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Help for anxiety | Using Decision Making skills to help your anxious child

Help for anxiety | Using Decision Making skills to help your anxious child

Anxiety is the anticipation of a future threat and one’s ability to cope with that threat. Throughout childhood it is normal to experience some anxiety about upcoming changes, unknown environments, or participating in a public presentation. Anxiety can even be motivating to prepare adequately for the future. However, when anxiety persists and interrupts daily functioning then it becomes a “disorder” and help should be sought out.

Types of anxiety disorders

There are several different types of anxiety disorders and although they share many of the same signs and symptoms, they each have unique characteristics that change the nature of the fears.

Generalized Anxiety Disorder (GAD)

With this disorder children worry excessively about a wide variety of things such as school, the health or safety of family members, relationships with peers, sports performance, or the future in general. “Children with GAD tend to be very hard on themselves and strive for perfection. They may also seek constant approval or reassurance from others.”

Separation Anxiety Disorder

It is normal for children to experience anxiety when separated from caregivers between the age of 18 months to 3 years. Children may also experience separation anxiety when first dropped off at daycare or left with a babysitter, but it usually subsides within a few minutes after they are engaged in the new environment. When a child is older and they refuse to be separated from their parent or caregiver, or take an excessive time to calm down after a parent leaves they may be suffering from Separation Anxiety Disorder. This disorder may also result in a refusal to go on campouts or to sleepovers because of extreme homesickness or fear of what may happen to their family members when they are away.

Social Anxiety Disorder (agoraphobia)

This disorder is triggered by social situations and speaking in front of others. It may also result in anxiety around starting conversations with peers. This disorder may result in a child’s decreased participation in school as well as affect their ability to make and maintain friendships.

Selective Mutism Disorder

Similar to Social Anxiety Disorder, but specifically deals with a child’s refusal to speak to others in public settings. Instead they may twirl their hair, avoid eye contact, and ignore attempts to communicate. The child usually acts normal in their home or other comfortable environments, but it greatly affects their school performance and ability to make friends.

Panic Disorder

Panic Disorder occurs when a child has recurring panic attacks for no apparent reason. During a panic attack a child suffers severe physical responses that are frightening for the child. This includes a pounding heart, dizziness, shortness of breath, or numbness and tingling feelings.

Specific phobias

A phobia is an intense, irrational fear about something or a situation that has no inherent danger, such as dogs, flying in an airplane, or heights. Common childhood phobias include animals, the dark, storms, and medical procedures. Phobias cause avoidance behaviors and will often surface through tantrums, clinging, crying, headaches and stomachaches. Unlike adults, children don’t recognize their phobia as irrational.

Obsessive Compulsive Disorder (OCD) and Post Traumatic Stress Disorder (PTSD) were once grouped with anxiety disorders because of the similar characteristics of fear and anxiety, but have since been separated in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), although most clinicians believe they are closely related.

Signs and Symptoms

Specific signs and symptoms depend on the individual child and the type of anxiety disorder they suffer from, however, these are the most common symptoms in children:
Other mental disorders are also commonly present with an anxiety disorder, including depression, substance abuse disorders, ADHD, autism spectrum disorders and eating disorders.

  • Excessive worrying for longer than 6 months about multiple events, which causes distress or impairment in normal functioning
  • Restlessness during waking hours
  • Easily fatigued
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbance
  • Avoidance behavior
  • School refusal
  • Intrusive thoughts



Although the exact cause of why one child suffers from severe anxiety and other children do not in similar life circumstances, there are some factors that seem to play a role in a child developing an anxiety disorder. Genetics, brain biochemistry, an overactive fight-or-flight response, and stressful life circumstances have all been shown to contribute to anxiety.

It has also been found that anxiety can be a learned behavior. If a child lives with a parent (or older sibling) struggling with anxiety and repeatedly observes a heightened response to a specific object or type of situation, they often learn to imitate those same behaviors and feel those same anxieties.

How to respond

The most important way to respond to a child who is feeling an anxiety, whether they have been diagnosed with an anxiety disorder or not, is not to minimize their feelings. Children often have a difficult time expressing themselves and avoid talking about how they feel for fear of rejection or embarrassment. Instead of minimizing how they feel, acknowledge their fears and behaviors in a nonjudgmental way, find out how it is affecting their daily life and then work together to help them find appropriate coping strategies.

It may also be necessary to seek help from a therapist who has experience in treating anxiety disorders. Much is known about anxiety disorders and many types of treatments have been proven successful for coping with anxiety. Common treatments used for anxiety are:

  • Smarter Parenting Skills
  • Cognitive Behavior Therapy (CBT)
  • Dialectic Behavior Therapy (DBT)
  • Mindfulness Meditation
  • Eye Movement Desensitization and Reprocessing (EMDR)
  • Stress and relaxation techniques
  • Occasionally medication can prescribed, although this should not be used alone without treatment

In addition to therapy and specific anxiety treatments several skills from Smarter Parenting can be used and taught in the home to help children find positive strategies to deal with their anxiety. Parents can use Preventive Teaching to teach children ahead of time ways to calm down appropriately. As a part of this Role-play should be used frequently during teaching, in spontaneous moments, and in preparation for anxiety-inducing situations.

Using Preventive Teaching parents can teach the skill of Decision Making to their child to help them learn how to identify multiple options in difficult situations so they can make positive decisions thoughtfully. When children feel they have the tools to make appropriate decisions when emotions are high, they will have more confidence to participate in uncomfortable situations.


Anxiety and Depression Association of America (2015, September). Childhood Anxiety Disorders. Retrieved from https://www.adaa.org/living-with-anxiety/children/childhood-anxiety-disorders.

American Psychiatric Association; DSM Library. Retrieved from http://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890425596.dsm05.

Lyness, D’Arcy, PhD (2014, March). Retrieved from http://kidshealth.org/en/parents/anxiety-disorders.html#.

Resources to Recover (2015). Anxiety. Retrieved from http://www.rtor.org/anxiety/?gclid=CK7PobSvjtQCFVKPfgodyvoJKA.