In the past couple of years, I have been asked about childhood anxiety more often than almost anything else. Sadly, anxiety is common in children with special needs. I treat it as part of the whole-child approach. In this blog, we’ll take a closer look at anxiety and discuss intervention from a whole-child perspective.
What is anxiety and when does anxiety warrant intervention?
As a pediatric occupational therapist, I have been working with children who experience anxiety and/or stress for many years. On a personal level, I dealt with anxiety for a really long time! The benefit of both perspectives is that I practice what I teach! Over the years, I’ve tried many strategies and found the best solutions for myself and the children and families I work with.
The official definition of anxiety is ‘a feeling of apprehension, nervousness, fearfulness or worry about an event or an anticipated event.’ The symptoms of anxiety can be triggered by a real or imagined event.
What does anxiety feel like?
Your heart is pounding, your breathing gets faster and shallower; you might experience a choking sensation and cough to clear your throat. Or perhaps fear overcomes you, your muscles tense, you tremble, and you start to sweat!
Does anxiety affect your child in the same way?
The answer to that question is, unfortunately, yes — although some of the outward signs can be different for children.
Anxiety in the body
- Muscle tension
- Pounding heart as rate increases
- Shortness of breath/shallow breathing
- Sleep disturbances
- Changes in eating habits
- Stomach issues/tummy aches
Anxiety in the brain
- Difficulty concentrating
- Memory issues
- Repetitive negative thoughts
Anxiety and the emotions and behavior
- Periods of intense fear
- Panic attacks
- Aggression — physical or verbal
- Emotional disturbances (sad, clingy, withdrawn, angry, crying).
If you were able to visualize the physical experience of anxiety, you will know it can be a scary and unsettling experience. For a child with sensory processing problems, a specific diagnosis like ADHD, an immature nervous system or poor coping skills, it can be difficult to express feelings and impossible to deal with anxiety in a socially acceptable way.
For example, aggression, restlessness or tantrums are all coping strategies that effectively ‘burn up’ the neurochemicals associated with anxiety but are not socially acceptable for obvious reasons.
Anxiety and children with special needs
Children with special needs are more likely to experience anxiety and other mental health conditions such as depression. Anxiety symptoms are strongly associated with autism spectrum disorder (70%), ADHD/ADD (30%), developmental delays (61%) and behavioral problems (69%). Sensory processing difficulties can cause or exacerbate anxiety symptoms.
Children with special needs have additional worries like:
- Not being able to keep up with peers
- Being different than their peers
- Needing additional help such as therapy or extra time taking tests
- Feeling rejected or judged
- Failing or having to re-do work
- Loss of control and not being able to recover
- Worry about what will happen in the future
When to intervene
Anxiety is not necessarily a bad thing. A little bit of anxiety can give a child the boost he needs to complete a task or study for a spelling test. But, if anxiety persists, it can interfere with many aspects of a child’s life and the daily life of the entire family.
How does a parent decide when to intervene and what strategies to use?
In our busy lives we can sometimes forget that our busy schedules, unexpected events or big changes can trigger anxiety in us and our children. We might not have time to deal with anxious behavior and/or expect our children to ‘tough it out, suck it up or get over it.’ Perhaps that was the way anxiety was dealt with when you were a child.
Or, to avoid anxiety-provoking experiences, we might over-manage our child’s life, often without realizing. This type of protection might help your child avoid anxiety in that moment, but you cannot control all aspects of your child’s life.
Both strategies above have positive and negative consequences. We often see the positive consequences in the short term, but these can lead to negative consequences in the long term.
We cannot push a child through anxiety-provoking situations without changing the child’s experience of the world, his confidence in himself or trust in others.
We cannot change every situation and remove anxiety-provoking aspects without denying our children the opportunity to take risks and learn to cope in difficult situations.
Anxiety happens! Using the right tools can lead a child to increased resilience, self-reliance and freedom! I think that’s what we want for all of our children. Research shows that traits like resilience, self-reliance and persistence (working through familiar activities that can be a bit boring) are more accurate predictors of success than academic achievement.
The whole-child approach to managing anxiety takes effort and consistency. During this process, we are not only changing a child’s nervous system and teaching effective strategies, we are also showing him that:
- Effort pays off
- He can learn to control his feelings and thoughts in a healthy way, and
- Most of all, that he is worth your time.
Whole child strategies for anxiety
- Re-pattern the nervous system
- Re-program breath patterns
- Calm the emotional brain
- Teach coping strategies for dealing with difficult situations
- Create peace and freedom.
There are many effective ways to manage anxiety. We have found, in our 23 years of practicing, that working with the whole child — from the foundations to learning coping strategies — is the most effective way. It provides immediate relief and teaches a child to use tools and techniques which lead to more independence and a sense of control.