how often they practiced a meditation task, their thoughts in a difficult situation, their worry behaviours, how often they drank alcohol – and many more types of behaviours. One study found that 83% of behaviourally orientated psychologists used self monitoring at least half the time with their clients.

Dealing with Coronavirus is tough for everyone – kids, young people and adults - and us as professionals too. For children with “big feelings” and challenging life events, it can be even harder.

Here are some ideas about how we can answer children or young people’s questions or respond to their worries. A few general principles in how to do this are as follows:

1. Try to ask a question or two before we respond to a child/teen’s concerns – we may be able to get more information about exactly what they are worried about and therefore answer more helpfully.

2. Express care and sympathy rather than “dismissing, shutting down or minimising”. As professionals working with children’s well-being - we are usually pretty good at this :)

3. Answer with a matter of fact, calm and confident voice and facial expression. Children are watching and learning from the adults around them - including us, their trusted teachers, psychologists, counsellors and support workers.

4. It’s okay to put some limits on the time we spend talking about this issue. We can keep our sessions, lessons and work with young people more or less as normal if this seems appropriate. For some children/teens we will need to spend more time on it, but it’s also okay to end the conversation. For example, we might say something like: “That’s a problem for adults to solve and there are lots of clever adults working on that right now. You don’t need to spend much time thinking about that. Let’s go back to doing X/discussing Y for a while”. We might also say something like: “We’ve spent enough time talking about this for now, it’s good for our brains and bodies to have a break from thinking about worrying things and problems, let’s do /talk about X/Y instead”.

In the last few weeks I’ve presented at a number of school “acquaintance” and “orientation” nights to parents of primary and secondary students – and one of the topics I cover in these seminars is sleep: how much children and teens need and how we support them to get enough.

It’s only a small part of the talk (I discuss a range of factors which are associated with success and wellbeing for young people) but I thought I’d do some reading to make sure I was across any significant developments in the science of sleep for young people.

Once I started reading, I went down the “reading research rabbit hole”. I spent a few hours (and missed some of my own sleep time) reading some interesting new studies and reports – as well as some old ones I’d missed.

I thought some of them might be worth sharing with you in this article. Here they are, in no particular order:

Like almost all Australians, I spent the Christmas/New Year period watching fire apps, bushfire news and feeling devastated for the families who have been impacted.  I know that many of our Calm Kid Central members/families/professionals who receive these articles - particularly those who live in the Gippsland regions, KI, Adelaide Hills - as well as others - have been significantly impacted by fires, with some of you experiencing massive stress, trauma and fear.  I'm so sorry for what some of you have experienced.  All of us at Developing Minds have been feeling distressed and worried for people around Australia, including our Calm Kid Central members from bushfire affected communities.  

I also know that many other families who have not been directly impacted by fires, also have children who are experiencing stress and anxiety as they watch the news, are affected by smoke or hear conversations by their friends and family.  Children with existing emotional health challenges are sometimes particularly impacted by this anxiety, as it adds "one more thing" to their existing worries.   As professionals, you like us are probably having many conversations each day with these children who are experiencing anxiety and stress about this topic.

There have been many excellent guides published by various organisations about how to talk with children about fires, what to say and how to help them.  Rather than recreate these here, I've included links to a few of the best I've seen at the end of this article so you can print out and give to families as you see fit.

One of the most powerful ways to help children act more calmly, more often – and to reduce their angry behavior – is to coach them to develop frustration management skills.   

These skills include the following: 

• Using (appropriate) language to express their feelings and desires

• Asking for help or support

• Using strategies to lower physiological arousal,

• Switching their attention away from difficult situations,

• Noticing “angry” (blaming, non-empathic, catastrophic) thinking

• Using calm sentences to remind themselves that frustrating situations and behaviours from others are not terrible, not always intentional, often understandable and can be managed.

• Identifying potentially frustrating situations ahead of time (and planning for them);

To help children learn these skills we need to first have a sufficiently warm and trusted relationship with them, provide age appropriate rationale and explanation, model the skills, rehearse with them and ensure they have enough motivation for practicing and using the skills.  

However, all of this coaching work can only be done when children are calm.

In other words, children do not learn these skills “in the heat of the moment” when they are angry or frustrated.  Instead, they learn these skills before and after frustrating situations, when they have the time and state of mind required to talk and practice efficiently.

There is no doubt that biological factors play a large part in contributing to children and young people’s anxiety.  We now have research which strongly suggests a genetic component (e.g. identical twins are more likely to have similar rates of anxiety than non-identical twins) to anxiety, research which has identified physiological differences (for example heart rate reactivity, a number of brain structures/processes) between more and less anxious children and research which has found differences in infant behavior which predict which children grow up to be more or less anxious. 

As I explain to families I work with, all these fields of study put together indicate that at least some tendencies towards anxiety in humans is “hard wired” into some young people much more strongly than in the average young person.

However there are other research studies which show that there are aspects of a young person’s environment which also influences their levels of anxiety.  For instance, various studies have found factors such as early traumatic life experiences, friend and peer relationships, school life, sleep quality, nutritional intake, exercise and technology use – also contribute to how much anxiety children and young people experience.  

In other words, when families ask about the causes of anxiety in young people, we can confidently state that it is a combination of nature and nurture.