Understanding Child Anxiety - What the Science Says

Author: ​Sabrina Lazzarato

If your child or a child you know has ever exhibited signs of anxiety, you are not alone. Anxiety is one of the most frequently diagnosed mental health disorders affecting children today. The good news is that science has created resources and information to be able to navigate child anxiety. Understanding child anxiety is the first, most important step towards helping a child to thrive.

What Causes Anxiety in Children?

Anxiety in children does not just appear or come out of nowhere. While the causes will be different for each child and situation, it’s usually a result of biology, temperament, life experiences, and environment. 

If there are so many factors involved with the development of childhood anxiety, how can you help? Well, a 2017 study by Lawrence, Rooke, and Cresswell examined how certain parental behaviors may contribute to anxiety disorders in children. They found that behaviors such as constant reassurance or allowing avoidance of feared situations may reinforce a child’s anxious responses. As parents are trying to help their child, sometimes they unknowingly reinforce avoidance, which is the underlying mechanism driving the anxiety process. The key part to understand what these results mean is that the action of a parent can be a powerful tool in helping a child build resilience. Encouraging a child to take small steps toward a situation rather than reinforcing avoidance can help a child build courage. This is also a reason that a parent, guardian, or caregiver should be involved in a child’s therapy related to anxiety, so that they know which behaviors are most helpful to the child in their care.

How Does Anxiety Affect a Child’s Development?

While it might be easier to dismiss childhood anxiety as a phase or something that will pass without intervention, research shows otherwise. 

A 2019 longitudinal study by Waite, Cresswell, and Cooper found that anxiety can significantly interfere with academic performance, especially in subjects that require significant attention such as math or reading. Anxious children were found to be more likely to perform poorly on standardized tests and to struggle with participation in school. Anxiety was also found to affect friendships, sleep, and even a child’s ability to regulate their own emotions. If anxiety is left untreated, it can develop further into depression or more severe anxiety as the child grows up. This means that the earlier intervention can be provided, the better the outcomes may be. Early recognition and intervention can make all the difference.

What Actually Helps?

The gold standard for treating child anxiety is Cognitive Behavioral Therapy (CBT). It is one of the most well researched and effective treatments. CBT is a type of talk therapy that aims to help children understand how their thoughts, behaviors, and feelings are all connected. The goal of CBT is to help kids recognize unhelpful thinking patterns and replace them with more realistic, confident thoughts (e.g., “If I raise my hand I will be embarrassed” to “I can still speak up and be okay even if I’m nervous”). 

CBT not only focuses on thinking, it also helps children to face their fears in a safe, gradual way rather than to avoid them. This helps their brain learn that the situation they are scared of is not actually dangerous. Over time, this helps decrease anxiety 

Additionally, a particular approach, the Supportive Parenting for Anxious Childhood Emotions (S.P.A.C.E.) was developed to help children that are not motivated for Cognitive Behavioral Therapy. In this approach, the therapist only works with the parents, and it has been found to have the same successful outcomes as individual CBT for the child. The therapist helps the parent understand the anxiety process, avoidance, and identify accommodations that may be reinforcing the anxiety cycle.  

Parents, guardians, or caregivers looking to enroll a child into CBT therapy should consult with a pediatrician or school counselor who can refer them to a licensed child therapist that specializes in CBT. At the Bay Area Center for Anxiety, we use both Cognitive Behavioral Therapy, and family involvement, incorporating principals of the S.P.A.C.E. program to help children and families overcome anxiety.

The Bottom Line

Anxiety may be common but debilitating anxiety is not normal and not something a child has to sit and suffer with. There are interventions and resources that can effectively reduce anxiety. Anxiety in children is real, but so is recovery. 

If you suspect your child may be struggling with anxiety, these are some next steps:

• Start by having an open conversation
• Reach out to a pediatrician, school counselor, or mental health professional
• Explore CBT-based programs and work towards taking small steps together

Works Cited
Lawrence, P. J., Rooke, S. M., & Creswell, C. (2017). The Role of Parenting in the Development of Anxiety Disorders in Children and Adolescents. Current Psychiatry Reports, 19(6), 41. https://doi.org/10.1007/s11920-017-0760-1

Waite, P., Creswell, C., & Cooper, P. J. (2019). The Effects of Child Anxiety on Academic Performance: A Longitudinal Study. Journal of Abnormal Child Psychology, 47(5), 739–749. https://doi.org/10.1007/s10802-019-00548-2