All of the anxiety disorders observed in adults also occur in children and early adolescents. Phobias, social anxiety disorder and obsessive-compulsive disorder usually first appear during these years. Although panic disorder onset usually occurs during the young adult years, many adults retrospectively recognize having had panic attacks during their childhood years that were not identified as such at the time. Children's reactions to traumatic experiences can be both like and unlike the reactions of adults.

Most children have occasional worry, separation concerns or anxiety symptoms that are an entirely normal aspect of development. However, for some children, truly persistent behaviors like excessive worry, severe anxiety about separation from parents, marked inhibition in new social situations, selective mutism, school phobia, significant behavioral avoidance, repetitive behaviors to reduce anxiety, or reactions to traumatic events may be manifestations of a developing anxiety disorder.

Over the years, most of the professional literature about anxiety disorders has merely extrapolated to children from what is known about adult anxiety disorders. More recently, cognitive-behavioral treatment techniques (e.g., exposure, anxiety management skills) geared to children and/or their parents have demonstrated effectiveness in controlled trials. Several trials have demonstrated moderate effectiveness of drug treatment (SSRIs and clomipramine) for obsessive-compulsive disorder in children. "A small developing evidence base suggests the selective serotonin reuptake inhibitors (SSRIs) are the pharmacological treatment of choice for pediatric non-OCD anxiety disorders (Seidel & Walkup, 2006)." However, given the safety and demonstrated efficacy of cognitive-behavioral techniques, they should usually be tried first.

Clinicians from the Anxiety and Stress Disorders Institute have special expertise for treating all of the anxiety disorders that present in children and adolescents.

Resources for Parents:

Chansky, TE. Freeing Your Child from Anxiety: Powerful, Practical Solutions to Overcome Your Child's Fears, Worries and Phobias. New York: Broadway Books, 2004.

Chansky, TE Freeing Your Child from Obsessive-Compulsive Disorder: A Powerful, Practical Program for Parents of Children and Adolescents. New York: Three Rivers Press, 2001.

Dacey, JS & Fiore, LB. Your Anxious Child. New York: Wiley, 2000.

Lite, L. A Boy and a Bear: The Children's Relaxation Book. Plantation, FL: Specialty Press, 1996.

Rapee, RM, Spence, S, Cobham, V, & Wignall, A. Helping Your Anxious Child: A Step-By-Step Guide for Parents. Oakland, CA: New Harbinger, 2000.

Wagner, AP. Worried No More: Help and Hope for Anxious Children, 2nd Edition. Deerfield Beach, FL: Lighthouse Press, 2005.

Wagner, AP Up and Down the Worry Hill: A Children's Book about Obsessive-Compulsive Disorder and its Treatment. Deerfield Beach, FL: Lighthouse Press, 2000.

Helpful Links on the Web:

Worry-wise Kids: http://www.worrywisekids.org/

The Child Anxiety Network: http://www.childanxiety.net/

Obsessive-Compulsive Foundation: http://www.ocfoundation.org/ (includes a downloadable guide for parents)

Anxiety Disorders Association of America: http://www.adaa.org/ (includes a find-a-therapist search engine)

SS

Anxiety and Stress Disorders Institute of Maryland:
Treating anxiety disorders and stress-related disorders in Towson, Maryland, since 1978.