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Fear & Anxiety

When do children have fear and anxiety?

  • Anxiety, worry or fear can be normal and often it does not last long in children
  • Stranger anxiety and separation anxiety are two common fears that young children will experience. It is part of normal development.
  • Stranger Anxiety
    • Refers to the fear reactions infants experience when approached by unfamiliar adults.
    • Occurs by age 4 – 5 months and intensifies at age 12 months
  • Separation Anxiety
    • Refers to the child’s reaction to the departure of the main care-giver
  • Factors affecting stranger and separation anxiety:
    • Child’s age
    • Nature of situation
    • Past experiences and
    • Quality of the child-carer attachment

When should help be sought?

  • It is advisable to get help when anxiety, worry or fear:
    • Causes marked distress
    • Affects the child’s functioning at home or school
    • Is prolonged

What are the types of anxiety disorders found?

Common types of anxiety disorder include:

  • Separation Anxiety Disorder
  • Generalised Anxiety Disorder
  • Phobic Disorder
  • Social Anxiety Disorder
  • Post Traumatic Stress Disorder
  • Panic Disorder

How can fear or anxiety be manifested?

  1. Unusual Behaviour e.g.:
    • Avoidance of activities e.g. family outings
    • Avoidance of place e.g. playground
    • Avoidance of person e.g. teacher
    • Distress behaviour e.g. before going to sleep
    • Unusual clinging behaviour
    • Change in habits e.g. starting to have thumb sucking
    • Fidgeting
  2. Depressed Mood / Emotion / Thinking :
    • Feeling worried or fearful
    • Excessive anticipation of negative events or disaster, e.g.
      • Rejection
      • Ridicule
      • Accident
      • Injury
      • Examination failure
  3. Physical complaints :
    • Headache
    • Stomachache
    • Choking sensation
    • Shortness of breath
    • Sweating
    • Tremors

Why should we be concerned?

Fear and anxiety may lead to :

  • Interference with normal progress of growing up
  • Interference with functions e.g.
    • Learning
    • Adversely affecting relationship with family members, friends or teachers
  • May lead to more serious behavioral problems e.g. conduct disorder
  • May lead to substance abuse to get comfort e.g. tobacco, alcohol, drugs
  • Risk of self harm
  • Risk of suicide

What can be done to help the child?

  • Listen to the child and understand his behavior
  • Give encouragement and praise
  • Help the child see his personal strength
  • Help the child accept his weaknesses and how to deal with them
  • Help the child use relaxation technique e.g. breathing exercises, visualization of calming scenery
  • Provide psychological support so the child can :
    • Learn to think positively
    • Deal positively with changes, fear, anger, frustrations etc
    • Develop positive social skills e.g. assertiveness
  • Provide counseling to the :
    • Individual child
    • Child’s family members
    • School – inform the school about his/her problems so the school staff is supportive
  • Give medication as advised by a psychiatrist

What can be done to prevent excessive fear or anxiety?

  • Help the child develop necessary emotional and social skills
  • Help the child deal with life events positively
  • Provide a warm, responsive and trusting relationship
  • Provide child with warm, harmonious environment
  • Ensure predictable failures

Where shall one go for further support?

Following professionals may be helpful

  • School counselor
  • Doctors at local health centres
  • General practitioners
Last Reviewed : 20 April 2012
Writer : Dr. Aminah binti Kassim
Reviewer : Dr. Nor ‘Izam Bt. Md Alias