phobia in children

What is a phobia?
A phobia is an identifiable and persistent fear that is excessive or unreasonable and is triggered by the presence or anticipation of a specific object or situation. Children and adolescents with one or more phobias consistently experience anxiety when exposed to the specific object or situation.
Common phobias include fear of animals, blood, heights, closed spaces, or flying. In children and adolescents, the identified fear must last at least six months to be considered a phobia rather than a transient fear. Types of phobias seen in children and adolescents include the following:
§ Specific phobia - anxiety is associated with a specific object or situation. The phobic object or situation is avoided, anticipated with fear, or endured with extreme anxiety to the extent that it interferes with normal routines and activities.
§ panic disorder with or without agoraphobia - an unpredictable, unexpected period of intense fear or discomfort compounded by shortness of breath, dizziness, lightheadedness, shaking, fear of losing control, and an increased, racing heart beat (called a panic attack). Symptoms can last several hours, but usually peak after 10 minutes. Agoraphobia is defined as a fear of open spaces such as being outside or leaving home alone related to one or more phobias or the fear of having a panic attack.
§ Social phobia - fear of one or more social or performance situations in an age appropriate setting with others within the same age group (i.e., school play, recital, giving a speech or book report in front of the class).
§ Selective mutism - the inability to speak in specific social situations in a child or adolescent who can and does speak in other situations.
What causes phobias?
Both genetic and environmental factors contribute to the onset of phobias. Specific phobias have been associated with a fearful first encounter with the phobic object or situation. Sometimes children develop phobias by observing fearful reactions of others. Children’s fears are often natural and arise at specific times in their development. Children may develop fears from a traumatic experience (e.g. traumatic dog attack), but for some children, there is no clear event that causes the fear to arise. Some children become fearful simply by watching another child acting scared. Some children may refuse to sleep alone due to fears of creatures in their closet, while other children report feeling afraid of the dark. Children's fears are often associated with avoidance, discomfort, and physical complaints, such as rapid heart beat, stomach distress, sweaty palms, or trembling. Researchers have found certain fears arise at specific ages in all children, and these fears tend to disappear naturally with time, as the child grows older. When children’s fears persist beyond the age when they are appropriate, and begin to interfere with their daily functioning, they are called phobias. Typically, children who are experiencing a phobia should be referred for treatment by a psychologist.
Child’s fears may be normal Most children are able to report having several fears at any given age. About 90% of children between the ages of 2-14 have at least one specific fear. If child’s fear is not interfering with his routine daily life (e.g., sleep, school performance, social activities), or your family’s life, then most likely you will not need to bring your child to a psychologist for help. Following are some common phobias found at different ages:
Ages 0-2 years- loud noises, strangers, separation from parents, large objects Ages3-6 years- imaginary figures (e.g., ghosts, monsters, supernatural beings, the dark, noises, sleeping alone, thunder, floods) Ages 7-16 years- more realistic fears (e.g., physical injury, health, school performance, death, thunderstorms, earthquakes, floods.


Who is affected by phobias?
Anxiety disorders are common in all ages. The occurrence of specific phobias in children and adolescents is estimated to range from 1 percent to as high as 9.2 percent. While specific phobias often begin in childhood, they must be differentiated from normal developmental fears. Social phobias are only estimated to occur in up to 1.4 percent of children and adolescents. Panic disorders can develop at any age, but most often begin in adolescence or young adulthood. The study of panic disorders in children (before puberty) has only recently begun.
What are symptoms observed child with a phobia?
The most common symptoms that may occur when a child is exposed to or anticipates exposure to, a specific object or situation that produces intense fear or anxiety are
increased heart rate
sweating
trembling or shaking
breathlessness
feeling of choking
chest pain or discomfort
feeling dizzy or faint
fear of dying
numbness
· chills or hot flashes
The symptoms of a phobia may resemble other medical conditions or psychiatric problems. Always consult your child's physician for a diagnosis.
How are phobias diagnosed?
A child psychiatrist, psychologist or pediatrician usually diagnoses anxiety disorders in children or adolescents following a comprehensive medical and psychiatric evaluation. Parents who note signs of severe anxiety in their child or teen can help by seeking an evaluation and treatment early. Early treatment can prevent future problems.
Panic disorder, however, may be difficult to diagnose in children and adolescents and may require multiple evaluations and tests in a variety of settings.
How to prevent Phobias
Preventive measures to reduce the incidence of phobias in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the child's normal growth and development, and improve the quality of life experienced by children or adolescents with anxiety disorders. Helping children overcome fears
Communicate with children
Give children information about their fears. Answer their questions about things like wars, death, hospitals, disease, etc. Knowing about things helps to make children less fearful (but not too much detail for young children).
Understand your child
· Do not making fun of your child's fears.
Reassure children that they are safe and cuddle or love them until they calm down.
However, while you show your child that you understand that her fears are real, it is important not to let her think that you are also afraid (unless it is genuine) because it will make her more fearful.
Encourage them
· Praise and reward the child when he makes a step towards fighting or confronting his fear, e.g. getting closer to a dog if he is frightened of dogs.
Don't force your child to fully confront his fear, but take it a small step at a time and let him know you are proud of him when he does.
Control his fears
Having some control of the situation often helps with fears.
· Make sure your child has his own comforters, e.g. Dummy, blanket, night light, Toys etc.
· If your child is old enough, ask him what he thinks would help him, or make some suggestions and let him choose.
· For example, if the child is afraid of burglars, he could check that the room or house is safe, with windows locked, etc.
Give them a chance
Provide opportunities for your child to develop skills and gain confidence in his own ability. Confidence can't be developed on praise alone. It is success and being able to do things that build up a child's confidence.
· Let your child try things that he can do, and then give him lots of support and approval.
· Read children's stories that deal with fearful events those children overcome.
· Provide times for fantasy play where children can express their fears and take control of them.
Be their Hero
You are a role model for your children
· Show that you are calm and confident in the situation which is frightening to your child.
· Remember that children can learn fears from parents, and if you show anxiety in a situation your child may pick it up.