Anxiety

Anxiety Onset in Early Childhood

Although there is variability in age of onset, two of these disorders are most likely to first occur during early childhood: separation anxiety disorder and selective mutism. The distinguishing feature for separation anxiety disorder is anxiety related to separation from individuals one has formed a deep emotional bond with (e.g., a parent). Symptoms may include fear about losing the primary caregiver or fear that grievous harm will occur to the caregiver. The resulting behaviors may include refusing to leave a caregiver, extreme distress when leaving home, and psychosomatic complaints. These behaviors can result in school absenteeism as well as a high incidence of school nurse visits for perceived [Page 96]physical complaints, thus missed instruction time and lower achievement.

Selective mutism has a pattern of only speaking in select social circumstances that are familiar and comfortable (e.g., at home) and only with certain individuals (e.g., parents, siblings). Children with selective mutism often avoid speaking at school, to teachers, and even to classmates. This behavior can result in limiting social skills development and also prohibit accurate classroom monitoring and assessment of skills.

Anxiety Onset in School-Age Children

Specific phobia and social phobia are anxiety disorders that most often occur among school-age children (i.e., those aged 7–15). Specific phobia involves a manifest significant fear of particular objects or circumstances, such as dogs, spiders, frogs, or high places (e.g., balconies). The level of fear accompanying exposure to the specific phobia may result in avoidant behaviors or hinder the individual from participating in activities. For example, a child afraid of heights may refuse to access a stairwell or elevator, thus mobility is compromised. For an adolescent with a fear of animals’ participation in required science labs may be problematic.

A social phobia is characterized by fearfulness of social settings wherein individuals may be observed by others and there is a perception that they will be negatively evaluated by others. This apprehension results in significant discomfort and sometimes avoidance of the social interaction. Individuals with social phobia may avoid meeting new people or even quit talking in groups, which can narrow their social networks. The effects of social phobia can be particularly devastating when purposeful evaluation is expected (e.g., a student class presentation assignment).

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