Managing Anxiety in Infants, Toddlers, and Preschoolers
Anxiety in preschoolers is important for parents. Managing anxiety in under fives depends very much on their ability to verbalize. If their vocabulary isn’t large it’s important to attend to their body language. Here are some tips for managing anxiety in infants, toddlers, and preschoolers.
Infancy from birth to age one is a wonderful time for rapid growth. Only you know your baby’s ways of communicating as you get to know him or her. She communicates by crying, turning her body this way and that, facial expressions, wiggling her toes, turning her head away from you or towards you, and many more gestures that only you pick up so frequently.
Babies do get anxious from time to time depending on their temperaments. Some get jostled by loud noises, others crave the loud stimulation. Some get thrown by crowds of people, others love the array of people around them. Only you know the best atmospheres that they are comfortable in. If their pattern changes, you can suspect or at least wonder if they feel anxious or in distress.
Always begin with a physical assessment by your pediatrician. If everything is fine, then consider signs of anxiety like a quiet baby crying excessively for long periods of time or a good sleeper waking up frequently during the night and having restless naps. Or, the reverse, an active baby showing signs of lethargy for example. You’re looking to find out how well your baby can shut out disturbing stimuli such as loud noises, transitions to different locations, being held by people they do or do not know, being away from you for long periods of time.
The hypersensitive infant cannot shut out stimuli and must respond over and over. They will need a very protected environment similar to those needed for premature infants. Undress this baby gently, observing his reactions to being handled. Some easily irritable newborns are recovering from maternal medications, alcohol, or exposure to narcotics during pregnancy. With narcotics, they may experience a period of withdrawal.
A sleepy baby may not be able to coordinate his sucking if he is anxious and will need to be roused before he gets started. After the parent awakens him, the infant will need to be soothed into a calm and focused state. Sensitive babies in general get agitated more easily than resilient ones, so keep an eye on your baby’s pattern of reacting. Other recommendations for anxious babies include the following:
- If the baby awakens frequently when she’s been a good sleeper, rock her gently and sing quietly. She is accustomed to her mother’s voice from when she was in utero. This is comforting.
- If the mother is nervous, have the father speak in his lower voice tone which is often soothing.
- If a parent is anxious, the baby will absorb that anxiety. So, calm yourself before holding the baby and allow each other to soothe one another in a gentle, rocking motion.
- If your baby turns away from you when you are playing, do not chase him with your face or eyes. Let him have his space. If you do not, you may enter into an activity called chase and dodge, where the baby gets increasingly anxious by your over attention.
- Look for environmental triggers to anxiety such as unexpected noises or movements around the baby. Remove the baby from that area and slowly pat her gently until she is calm.
- If the baby is traumatized by the loss of her primary caretaker or the mother has postpartum depression and does not want to care for her infant, make sure one substitute person becomes the caretaker for the baby to get attached to.
- If early day care is needed, again make sure the baby is attached to one primary caretaker rather than random childminders who go on shifts.
Once your baby is walking, usually about at 1 year, they begin to toddle. Opening cabinets, searching all over the house, discovering what makes their world tick. It’s a fun time for most but some do bear anxiety. Look for changes in their patterns of eating, sleeping, and playing for changes from their usual routines to indicate they may be feeling some distress. Object permanence typically starts to develop between ages 4-7 months and involves the baby understanding that when things disappear, they aren’t gone forever. However, it may take your toddler longer to be convinced that when you are not around, you still can be found, or will return home. Some toddlers experience separation anxiety until they have this concept down pat. They may cling when you go out or even cry. Soothe them gently telling them when you will be home in a way they can understand because they can’t tell time. (“I’ll be home for the cartoon show. We’ll watch it together.”)
Toddlers with anxiety often are clingy and emotional. There may be environmental causes such as changes in day care, new activities to transition to, and losses that are traumatic. Always soothe your toddler; don’t let her wander aimlessly around sadly on her own. Explain what you can to help her shoulder and adjust to any changes. Explanations may go on deaf ears if they are over her head, but your warm tones will comfort her.
Typically, nine months is normal stranger anxiety, but it may last a bit longer. Monitor your toddlers reaction to strangers and don’t push the hypersensitive toddlers to go to people they don’t know during this transition.
Ages 3-4 are generally when kids start preschool. They may be excited to be part of school life, or they may feel afraid to meet this new adventure. Visit the school several times to help your child get acclimated to the building and the teachers. Tell her what she will be doing and offer to show her around the classroom. If she can form a warm attachment to at least one teacher who will greet her the first day this can go a long way in an easier adjustment.
If you’re child shows separation anxiety at 3 you might want to wait until 4 if it’s extreme. Playdates at age 3 can fulfill the socialization needs and you can provide craft materials and other play things to fill in the gap. Play at preschool is more important than just rote learning the A,B,C’s. Children need to learn to share, to sit in circle time, and begin to love to be read to (which hopefully has been going on at home for some time.) If separation anxiety seems manageable and the preschool allows it, stay in the room the first few days for a few minutes or so while your child becomes involved in playing. Do not disappear when you leave even if your child is tearful. It’s best to say when they will be picked up and by whom, so they know they aren’t forgotten. If they are crying, have the best attachment figure in the room be by their side and have the teacher call you after about an hour to tell you how things are going. Give your child time to adjust. For some it takes several weeks. School should be a happy time. If it’s not, find out why by consulting with the teacher and rethinking your routine so it’s not overwhelming but easy to manage. Your child will pick up on your anxiety, so learn to understand your worries as well and resolve them because your nervousness will be contagious to your child.
Children this age don’t generally say when they are worried, but they may say they are sad. Listen attentively to this expression and try to find out what they are concerned about. Take them seriously and give them your time and calm responses to their questions. Some children on the cusp of three, depending on their birthdays, are better off waiting 6 months or so before beginning preschool so it’s a positive experience.
Usually if the household is calm when they begin school, and routines are set for awakening, eating a good breakfast, and time to chat, going to school is a pleasurable experience. There will be some days your child needs a hang out at home time, consider this normal if it’s not prolonged. You are still their principal person that they trust. If they see you trust the teachers, they will, too. Also, have play dates with some of the kids in their class to build some relationships.