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Anxious Child Needs Evaluation

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Editor's Note: Sylvia Rimm is off. The following column has been published in the past few years.

Q: We have two daughters ages 5 and 3. The 5-year-old has anxiety issues. Our pediatrician and in-laws view these issues as no big concern or something she'll outgrow. She's a happy, smart and physically gifted kid, but she has emotional breakdowns when exposed to new environments and new people. She cries, covers her face, and won't talk. She has similar breakdowns if focus turns toward her, like when the class sings happy birthday to her.

We've tried to downplay these situations as "no big deal," as well as discuss them ahead of time to prepare her and talk about her feelings. She goes with a good attitude, but when we think she has it under control, the same emotional breakdown occurs nine out of 10 times. Sometimes, she gets over it within minutes and is OK for the rest of class. Other times, it goes on until we pull her out of the situation. When we pull her out, we've tried taking her off to the side and calmly talking to her, as well as firmly saying, "You're a big girl," but neither seems to help. We feel bad for her and can foresee this problem escalating.

My husband and I go through phases where we think we need to do something, but time passes between episodes, so we let it slip. She's putting stress on the entire family and is also teaching her fears to her younger sister.

We don't want to dismiss something that can hopefully be made better if it's addressed. A mental health issue like this puts the parents on an island all alone trying to figure out what's the right way to address it. I don't want my 5-year-old on any medication and would hope this situation could be dealt with by talk therapy. Any guidance would be greatly appreciated.

A: There's no doubt that your daughter is an anxious child. The fact that her pediatrician hasn't recommended an evaluation suggests that he believes her anxiety is lessening and maturity may diminish the problem.

I'll suggest a few approaches. If they help and her anxiety lessens, you can assume it will continue to get better. If it worsens, get an evaluation by a psychologist who will work closely with you around parenting to support you through the hoped for changes.

Most importantly, your daughter shouldn't hear you and your parents or in-laws discussing your differences about whether or not she has a problem. It's also important not to refer to her anxiety around others or label her as anxious. Instead, explain privately that some children are more fearful than others, but with time they usually get better at handling their fears. Also, suggest that if she feels anxious enough that she wants to cry at gymnastics or someplace new, she could excuse herself and go off to the side of the room or to the girls' restroom, provided there's a safe one nearby. When she feels better, she can wash her face and go back to class.

Tell her that you'll alert the teacher to let her get herself under control and will ask the teacher to say nothing to the class when she leaves or returns. Giving her the power to control herself without the worry that there's something wrong with her can make a big difference — in whether she learns to deal with her anxiety or requires additional help.

Children are born with different temperaments. Some are anxious, and ideally, as we help them cope with their small fears, they become stronger. We can't control the attention the tears and embarrassment attract, which may cause problems to worsen. Be sure to get professional help if her problems continue.

For a free newsletter about fearful children, send a large, self-addressed, stamped envelope to the address below.

Dr. Sylvia B. Rimm is the director of the Family Achievement Clinic in Cleveland, Ohio, a clinical professor of psychiatry and pediatrics at the Case Western Reserve University School of Medicine, and the author of many books on parenting. More information on raising kids is available at www.sylviarimm.com. Please send questions to: Sylvia B. Rimm on Raising Kids, P.O. Box 32, Watertown, WI 53094 or srimm@sylviarimm.com. To read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

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1 Comments | Post Comment
When you discuss her feelings beforehand, add acting the situation out. Make it as realistic as possible. Also, have her take a role other than herself--like the person who wants to start the singing of Happy Birthday. This will help desensitize her.
Comment: #1
Posted by: BB
Wed Jul 14, 2010 8:22 AM
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