Anxiety: Assessment of children should start at the age of 8 years – 04/14/2022 – Balance

The growing state of mental health in children has led an influential team of experts to recommend for the first time that all children and adolescents between the ages of 8 and 18 be screened for anxiety, one of the most common mental health disorders. Childhood

The draft text of the new guidelines, which is open to the public for comment, will probably be finalized later this year. It was published on Tuesday by the U.S. Preventive Services Task Force, a committee of volunteer experts appointed by a federal government agency to outline the recommendations of healthcare providers on preventive clinical care.

Created by Congress in 1984, the task force has no regulatory authority, but its recommendations are often heard by physicians.

Screening more children for anxiety is “really important,” said child psychologist Stephen PH Whiteside, director of the Pediatric Anxiety Clinic at the Mayo Clinic in Rochester, Minnesota, who is not part of the task force. “Most children who need mental health care do not get it.”

This is especially true for anxious children, he said.

It is more common for children with behavioral problems to be identified as in need of help, but according to Whiteside, if children with anxiety disorders do not have problems at school or at home, their difficulties can be easily overlooked.

The epidemic only exacerbated the problems that children were already suffering from.

Why is early detection of anxiety important?

The U.S. Task Force recommends that children be screened for potential concerns regardless of whether a physician has identified any signs or symptoms.

“Being able to intervene before a child’s life is in danger is crucial,” explained Martha Kubic, a member of the task force and a professor at the George Mason University School of Nursing in Fairfax, Virginia.

Childhood anxiety disorders are associated with an increased risk of depression, anxiety, behavioral problems and substance abuse in later life, according to a report by the Child Mind Institute, a non-profit organization that provides therapy and other services to children and families with disabilities. Health and learning problems.

The task force said it still did not have enough evidence to recommend whether children under the age of 8 should be screened for anxiety. Experts continue to recommend depression screening for children under 12 years of age.

How will this screening work?

Kubik said there are already a number of different surveys and questionnaires that could be used to identify concerns in general practice.

Some of these tools can detect certain anxiety disorders, others can capture different disorders. “Our review has shown that these screening tools are effective in capturing the anxiety of children and adolescents before they show obvious signs and symptoms,” he said.

According to Kubik, ideally children should be examined during their annual child health examination, but doctors should also open up opportunities to examine children during other visits.

If one of the instruments used indicates that a child needs further assistance, it is not a diagnosis, experts say, but rather a starting point for extensive discussion and follow-up, which may include a referral to a mental health professional.

“Psychotherapy is the first treatment option,” said Tami de Benton, director of child and adolescent psychiatry and behavioral science at Children’s Hospital of Philadelphia. If anxiety interferes with the baby’s ability to survive normally or if psychotherapy alone does not work, he added, medication may be needed.

Finding a mental health professional is not necessarily an easy or time consuming task, but examining children is no less important.

More children and adolescents who have been identified as in need of assistance, “this is starting to put pressure on many decision makers and money control people,” including insurance companies. Carol Weitzmann, co-director of the Autism Spectrum Center at Boston Children’s Hospital and spokeswoman for the AAP (American Academy of Pediatrics).

“We need to shed more light on the mental health needs of children, adolescents and young people in this country and fight for better access to our mental health services.”

Other agencies have their own procedures for drafting recommendations that differ from the US Task Force.

Weitzmann said AAP is in the process of developing more tools to help pediatricians screen for concerns.

What is the risk of suicide?

Highlighting the need for further research, the task force said that there was not enough evidence to recommend systematic screening for the risk of suicide in children 12 years of age or older. Suicide is the second leading cause of death among children aged 10 to 19 years.

“A lot of kids hide their suicidal thoughts from other people, they talk about it when someone asks,” he said. Weitzmann, who is also a developmental and behavioral pediatrician. “So when you screen all kids 12 years of age or older, it helps to create the impression that there’s a safety net. It’s okay to talk about it.”

How common is childhood anxiety?

According to the CDC (Centers for Disease Control and Prevention), more than 7% of children aged 3 to 17 have been diagnosed with anxiety. But, Benton says, “many children and adolescents who suffer from anxiety have not been diagnosed.” For example, a representative study of families in the U.S. found that about one in three adolescents – about 30 percent – met the criteria for an anxiety disorder.

And a study published in the journal Pediatrics found that between 2016 and 2020 there was a significant increase in the diagnosis of anxiety and depression in children, as well as a decrease in the mental health of those responsible.

How do you know if your child needs help?

If you are concerned that your child may be experiencing anxiety, experts recommend that you consult your child’s pediatrician or general practitioner, who may be able to distinguish between normal anxiety and the type of anxiety indicator of an emerging problem or disorder.

Some levels of anxiety are normal, experts say, and anxiety can have benefits that help keep us safe. Also, there may be times in life when anxiety increases, to normal. And, regardless of the situation, some children tend to be more anxious than others.

But constant anxiety that affects a child’s daily life can be an indication of a disorder. Experts recommend that parents watch out for the following symptoms, especially if they reflect changes from previous behavior:

  • Eating too much or too little
  • Sleep more or less than usual
  • School performance drops
  • Change of relationship
  • Annoyance
  • Anger
  • Sensitivity to criticism
  • Decreased interest in activities
  • Physical symptoms such as headache or abdominal pain
  • Difficulty separating from parents or guardians and avoiding going to school or sleeping alone

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