Strategies to Help School-Aged Children with Anxiety

ParentingFeatured

Feb 26

Kelly Budnick, MOT, OTR/L

What is Anxiety?

Anxiety is a normal response our bodies have to danger. It is a necessary response to keep our bodies safe. Everyone should experience some form of anxiety in their lives because it is a cue to help us recognize unsafe situations. However, it is a problem when our bodies sense anxiety in non-dangerous situations. Anxiety can manifest in school-aged children in many forms. Regine Galanti, a licensed child psychologist describes that children can complain of physical pain such as a stomachaches and headaches or muscles tension that “cannot be explained by another medical issue.” They can also show anxiety with meltdown behaviors in school or home because of something that triggers their anxiety. Some children can display their anxiety with avoidance of activities and refusing to participate in different activities. Additionally, some children may be constant worriers. (Galanti, 2024). Childhood anxiety disorders researcher, Eli R Lebowitz (2021), explains, “children don’t actually get to choose whether to believe in negative or positive scenarios that they imagine...if you believe your child can choose to just turn off his anxiety and be less worried...it is important to understand, however, that human brains function in different ways, and some children are going to be more anxious than others, whether they want to or not.”

How many children experience Anxiety Disorder?

“Anxiety problems are the most common mental health problems in children and adolescents” (Lebowitz, 2021). Between 5% and 10% of children from preschool through adolescence currently have an anxiety problem” (Lebowitz, 2021). “Surveys show that around 30 percent of kids will be diagnosed with anxiety disorder before they turn eighteen. Anxiety problems also start young, often around age six – but can manifest even before preschool” (Galanti, 2024). This means that a staggering number of children will experience anxiety mental health issue at some point in their childhood.

How Can Parents Help? Strategies for Parents of School-Aged Children:

1. Model Behavior

For school aged children, parents and peers are kids’ biggest influences. Children are consistently observing parents’ reactions and seeing how they respond in situations. Galanti asserts, “modeling brave language and behavior can be a huge asset in helping an anxious child...you’re still allowed to feel your feelings, but...show your child the same style of responding to your own emotions triggers that you would expect from them.” For example, express your emotion aloud to your child in a situation and then describe in age-appropriate language how you will confront the situation and try a “just-right challenge” strategy to overcome it.

2. Have an Open Dialogue about Anxiety

As mentioned above, talking about our feelings and acknowledging that difficult feelings occur is important to validate children’s emotions. For school age children, talking about specific feelings in specific situations is easier for children to conceptualize. For example, this may mean talking about the disappointment a close friend felt when they did not win a game or the fear a family member felt when they got hurt on the soccer field. Choosing the right time and environment is key for these conversations. Communicating when a child is regulated is the best time for these conversations. Some recommended times for these conversations may be while driving home from a weekend activity, so you and the child have parent to child one-to-one time or while a parent is sitting in bed prior to an evening reading routine.

3. Reduce Accommodation

A crucial part of parenting is protecting children from real danger. “Parents are hard-wired to protect their children from harm or danger. This protection is a healthy and normal part of parenting... (Raggi, 2022). It is important to emphasize to children of their safety as well as provide supportive communication and validation. Accommodation from parents, however, reduces children’s ability to trial and error in real-life, appropriate childhood situations. “Accommodation is any action parents engage in with the purpose of alleviating their child's anxiety or stress” (Raggi, 2022). This means that children are allowed to avoid developmentally appropriate activities and situations that would be healthy for them to face (Raggi, 2022). Facing these activities with a just-right challenge in place can build coping skills, social skills, independence and resilience. Examples of accommodating include doing something in a particular sequence to avoid triggering your child’s anxious behaviors, picking up a child early to avoid a school activity, or repeatedly answering questions about the same topic in a continuous cycle. Breaking Free of Child Anxiety and OCD provides parent roadmaps including accommodation logs and creating a plan for support and not protection for the child. Support in this context means, “acceptance and confidence... you are being supportive when you respond to your child’s anxiety in any way that tells him that you get it, that understand he is actually anxious. And that you don’t judge him for it (acceptance)” (Lebowitz, 2021). This book provides a guideline for making a concrete plan for reducing parental accommodation behaviors and supportive communicating with your child on a plan to help them feel less anxious and cope with anxiety.

4. Practice Relaxation and Mindfulness

The Child Mind Institue defines Mindfulness as the “being aware and being focused on what’s happening right now in this moment, without rejecting it or judging it. It also means focusing on the present and not what has happened in the past or might happen in the future. Regular mindfulness practice helps people develop the ability to put distance between the intensity of their emotions and the way in which they react to them — in particular, how they engage in or react to negative, difficult or stressful thoughts,” (2024). Some strategies and activities to practice mindfulness with school-age children include pausing and observing each of the five senses including asking what they see, hear, taste, smell and feel/touch in the moment, visual breathing activities, like “rainbow breathing” and “box breathing” children’s yoga activities, and observational nature walks (Saxena, 2024).

5. Reduce Experiences on Screens

Social psychologist Jonathan Haidt writes in The Anxious Generation, “between 2010 and 2015, the social lives of American teens moved largely on smartphones...this Great Rewiring of Childhood...is the single largest reason for the tidal wave of adolescent mental illness that began in the early 2010’s.” He recommends, “focus more on maximizing in-person activity and sleep than on total screen hours” (Haidt, 2024). Haidt emphasizes the importance of doing things in “real-world communities” rather than solo playing on video games, mobile phones or reading posts on social media. He recommends using parent controls and content filters on all digital devices in the home. Implementing a clear and structured schedule for when devices can be used and in which situations screens are allowed. Haidt recommends taking a “digital Sabbath” every week or “full day where no screen devices are being used.”

6. Create Visuals

A visual schedule is a series of sequential pictures that help children know what is planned for the hour, day or even week ahead. Visual schedules can help inform children of what activities lie ahead and understand a family’s plan. Visual schedules can reduce children’s difficulty with transition, help them sequence steps, and increase their independence in daily routines. Consistent routines are

beneficial for increasing regulation because they give children a sense of control, predictability and reduce decision fatigue. Below are resources to help create a visual schedule.

7. Implement Sensory Regulation Activities

The STAR Institute (2024) describes people with “sensory over-responsivity (SOR) “as individuals that are more sensitive to sensory stimulation than most people. “Their bodies feel sensation too easily or too intensely. They might feel as if they are being constantly bombarded with information. Consequently, these people often have a “fight or flight” response to sensation, e.g. being touched unexpectedly or loud noise... They may try to avoid or minimize sensations, e.g. withdraw from being touched or cover their ears to avoid loud sounds.” (STAR Institute, 2024). This nervous system response can lead children to have anxious behaviors in particular situations because their sensory systems are not regulated. OT’s can assess a child’s sensory profile and implement a sensory diet or schedule for parents to utilize at home, school and the community to improve regulation in various contexts. One of our “invisible” sensory systems, the proprioceptive system, can be activated to calm a child’s nervous system. Stimulating the proprioceptive system through activities that provide deep pressure or pushing, pulling, lifting or weight bearing can be highly calming. Activities such as these are referred to as “heavy work.” The STAR Institute provides activity examples for proprioceptive engaging activities. Resources are listed below.

Sources:

Anxiety. Child Mind Institute. (2024, November 25). https://childmind.org/topics/anxiety/

Galanti, R. (2024). Parenting anxious kids: Understanding anxiety in children by age and stage. Sourcebooks.

Haidt, J., & Pratt, S. (2024). The anxious generation: How the great rewiring of childhood is causing an epidemic of mental illness. Books on Tape.

Heller, S. (2014). Too loud, too bright, too fast, too tight: What to do if you are sensory defensive in an overstimulating world. Harper Perennial.

Lebowitz, E. R. (2021). Breaking free of child anxiety and OCD: A scientifically proven program for parents. Oxford University Press.

Raggi, V. (2022, May 2). The risks of accommodating a child’s anxiety. Psychology Today. https://www.psychologytoday.com/us/blog/brave-voices/202205/the-risks-accommodating-childs-anxiety

Saxena, S. (2024, September 23). 9 mindfulness activities to Boost Kids’ mental resilience: Lead group. LEAD School. https://leadschool.in/blog/9-mindfulness-activities-for-kids-that-will-boost-their-mental-resilience/#:~:text=Deep%20breathing%20is%20one%20of%20the%20critical,use%20if%20they%20feel%20berserk%20or%20stressed.

The STAR Institute . (n.d.). Subtypes of SPD. Sensory Processing - STAR Institute. https://sensoryhealth.org/basic/subtypes-of-spd

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