St. Louis Children’s Hospital

“One way for parents to identify anxiety disorders in their children is to look at the developmental timing of a behavior,” says Catherine Hutter, PhD, clinical child psychologist at St. Louis Children’s Hospital. “If your 3-year-old experiences separation anxiety, that’s normal, but your 10-year-old wanting to be in the same room with you at all times is not developmentally appropriate.”

Duration of worry is another anxiety disorder indicator: It’s okay if your child is worried about a test a couple of days beforehand, but the worry shouldn’t persist for weeks. If a behavior affects a child’s functioning, it’s probably an anxiety disorder.

Untreated anxiety disorders can lead to future complications, including depression and possible substance abuse. Children may experience one of three major types of anxiety disorders, each with its unique symptoms and challenges.

Separation Anxiety Disorder
Separation anxiety disorder occurs most commonly in children ages 7 to 9 and affects approximately 4 percent of children in the United States, according to the Anxiety Disorders Association of America. The disorder is characterized by children’s struggle between asserting their independence and remaining dependent on parents. Marital or financial upheaval in a family or a traumatic event, such as a parent forgetting to pick up a child after school, can lead to separation anxiety disorder.

“Since parents often are the objects of their children’s worry, separation anxiety disorder is usually easy to identify,” says Katherine Kreusser, MD, community pediatrician at St. Louis Children’s Hospital. “Signs to watch for include children following their parents around and refusing to go places by themselves, including school or camp.”

Children with separation anxiety disorder may benefit from a desensitization hierarchy strategy in which they gradually practice being in separate rooms of the home from their parents until anxiety disappears.

Social Anxiety Disorder
Children who avoid interaction with others because they worry about being disliked or embarrassed may have social anxiety disorder, a condition characterized by underdeveloped social skills. Symptoms include discomfort in the spotlight, refusal to start conversations, soft speech and avoidance of eye contact.

In structured situations where an adult is present, children with social anxiety disorder do well; however, problems may arise in unstructured situations, such as at parties or when they are forced to make small talk. Parents can help children overcome the disorder by working with them to plan a play date with a friend. After several play dates, the child may take the lead in planning the event.

Generalized Anxiety Disorder (GAD)
“Children with GAD may not have a specific compulsion, but they tend to worry about everything,” Dr. Kreusser says. “Parents should watch for restlessness, irritability and fatigue in their children.”

GAD often causes children to become very future-oriented and concerned about what’s going to happen instead of focusing on present circumstances. Cognitive behavioral therapy—and sometimes anti-anxiety medication—is often recommended by psychologists to help children with GAD master anxiety-provoking situations.