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April 17, 2014
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Too Many Tantrums: Could be Childhood Anxiety

If your 3-year-old is having regular meltdowns, or your 4-year-old can’t seem to switch from one activity to another without a major fit, then you may be dealing with an anxious child. Even infants can suffer from anxiety.

Does your young child constantly worry? Does she have frequent temper tantrums that last longer than 15 minutes? Does he repeatedly refuse to take part in normal, daily activities?

It may be more than just a phase. Your young one may be showing symptoms of childhood anxiety.

On Tues., February 28, as part of this year’s OU Seed Sower Lecture series, Dr. Robert Hudson, clinical professor of pediatrics at OU-Tulsa and a practicing physician since 1970, will talk about symptoms of anxiety for youth from birth to age 12. He will also address what all parents and caregivers of children at-risk of anxiety will want to know: what we can do about it.

I had the opportunity to meet with Dr. Hudson on a snowy morning in early January to get a small preview of his upcoming lecture. For the last 10 years of his clinical practice, Dr. Hudson has been seeing and learning about kids he likes to call “not easy.” He emphasized, “If you say ‘difficult,’ you’re implying that there is intent.”  Over the next hour of our conversation, that bit of information – the lack of intentional misbehavior—and, in fact, the genetic basis of being “not easy” proved to be a key point in understanding childhood anxiety and how to overcome it.

Dr. Hudson explains that anxiety is a general feeling of apprehension, dread or distress. All children experience some anxiety at points in their development, particularly when they initially are faced with unfamiliar or highly stressful situations, such as attending a new school or child care center, or being asked to perform some sort of test. Typically, the anxiety will subside as the child adapts to the situation and uses learned skills to make the situation more familiar and manageable. Concern arises when the anxiety is persistent and begins to affect a child’s functioning.

Hudson’s research interest is in discovering why some children successfully overcome potentially anxiety-producing situations and others struggle. His findings point to the importance of resilience, which is “the positive capacity of children to cope with stress and adversity” and is influenced by the child’s environment, cognitive ability, and genetic temperament. For parents of “not easy” children, understanding their children’s temperaments especially represents a golden opportunity for skill development to build resiliency.

“Temperament is stable by 18 – 24 months,” Dr. Hudson said, “and can be tested by 4 months.”

For each temperament trait, there is a range that any given child may fall in, and though, as Dr. Hudson says, “there’s no abnormal temperament,” near the mean of the range, temperament tends not to cause problems leading to anxiety. Outside of the mean and toward temperamental extremes, children may struggle and be at-risk of anxiety due to their natural preferences to behave and learn in ways that are different from what society considers acceptable. Those children outside of the mean of a given temperament trait, which is about 25 – 35 percent of the population, will need help from their parents and caregivers to modify their at-risk traits with skills to develop resiliency.

In our discussion, Dr. Hudson highlights the temperament trait of adaptability, which he identifies as “probably the biggest driver of behavior.”

“Non-adaptable children need to know what is going to happen. They are your ‘no-surprise’ kids,” Hudson said. “If you surprise them, they don’t do well.”

As they grow older, non-adaptive people have issues with impulse control and problem solving, which are executive functions of the brain’s working memory. Yet, Dr. Hudson reminds us that this is not the end of the story: “Temperament doesn’t typically change over time, but individuals can learn skills to better manage their problems.”

So how do we help our anxious children? Dr. Hudson says parents need to know how to teach the kids the skills they need. With clients under the age of 12, Dr. Hudson typically meets with the child only once; all other meetings are with the child’s parents so that they can learn how to teach their child problem-solving skills, which in turn build resiliency. “Parents working with the kids all day every day makes change,” he said.

When in an unfamiliar or stressful situation, children need to know how to get to the point Hudson calls “now what.” Instead of locking up, melting down, and throwing a tantrum because they can’t use one preferred answer to the problem they face, they should be able to draw on skills to identify and use other acceptable answers.

The need for our children to develop problem-solving skills and resiliency is not just to make things easier for us as parents. This issue affects our children’s physical health, too. Stress, which can lead to the response of chronic anxiety, increases cortisol in the body, which over time can lead to immune system problems and other health concerns.

“The symptoms that we see early on are what we ought to be addressing instead of thinking it’s just a phase. It’s probably not just a phase,” Dr. Hudson, explained. And “looking at [highly anxious] behavior as willful, intentful, and judging it morally is counterproductive to helping a child.”

In other words, instead of pressuring our children and ourselves to make them into who they aren’t, let’s get to know who they are, listen to them, and value who they are. At the same time, help them get to know themselves better, including their strengths and weaknesses.

“Don’t go out of your way to make their lives hard,” Dr. Hudson said. “Prepare them.”


Signs that children is struggling because they can’t solve a problem:
• Locking up, so they can’t complete a task, or move forward with an activity.
• Meltdowns.
• Tantrums.

Anxiety: Coping with the Stresses of Everyday Life
Seed Sower Series, 6:30 – 8 p.m.
Perkins Auditorium, OU-Tulsa Schusterman Learning Center
41st & Yale
Feb. 21: “Everyday and Clinical Anxiety in Adults,” Gerard P. Clancy, M.D., President, OU-Tulsa
Feb. 28: “How to Help Anxious Children,” Robert J. Hudson, M.D., Pediatrician, OU Physicians
March 6: “Beyond Normal Teen Angst,” Jana Bingman, M.D., Oxley Foundation Chair in Child Psychiatry, OU School of Community Medicine
Lectures are free and open to the public, but reservations are required. For information and details, go to tulsa.ou.edu.

 

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