Dear Dr. Markel,
I would like to know about anxiety in preschoolers and to what extent that is typical and age appropriate. — My 3.5yo daughter is bright, creative, and fairly well adjusted but has what I consider to be a real anxiety problem. It doesn’t affect her every single day, but it definitely comes and goes in phases and when it is at it’s worst, it affects all the members of our family. When she was younger I worked, so she was used to being left with fantastic caregivers for almost three years. In February I lost my job and started staying home with her and her little brother, and the anxiety went from fairly typical separation anxiety to something more. She started being scared that I would leave her and not come back, even for example when I put her in her carseat and walked around to the other side of the car. She would become hysterical. This morning we were home together and I was doing normal household chores, every time I turned a corner or left the room she panicked and wanted to know where was. She is scared of doors being shut, of me going out into the yard for a second, even sometimes when she can still hear and see me. As I said, it is not everyday, but I feel there is something more going on than typical childhood fears. Can you tell me what’s age appropriate and if I should start looking for professional guidance for us?
— M.P. (Shelburne, Falls, MA)
Children typically experience anxiety as they begin to understand some of the realities of the world, which to them may be disappointing and sometimes frightening. From your daughter’s point of view, the feeling of being afraid and out of control is probably a practical definition of anxiety. It is particularly common for children to experience this kind of anxiety between the ages of 2 and 6.
Young children may have short-lived fears such as fear of dark, storms or animals. Natural developmental fears during these years might include fear of being left alone – such as what your daughter is experiencing now – or fear of strangers. Life transitions are also stressful events for children, and the change from a daycare to a home situation is certainly that for your daughter.
Children may express stress differently according to their age, maturity level and previous experiences. Young children may react with certain symptoms and behaviors when the stability and security of their lives are violated. They may exhibit regressive behavior which is not to be confused with a child’s typical moment-to-moment inappropriate behavior. Regressive behavior is a cry for help from a child who is not feeling safe or who feels unable to cope with his or her situation.
In the pre-schooler age group, a child who expresses constant anxiety and fear of being alone is definitely showing signs of stress. It sounds as if she is in particular need of being cared for and protected. Children under stress need help in expressing their fears and concerns. Your daughter’s fears need to be address because they certainly are real to her. So my best suggestion is, yes, some therapeutic intervention would be helpful at this time.
— Dr. Susan Markel, MD
ABOUT THE AUTHOR
Susan Markel, M.D. is a board-certified pediatrician who has a private consultative practice specializing in parent coaching and child health. A graduate of Tufts University School of Medicine in Boston, Dr. Markel became a fellow of the American Academy of Pediatrics in 1981 and an International Board Certified Lactation Consultant (IBCLC) in 1997. For many years she served as a medical liaison for La Leche League and is the author of What Your Pediatrician Doesn’t Know Can Hurt Your Child.
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