When our daughter HJ was about 4 years old, the developmental pediatrician we took her to diagnosed her with generalized anxiety. It may surprise you, as it did for us, that a child that young can be diagnosed with an anxiety disorder, but looking over all her symptoms and the concerns that we shared, it did make sense. At the time, HJ was going through a somewhat intense fear of elevators, highways, and separation from family, to name just a few things. Since then, through counseling and occupational therapy, I’m happy to say she’s made a great deal of progress. And thankfully, she can go on elevators, doesn’t protest too much when we have to drive on the highway, and is pretty much happily riding the bus and going to first grade.

Of course, she still has her fair share of anxiety over new situations, both big and small, so we’re doing our best to implement some strategies to help her remain calm and less fearful. Here are a few of them that have been working for us.

1. Verbalizing her emotions for her. 

Her counselor has been using the phrase, “Name it, tame it, and reframe it” from a children’s book called Zach Gets Frustrated. This has been such a simple and helpful strategy for us because HJ has really strong emotions but has difficulty verbalizing how she feels, especially in those heightened moments. Her occupational therapist also does a great job of noticing and verbalizing even the smallest changes in her body language or facial expressions. If someone unexpectedly opens the door and walks in during HJ’s session, the therapist immediately says, “Wow, I bet that surprised you. I bet you weren’t ready for someone to come in right now.” Even such a simple acknowledgment of her feelings seems to help HJ calm down and realize that she is in a safe environment with her therapist.

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2. Create a plan before going somewhere new
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Since HJ was little, her therapists have been reminding me of the benefits of “previewing” a new place for HJ well in advance of actually going there by showing her pictures or videos and helping her plan the schedule or activities. Nevertheless, in reality, we are often running out the door when I realize that I have not done enough preparation. I saw the negative effects of this recently when I took her on a spontaneous trip to a local indoor playground filled with screaming kids, bouncy bridges, and general overstimulation.

However, I’ve also seen the benefits of actually putting a plan into place, such as when we took a long-awaited trip to the art museum downtown. We looked at pictures online. We discussed what we would do and the children’s education center we would visit. We talked about where we would have lunch. We planned what small book or toy she could bring with her to make the long car ride downtown a little easier. And fortunately, the trip turned out to be a success.

3. Give her an out.

This is also another simple strategy that I haven’t been implementing as much as I should be. In advance of a big outing, birthday party, long weekend, HJ’s occupational therapist suggested that we come up with a phrase that HJ could say when she’s starting to feel really overwhelmed. HJ’s already getting to the point where she uses it a bit at home, such as after a long day at school when her little sister is hanging all over her, HJ can say, “I need some quiet time,” or “I need to be alone.”

When we’re out in the middle of a busy restaurant, for example, it’s a little bit harder to remember, but there have definitely been times where HJ just needed a little “sensory break” to walk outside, or get something from the car. The hardest part is when these sensory breaks don’t seem to help and she’s just gone beyond the point of being able to calm down. At these moments, her therapist has reminded me that it’s ok, and sometimes necessary, to just leave.

4. At the same time, know when to push through the anxiety

This has been a tough one for us. A lot of times we have caved in to HJ’s tantrums, or tried so hard to minimize her fears, that we haven’t helped her to push through some of the anxiety when that might be a good thing. For example, even getting to the therapist or any appointment, in fact, has often been a challenge for us because HJ usually wants the entire family to go together, meaning Mommy, Daddy, and little sister.  Sometimes that’s ok, such as going all together to a swim lesson. Other times, such as going to a therapy session where it should just be focused on her, it’s a big pain to drag her little sister along to wait in the waiting room for an hour with Daddy.

We’re slowly learning that it’s ok to have her be upset and cry and not get her way. I’ve been able to leave Lila at home with my parents a few times, and by the time we get to HJ’s appointment, she has generally calmed down and is ready to participate. The therapist also does a good job of saying, “Next time, maybe we can have your little sister come in for part of the time and join us,” so she knows that there’s a plan in place for the future.

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Do you have any tips or strategies for helping your children overcome their fears or anxieties? It’s always helpful for me to hear what works for others, even knowing that every child and family has their unique set of circumstances.