Big worries in little people – understanding anxiety in 2- to 5-year-olds
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Big worries in little people – understanding anxiety in 2- to 5-year-olds
Anxiety is one of the most common mental and emotional health challenges in childhood and it can emerge surprisingly early in some children – research suggests that 9 to 22% of pre and early school aged children may meet criteria for an anxiety disorder at some point. Some of the most common challenges with anxiety for children of this age include worries about separating from a parent, fears of the dark, worries about being in bed on their own, shyness and anxiety about being around other children and worries about change or new situations. Here are some ideas which might be helpful for parents/caregivers who are supporting young children with anxiety.
1. Understand that there are a variety of contributing factors to anxiety – not just one simple cause.
Trying to find the “one simple” cause for our children’s anxiety is unlikely to be helpful. Instead, we should understand there are likely to be many different factors which cause young children to be anxious including:
a. Being a normal kid! As humans we are designed to have an anxiety response – an evolutionarily driven tendency to think about things that are new, that could go wrong or that might hurt us – and children are the same. Young children’s brains are designed to seek safe and familiar environments. and it is normal for them to experience some anxiety outside these environments.
b. Experiencing tricky life events: What happens to and around young children can also contribute to anxiety. This might be grief and loss, traumatic events, managing disability and family and environment challenges. Particular types of parenting styles can also impact anxiety in some children – although of course are not a single “cause” of anxiety. Specific parenting behaviours which have been linked to higher anxiety in young children include low “autonomy granting/independence building” parenting, high levels of “overcontrolling” caregiving behaviours, and high levels of “harsh/punitive” parenting.
c. Biological factors: Research shows there is genetic component to anxiety. There are brain and body differences between anxious and less anxious children. We also know that difficulties with sleep, nutrition and illness can contribute to biological mechanisms which contribute to anxiety in children of this age.
2. Gently ask young children questions about their worries
It can be helpful to resist the temptation to jump in with advice or reassurance (“you will be fine!) and instead taking time to ask children some questions about their worries if we can. This helps children know we care, sometimes gives us information about how to help and gives children an opportunity to practice expressing feelings and thoughts. Some examples of questions we might ask are:
What was the hard bit about that?
When do you feel most scared/wobbly? When do you feel better about it?
What happened?
Where were you? Who was there? What did they say? What could you hear/see/notice?
Show me, where this (gesture) is the smallest and this (gesture) is the biggest, how big was that feeling?
(Using a visual) On a scale from 1 to 10, where 10 is the biggest and 1 is the smallest, how big/strong was that feeling?
What did you think could go wrong?
What is the worst thing about that? What is the best?
What do/did you think could/should happen?
What were you worried people might think/do?
What would have helped you?
What made you more upset about X compared to Y?
What might make you feel better?
Who helps you?
When is it not as bad?
What can you do to make you feel calmer?
Is there anything I can do?
One important point about asking questions - it is important we do this calmly and show confidence in our face and body language - if children get a message that we are anxious about their worries, they may become more anxious over time.
2. Show care and empathy
When we show children we care about their worries, rather than just jumping in to solve them or reassure them – over the long term it helps them feel more like wanting to talk to us and feel better. Empathy can be shown in all kinds of ways, but it often means stopping, turn and looking, being on a child’s physical level, having our body and face show “I’m noticing”. We might say:
I’m so sorry you’re going through this
I wish that hadn’t happened for you.
I can see you feel really XXX
If I was in your situation I would probably feel upset too
3. Help children lower their physiological “fight or flight” responses
We all have a “fight or flight” response which occurs when we perceive danger. When this happens our brain redirects activity away from “complex thinking centres” and towards systems that ensures our heart rate, blood pressure, muscle tension and breathing rate increase. This helps us survive but means we can’t think effectively when they are in a highly aroused state. When children are highly anxious this happens to them too. This means one of the ways we can help children when they are anxiety is to help them reduce their physiological arousal. This might mean reducing expectations, slowing down and reducing the number of “words” we are saying, and helping children notice other things and talk about other topics for a time. It might also mean we help them practice taking big belly breathes and making their muscles floppy. Sometimes this takes practice outside of worrying situations first!
4. Help them learn to reassure themselves (Use calm words/sentences)
Instead of only (repeatedly) providing reassurance to children, we might want to help them start to learn to reassure themselves. This might mean we help them create and use their own “calm sentences”. We can explain to children that “calm sentences are things we say to ourselves which make us feel a bit better”. We might then provide the calm sentence (I will have fun at childcare, I am okay, I am safe in a storm), help children do drawings about their calm sentences or make up songs about their calm sentences and encourage them to use them.
5. Help them learn to redirect their attention
It is not helpful for young children to ruminate/spend very long periods of time talking about their worries to us. Sometimes we must redirect their attention. We might say, “we have done some talking about this – now let’s make our brain busy doing other things.
6. Encourage and enforce brave behaviour
The more children avoid anxious situations over time or are protected from scary (but safe) experiences, the more anxious they may become. One of the most important ways we support anxious children is to support them to act in brave ways and take (age appropriate) steps to do things which are initially frightening for them. This is not easy! Here are some ideas for how we might help children act in brave ways.
a) Pick our battles: It is not vital that children must face all their fears. Usually we should pick one area at a time – and one which is important for them to live meaningfully.
b) We need to explain to children the importance of acting bravely: “I am going to ask you to act bravely even though you feel scared because I know this is the way your brain will learn to feel more and more confident”.
c) We often need do this in VERY small steps sometimes – starting with tiny amounts of time, very small ways of facing their fears (even just imagining or drawing or looking at something scary).
d) Children often need VERY frequent practice of acting in brave ways – for instance brave behaviour practice might sometimes need to happen many times a day for a little while.
e) We might remind and help children to use their ways of coping with anxiety (ie calm sentences, distraction, using imagination to take on a brave character, role play and comfort/safe items).
f) We might also reward and praise brave behaviour, make being brave as fun as possible, help them notice us being brave (I was nervous but I wanted to do….).
Hopefully this gives you some ideas about how to support young children with anxiety – if you have ongoing concerns, don’t forget to check in with a professional (your GP is a good place to start). You can also call our clinics on 8357 1711 for information about your children having therapy with our team - or you might like to look at our online program for children who are anxious – go to www.calmkidcentral.com. Please note we also have a “Parent-distress program” which is 6 sessions of 1:1 work with a psychologist to help manage the frustration, overwhelm, anxiety and fatigue that comes with supporting a child with mental health or life challenges.
To access similar articles/videos about how to best support your child, please visit the Parent Learning Library on Calm Kid Central.
If you would like to learn more, please go to calmkidcentral.com. Within this program, you can visit our parent’s library, which has a range of modules about parenting and supporting children with emotional health challenges. Additionally, there is a children’s library with videos, lessons and games specifically designed for 4-11 year old children. You can also ask questions of our child psychologists and receive a response within 48 hours. Follow the link above or click on the image to the left to find out more.
