The Video Game Dilemma and the ADHD Child

Do you sometimes wonder if your child is addicted to video games?  Is getting off or ending video game sessions often the cause of fights or meltdowns for your child?

In an increasingly digital world, children are spending more time in front of screens and parents are left  to negotiate the muddy waters of figuring out how much screen time/video game time is healthy for their child.  This can be particularly difficult for a child with ADHD as video games lend themselves to being ‘time sucks’ and can often distort a child’s temporal awareness.  Here are some tips for setting and maintaining healthy boundaries for video games and screen time.

  1. Communicate clearly with your child about the amount of screen time that is allowed

During a calm period of the day, sit down with your child and discuss your concerns about screen time and present your concerns.  Make sure to listen to your child and reflect their concerns.

  1. Consider the time of day when you agree to schedule gaming/screen time.

Scheduling screen time right before homework or bedtime can be a recipe for disaster especially for children who have very difficult moments detaching.  Try to involve your child in problem solving and ask for ideas of when you can best schedule screen time so that it is not disruptive when it must come to an end.  Be flexible.

  1. Always monitor and preview content before your child views it.

Some games and videos can have violence or sexual content that may be inappropriate or overwhelming for your child.  Always check the suggested ages and consider watching the video game first before you purchase or rent it for your child.

  1. Consider what your child is getting out of screen time.

Playing a video game or watching a youtube video may provide much needed zone out time for the ADHD brain.  Make sure to expose your child to a range of other activities that may also provide relaxation and self-soothing feelings such as yoga, meditation, music lessons etc.

  1. Practice what you preach.

Modeling is one of the most powerful tools of influence that parents possess.  Practice your own healthy boundaries with your cell phone and screen time.  Schedule regular family media -free times or zones, such as meal times, bedtime or family outings.

  1. Use Screen time to build on your child’s strengths

Not all screen time is unhealthy. There are amazing tools available that can help support learning.   Research some great new learning sites or games that support your child’s reading or math and spend some time with your child exploring their interest in art or science by checking out online museums.  Speak to your child’s teacher or the school librarian for recommendations.

 

 

How to Talk to Your Child About School Shootings

Sadly school shootings have become normative in our culture and parents are faced with the question of how and when to talk to their kids about being safe in school. Here are a few tips and resources to help parents navigate these discussions:
1. Keep discussions age appropriate. Younger children need more reassurance and less specific information. They may have questions about active shooter drills or why there was a school walkout. Keep information short and age appropriate and reassure your child that adults are always taking measures to keep students safe. Older kids and teenagers will want to talk more and may want to get more involved in advocacy efforts. Make sure to make time to talk and practice reflective listening. Echo back their concerns and ideas.
2. Limit exposure to the news. News tends to refresh and replay the same upsetting images and soundbytes. Exposure to these stories via television or on the radio can be upsetting and confusing for children. Also, keep an eye out for newsfeeds that come up as ads or pop-ups on social media. Your child may be watching news footage unbeknownst to you.
3. Pay attention. Know the signs of stress or anxiety in your child. Pay attention to changes in behavior such as excessive worry, nightmares or sleep disruptions. Consider reaching out to a qualified child mental health professional if you see any of these symptoms for an extended period.
4. Stay on top of what is happening locally. Follow and attend school board meetings, talk to your child’s school principal or administrator. In the wake of the latest shooting at Parkland, many school districts have made changes to their safety policy. Share this information with your child as well as with other caregivers so that they can be prepared for changes in school visitation or pickup policies.
5. Stay connected. Encouraging regular communication with your child is the best way to know what’s going on in your child’s school . Consider scheduling a regular time to meet with your child to discuss any concerns they may have. Creating an environment of open communication will beget open communication.

Resources for parents:

Check out this recent piece which was featured in Time magazine by Dr. Ross Greene:
https://www.livesinthebalance.org/Nineteen-years-tragedy

ADHD: Myths vs. Reality

 

Attention difficulties commonly occur in children and adults for various reasons. Sometimes they can be related to mood issues, motivational issues, environmental challenges or physical health issues. But, when there are significant and persistent difficulties, with a combination of inattention, overactivity, impulsivity, and distractibility that impairs functioning or development in multiple settings, this can be attributed to Attention Deficit Hyperactivity Disorder in children and/or adults.

Of children aged 4-17 years of age in the United States, 5.1 million or 8.8%, have a current diagnosis of ADHD, with boys (12.1%) more than twice as likely as girls (5.5%) to have ADHD. Approximately half of children with ADHD continue to have symptoms into adulthood, or 4.4% of adults overall.

The exact cause of the disorder is unknown but research shows that areas of the brain are affected and there is a family/genetic connection. The impact of the disorder includes lower academic performance, increased risk of injury, increased risk of traffic accidents, increased likelihood of smoking, poorer social function and lower self esteem. Treatment can reduce the symptoms of ADHD, but it does not completely eliminate the impact of these complications.

When it comes to ADHD, it’s important to separate the myths vs. the facts. Here are some important considerations to keep in mind when thinking about an evaluation, diagnosis and treatment.

Myth


Fact


“ADHD isn’t a real disorder”

  • It is a recognized medical condition
  • ADD = ADHD
  • Exact cause unknown
    • Multiple factors have been implicated in the development of ADHD – family history/genetics, certain environmental factors, problems with the central nervous system /an imbalance of chemical messengers, or neurotransmitters, within the brain.
  • Research has shown that certain brain regions don’t synchronize properly and overall brain architecture is different.

“ADHD is overdiagnosed”

  • Studies show that ADHD is underdiagnosed in minority populations
  • Awareness of the disorder has been growing since the 1990s when it became recognized under special education law as a condition that affects learning.

“ADHD only occurs in childhood”

  • The symptoms of ADHD can occur as early as the preschool years. The intensity of the behaviors and how they are affecting a preschooler’s life, development, self-esteem, and general functioning is considered.
  • Some children with ADHD continue to have symptoms during their teen years and about 50 out of 100 have symptoms into adulthood.
  • Symptoms in adults look different.
  • Hyperactivity tends to diminish
  • Inattentive symptoms become more troublesome
  • Sense of “inner restlessness”

“Children outgrow ADHD”

  • ADHD is a lifelong condition
  • Some children do outgrow their symptoms
  • Most children carry the disorder into adolescence and adulthood
  • Symptoms change as a child gets older and learns ways to manage them

“My child is just lazy or dumb or unmotivated”

  • ADHD has nothing to do with a person’s intellectual ability.
  • A child who finds it nearly impossible to stay focused in class, or to complete a lengthy task may try to “save face” by acting as though he/she does not want to do it or is too lazy to finish.
  • This behavior stems from real difficulty in functioning and possible frustration.
  • They simply work differently.

“My child is a handful or is a daydreamer – but that’s normal”

  • There are variations of “normal”
  • How much behaviors consistently impede a child and their ability to succeed at school, fit into family routines, follow household rules, maintain friendships, interact positively with family members, avoid injury or otherwise manage in his/her environment should be considered

“My child focuses on video games for hours. He/she cannot have ADHD”

  • ADHD poses problems with tasks that require focused attention over long periods of time, not so much for activities that are highly engaging or stimulating
  • Less or unstructured time can be difficult to manage
  • Social situations can also be problematic due to the constant, subtle exchange of social and emotional information

“ADHD is caused by poor parental discipline”

  • ADHD is not caused by bad parenting.
  • Parenting techniques can affect symptoms.
  • Try to stay positive
  • Establish structure and stick to it
  • Set clear expectations and rules
  • Encourage healthy lifestyles – eating, exercise, sleep
  • Teach how to make friends
  • Learn to anticipate potentially explosive situations
  • Be a good role model

“If after an evaluation, a child does not receive the ADHD diagnosis, he/she doesn’t need help”

  • ADHD is diagnosed on a continuum
  • A child may not always show symptoms of ADHD, especially in an unfamiliar setting
  • Monitoring symptoms and behaviors in multiple settings is critical
  • Counseling, home management tools, school behavior management recommendations, social skills interventions, and help with managing homework flow, organization and planning can be helpful

“All you need are medications to treat ADHD”

  • Medications often curb symptoms
    • They help children focus and be less hyperactive
  • Typically a combination of treatments are the most effective way to treat ADHD
    • Behavioral therapy
    • Notes/reminders to prevent self from forgetting tasks
    • Academic help

“Medicine for ADHD will make a person seem drugged”

  • Properly adjusted medicine for ADHD sharpens a person’s focus and increases his or her ability to control behavior
  • Sedation or personality changes are not side effects of the medication

“ADHD stimulant medication leads to addiction”

  • No evidence
  • Research has shown that people with ADHD who take medication tend to have lower rates of substance abuse than people with ADHD who don’t take the medication
  • A long-term study looked at childhood & early teen use of stimulants and early adulthood use of drugs/alcohol/nicotine in males with ADHD and showed no increase or decrease in substance use.

“Treatment for ADHD will cure it. The goal is to get off medication as soon as possible”

  • ADHD is a chronic condition that changes over time
  • Depending on the circumstances and demands as a person matures, the need for continuing medication or other treatments varies
  • TRUE GOAL = function well at stage of development in all environments

Teen Stress: On the Rise, But So Are Their Remedies

Teenagers are experiencing stress like never before. Their stress tends to be over many things, including schoolwork, parents, relationships and friends. Often, it feels overwhelming, even paralyzing, and it can lead to isolation, withdrawal, academic decline, aggression and depression.

Perhaps our competitive and technologically advanced society is a part of the problem. The pressure applied by educators, and the message transmitted to students, as well as to their parents, that they must perform to ever rising levels of excellence in order to get into that mythical “good school” following graduation, leaves them in a state of fear, or even panic, that anything less will assure a life of failure and lost opportunity.

Today’s world of social media is another source of stress. Peer acceptance is incredibly important in the teenager’s life. To fit in is everything. But, with Facebook, Instagram, Twitter and other forms of social media, a teen’s personal information, reputation and social valuation can be tossed to and fro, at internet speed, by anyone with an electronic device and an opinion.

Teens are dealing with increasing responsibilities and heightened expectations, but have not learned how to cope with the stress that accompanies them. Teens learn Algebra and trigonometry, but they do not learn coping strategies. They learn Language Arts and European History, but they don’t know how to deal with their emotions or to problem solve in stressful situations.

As a result, some schools around the country are beginning to realize there is a real need for stress reduction training to be offered in the school setting. In these schools, teens are being taught various tools to help them deal better with stress. Studies show that the practice of meditation, yoga and mindfulness can be quite effective in treating stress. CBT and DBT therapies are specific forms of psychotherapy that teach the re-assessment of one’s thoughts about a stressful situation, about one’s self and one’s life, which in turn changes one’s feelings and emotional state, to that of greater calm, hope and optimism, and allows for more effective problem solving.

Our challenge is to help our teens to deal better with the stresses in their lives. Stress reduction begins with a healthy lifestyle, with adequate sleep and healthy nutrition. It also requires a balance of relaxation and fun to offset the rigors of school and social pressures. But, if they also learn some stress reduction tools that they can apply when life begins to feel a bit overwhelming, these tools will serve them well, through their teenage years and well beyond.

Children Who Can’t Pay Attention/ADHD

Parents are distressed when they receive a note from school saying that their child won’t listen to the teacher or causes trouble in class. One possible reason for this kind of behavior is Attention Deficit/Hyperactivity Disorder (ADHD).

Even though the child with ADHD often wants to be a good student, the impulsive behavior and difficulty paying attention in class frequently interferes and causes problems. Teachers, parents, and friends know that the child is misbehaving or different but they may not be able to tell exactly what is wrong.

Any child may show inattention, distractibility, impulsivity, or hyperactivity at times, but the child with ADHD shows these symptoms and behaviors more frequently and severely than other children of the same age or developmental level. ADHD occurs in 3-5% of school age children. ADHD must begin before the age of seven and it can continue into adulthood. ADHD runs in families with about 25% of biological parents also having this medical condition.

A child with ADHD often shows some of the following:

  • trouble paying attention
  • inattention to details and makes careless mistakes
  • easily distracted
  • loses school supplies, forgets to turn in homework
  • trouble finishing class work and homework
  • trouble listening
  • trouble following multiple adult commands
  • blurts out answers
  • impatience
  • fidgets or squirms
  • leaves seat and runs about or climbs excessively
  • seems “on the go”
  • talks too much and has difficulty playing quietly
  • interrupts or intrudes on others

A child presenting with ADHD symptoms should have a comprehensive evaluation. Parents should ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist, who can diagnose and treat this medical condition. A child with ADHD may also have other psychiatric disorders such as conduct disorder, anxiety disorder, depressive disorder, or bipolar disorder. These children may also have learning disabilities.

Without proper treatment, the child may fall behind in schoolwork, and friendships may suffer. The child experiences more failure than success and is criticized by teachers and family who do not recognize a health problem.

Research clearly demonstrates that medication can help improve attention, focus, goal directed behavior, and organizational skills. Medications most likely to be helpful include the stimulants (various methylphenidate and amphetamine preparations) and the non-stimulant, atomoxetine. Other medications such as guanfacine, clonidine, and some antidepressants may also be helpful.

Other treatment approaches may include cognitive-behavioral therapy, social skills training, parent education, and modifications to the child’s education program. Behavioral therapy can help a child control aggression, modulate social behavior, and be more productive. Cognitive therapy can help a child build self-esteem, reduce negative thoughts, and improve problem-solving skills. Parents can learn management skills such as issuing instructions one-step at a time rather than issuing multiple requests at once. Education modifications can address ADHD symptoms along with any coexisting learning disabilities.

A child who is diagnosed with ADHD and treated appropriately can have a productive and successful life.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry

Conduct Disorder

“Conduct disorder” refers to a group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. They are often viewed by other children, adults and social agencies as “bad” or delinquent, rather than mentally ill. Many factors may contribute to a child developing conduct disorder, including brain damage, child abuse, genetic vulnerability, school failure, and traumatic life experiences.

Children or adolescents with conduct disorder may exhibit some of the following behaviors:

Aggression to people and animals

  • bullies, threatens or intimidates others
  • often initiates physical fights
  • has used a weapon that could cause serious physical harm to others (e.g. a bat, brick, broken bottle, knife or gun)
  • is physically cruel to people or animals
  • steals from a victim while confronting them (e.g. assault)
  • forces someone into sexual activity

Destruction of Property

  • deliberately engaged in fire setting with the intention to cause damage
  • deliberately destroys other’s property

Deceitfulness, lying, or stealing

  • has broken into someone else’s building, house, or car
  • lies to obtain goods, or favors or to avoid obligations
  • steals items without confronting a victim (e.g. shoplifting, but without breaking and entering)

Serious violations of rules

  • often stays out at night despite parental objections
  • runs away from home
  • often truant from school

Children who exhibit these behaviors should receive a comprehensive evaluation. Many children with a conduct disorder may have coexisting conditions such as mood disorders, anxiety, PTSD, substance abuse, ADHD, learning problems, or thought disorders which can also be treated. Research shows that youngsters with conduct disorder are likely to have ongoing problems if they and their families do not receive early and comprehensive treatment. Without treatment, many youngsters with conduct disorder are unable to adapt to the demands of adulthood and continue to have problems with relationships and holding a job. They often break laws or behave in an antisocial manner.

Treatment of children with conduct disorder can be complex and challenging. Treatment can be provided in a variety of different settings depending on the severity of the behaviors. Adding to the challenge of treatment are the child’s uncooperative attitude, fear and distrust of adults. In developing a comprehensive treatment plan, a child and adolescent psychiatrist may use information from the child, family, teachers, and other medical specialties to understand the causes of the disorder.

Behavior therapy and psychotherapy are usually necessary to help the child appropriately express and control anger. Special education may be needed for youngsters with learning disabilities. Parents often need expert assistance in devising and carrying out special management and educational programs in the home and at school. Treatment may also include medication in some youngsters, such as those with difficulty paying attention, impulse problems, or those with depression.

Treatment is rarely brief since establishing new attitudes and behavior patterns takes time. However, early treatment offers a child a better chance for considerable improvement and hope for a more successful future.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry

Children With Oppositional Defiant Disorder

All children are oppositional from time to time, particularly when tired, hungry, stressed or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is often a normal part of development for two to three year olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child’s social, family, and academic life.

In children with Oppositional Defiant Disorder (ODD), there is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster’s day to day functioning.

Symptoms of ODD may include:

  • frequent temper tantrums
  • excessive arguing with adults
  • active defiance and refusal to comply with adult requests and rules
  • deliberate attempts to annoy or upset people
  • blaming others for his or her mistakes or misbehavior
  • often being touchy or easily annoyed by others
  • frequent anger and resentment
  • mean and hateful talking when upset
  • seeking revenge

The symptoms are usually seen in multiple settings, but may be more noticeable at home or at school. Five to fifteen percent of all school-age children have ODD. The causes of ODD are unknown, but many parents report that their child with ODD was more rigid and demanding than the child’s siblings from an early age. Biological and environmental factors may have a role.

A child presenting with ODD symptoms should have a comprehensive evaluation. It is important to look for other disorders which may be present; such as, attention-deficit hyperactive disorder (ADHD), learning disabilities, mood disorders (depression, bipolar disorder) and anxiety disorders. It may be difficult to improve the symptoms of ODD without treating the coexisting disorder. Some children with ODD may go on to develop conduct disorder.

Treatment of ODD may include: Parent Training Programs to help manage the child’s behavior, Individual Psychotherapy to develop more effective anger management, Family Psychotherapy to improve communication, Cognitive-Behavioral Therapy to assist problem solving and decrease negativity, and Social Skills Training to increase flexibility and improve frustration tolerance with peers. A child with ODD can be very difficult for parents. These parents need support and understanding.

Parents can help their child with ODD in the following ways:

  • Always build on the positives, give the child praise and positive reinforcement when he shows flexibility or cooperation.
  • Take a time-out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child. Support your child if he decides to take a time-out to prevent overreacting.
  • Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time-out in his room for misbehavior, don’t add time for arguing. Say “your time will start when you go to your room.”
  • Set up reasonable, age appropriate limits with consequences that can be enforced consistently.
  • Maintain interests other than your child with ODD, so that managing your child doesn’t take all your time and energy. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with your child.
  • Manage your own stress with exercise and relaxation. Use respite care as needed. Many children with ODD will respond to the positive parenting techniques.

Parents may ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist, who can diagnose and treat ODD and any coexisting psychiatric condition.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry

Bipolar Disorder In Children And Teens

Children and teenagers with Bipolar Disorder have manic and/or depressive symptoms. Some may have mostly depression and others a combination of manic and depressive symptoms. Highs may alternate with lows.

Research has improved the ability to diagnose Bipolar Disorder in children and teens. Bipolar Disorder can begin in childhood and during the teenage years, although it is usually diagnosed in adult life. The illness can affect anyone. However, if one or both parents have Bipolar Disorder, the chances are greater that their children may develop the disorder. Family history of drug or alcohol abuse also may be associated with greater risk for Bipolar Disorder.

Manic symptoms include:

  • severe changes in mood-either unusually happy or silly, or very irritable, angry, agitated or aggressive
  • unrealistic highs in self-esteem – for example, a teenager who feels all powerful or like a superhero with special powers
  • great increase in energy and the ability to go with little or no sleep for days without feeling tired
  • increase in talking – the adolescent talks too much, too fast, changes topics too quickly, and cannot be interrupted
  • distractibility – the teen’s attention moves constantly from one thing to the next
  • repeated high risk-taking behavior; such as, abusing alcohol and drugs, reckless driving, or sexual promiscuity

Depressive symptoms include:

  • irritability, depressed mood, persistent sadness, frequent crying
  • thoughts of death or suicide
  • loss of enjoyment in favorite activities
  • frequent complaints of physical illnesses such as headaches or stomach aches
  • low energy level, fatigue, poor concentration, complaints of boredom
  • major change in eating or sleeping patterns, such as oversleeping or overeating

Some of these signs are similar to those that occur in teenagers with other problems such as drug abuse, delinquency, attention-deficit hyperactivity disorder, or even schizophrenia.

Teenagers with Bipolar Disorder can be effectively treated. Treatment for Bipolar Disorder usually includes education of the patient and the family about the illness, mood stabilizing medications such as lithium and valproic acid, and psychotherapy. Mood stabilizing medications often reduce the number and severity of manic episodes, and also help to prevent depression. Psychotherapy helps the child understand himself or herself, adapt to stresses, rebuild self-esteem and improve relationships.

The diagnosis of Bipolar Disorder in children and teens is complex and involves careful observation over an extended period of time. A thorough evaluation by a child and adolescent psychiatrist identify Bipolar Disorder and start treatment.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry

The Depressed Child

Not only adults become depressed. Children and teenagers also may have depression, which is a treatable illness. Depression is defined as an illness when the feelings of depression persist and interfere with a child or adolescent’s ability to function.

About 5 percent of children and adolescents in the general population suffer from depression at any given point in time. Children under stress, who experience loss, or who have attentional, learning, conduct or anxiety disorders are at a higher risk for depression. Depression also tends to run in families. The behavior of depressed children and teenagers may differ from the behavior of depressed adults. Child and adolescent psychiatrists advise parents to be aware of signs of depression in their youngsters.

If one or more of these signs of depression persist, parents should seek help:

  • Frequent sadness, tearfulness, crying
  • Hopelessness
  • Decreased interest in activities; or inability to enjoy previously favorite activities
  • Persistent boredom; low energy
  • Social isolation, poor communication
  • Low self esteem and guilt
  • Extreme sensitivity to rejection or failure
  • Increased irritability, anger, or hostility
  • Difficulty with relationships
  • Frequent complaints of physical illnesses such as headaches and stomachaches
  • Frequent absences from school or poor performance in school
  • Poor concentration
  • A major change in eating and/or sleeping patterns
  • Talk of or efforts to run away from home
  • Thoughts or expressions of suicide or self destructive behavior

A child who used to play often with friends may now spend most of the time alone and without interests. Things that were once fun now bring little joy to the depressed child. Children and adolescents who are depressed may say they want to be dead or may talk about suicide. Depressed children and adolescents are at increased risk for committing suicide. Depressed adolescents may abuse alcohol or other drugs as a way to feel better.

Children and adolescents who cause trouble at home or at school may also be suffering from depression. Because the youngster may not always seem sad, parents and teachers may not realize that troublesome behavior is a sign of depression. When asked directly, these children can sometimes state they are unhappy or sad.

Early diagnosis and treatment are essential for depressed children. Depression is a real illness that requires professional help. Comprehensive treatment often includes both individual and family therapy. For example, cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are forms of individual therapy shown to be effective in treating depression. Treatment may also include the use of antidepressant medication. For help, parents should ask their physician to refer them to a qualified mental health professional, who can diagnose and treat depression in children and teenagers.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry

The Anxious Child

All children experience anxiety. Anxiety in children is expected and normal at specific times in development. For example, from approximately age 8 months through the preschool years, healthy youngsters may show intense distress (anxiety) at times of separation from their parents or other persons with whom they are close. Young children may have short-lived fears, (such as fear of the dark, storms, animals, or strangers). Anxious children are often overly tense or uptight. Some may seek a lot of reassurance, and their worries may interfere with activities. Parents should not discount a child’s fears. Because anxious children may also be quiet, compliant and eager to please, their difficulties may be missed. Parents should be alert to the signs of severe anxiety so they can intervene early to prevent complications. There are different types of anxiety in children.

Symptoms of separation anxiety include:

  • constant thoughts and intense fears about the safety of parents and caretakers
  • refusing to go to school
  • frequent stomachaches and other physical complaints
  • extreme worries about sleeping away from home
  • being overly clingy
  • panic or tantrums at times of separation from parents
  • trouble sleeping or nightmares

Symptoms of phobia include:

  • extreme fear about a specific thing or situation (ex. dogs, insects, or needles)
  • the fears cause significant distress and interfere with usual activities

Symptoms of social anxiety include:

  • fears of meeting or talking to people
  • avoidance of social situations
  • few friends outside the family

Other symptoms of anxious children include:

  • many worries about things before they happen
  • constant worries or concerns about family, school, friends, or activities
  • repetitive, unwanted thoughts (obsessions) or actions (compulsions)
  • fears of embarrassment or making mistakes
  • low self esteem and lack of self-confidence

Severe anxiety problems in children can be treated. Early treatment can prevent future difficulties, such as loss of friendships, failure to reach social and academic potential, and feelings of low self-esteem. Treatments may include a combination of the following: individual psychotherapy, family therapy, medications, behavioral treatments, and consultation to the school.

If anxieties become severe and begin to interfere with the child’s usual activities, (for example separating from parents, attending school and making friends) parents should consider seeking an evaluation from a qualified mental health professional or a child and adolescent psychiatrist.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry