Most children experience fears at some time during their lives. In most cases these fears are a normal part of development.

As with adults, it is appropriate for children to be fearful at times. Fears alert us of dangerous situations. For example, parents want their children to be afraid of, and thus stay away from, a growling, snarling dog. It is when such a fear generalizes to a fear of all dogs, or when it becomes so intense that children fear leaving the house, that the fear becomes a problem.

Just because many fears are considered normal does not mean that parents should ignore them. If children's normal fears are not handled correctly they can become excessive and/or can persist into adulthood. Therefore, parents should try to help their children cope with their fears before they become a problem.

Common Symptoms of Fear/Anxiety

Often children are unable to identify what makes them fearful. Children can express anxiety in many ways. Many times these expressions do not seem to be directly related to the actual fear. Here are some of the ways that anxiety can express itself in children:

*Difficulty concentrating. A child who is fearful will often have difficulty paying attention. For example, a fearful child may have problems completing school assignments, listening in class, etc.

*Changes in normal activity level. Children who are experiencing anxiety may be more active than usual, even seeming hyperactive. Or, they may be less active than usual, seeming slow and lethargic. What parents should look for is a change in their children's activity levels.

*Changes in eating habits. Some children who are anxious or fearful have little or no appetite, and as a result eat less than what is normal for them. Other children eat more than usual as a response to anxiety.

*Regression. Many children who are experiencing anxiety will regress in some way. For example, a child who is fully toilet trained may begin night time wetting, or a child who has stopped sucking his or her thumb may start the habit again.

*Changes in sleep habits. Children who are anxious may have difficulty getting to sleep or staying asleep. Children experiencing anxiety may also have more frequent nightmares and/or night terrors.

*Occurrence of psychosomatic (physical) complaints. Children who are fearful may complain of physical ailments such as stomach aches or headaches.

*Wetting/soiling. Children that are experiencing high levels of anxiety may, even if they are fully toilet trained, begin wetting or soiling.

Parents should keep in mind that children experiencing normal fears do not generally experience the above symptoms. When fears become excessive, these symptoms can develop.

What Parents Can Do

There are many things parents can do to help children pass through the stages of normal fears without them developing into phobias.

*Model appropriate behaviors. Children learn many things by watching their parents. Therefore, parents who are fearful often have children who are fearful. Since children learn so much from their parents, parents should try to teach their children how to appropriately handle their fears by doing so themselves. Parents should be careful not to overreact to their fears. Instead, they should confront and deal with them. This way, children will learn that while fears are often normal, they can be dealt with and overcome.

*Don't overreact to children's fears. While parents shouldn't ignore their children's fears, they should also try not to overreact to them. How parents respond to their children's fears can determine whether the fear will continue to be a problem, or be overcome. Parents should respond to their children's fears matter-of-factly, offering support and understanding, but not too much sympathy or attention. Parents should also try not to make changes in their children's lives to accommodate their fears (e.g. canceling doctor's appointments because child is afraid, letting child sleep in parents' bed because he or she is afraid of the dark). Such behavior may inadvertently reinforce fearful behavior. The key is for parents to try to keep life as normal as possible and to help children confront fears as they occur.

*Let children know it's okay to be afraid. It is not uncommon for children to feel guilty or embarrassed about their fears. Therefore, parents need to let their children know that everyone is afraid, even adults, at one time or another. At the same time, parents should make sure that their children know that there are things that can be done to overcome fears.

*Encourage discussion. Sometimes it helps for children to talk about what they are afraid of. Parents should let their children know that they are available to listen and lend support. Very young children are often unable to put their fears into words. In these instances, activities such as coloring, painting, and play-acting can help children communicate their fears.

*Teach positive self-talk. Positive self-talk is saying positive things about one's self to one's self. Positive self-talk is a very powerful tool for children to have. The more children repeat good things about themselves to themselves, the more likely they will be to actually believe them and incorporate the positive feelings that go along with them. Parents can teach their children to use positive self-talk with regard to their fears. For example, a child who is afraid of the dark can be taught to say things like, "I'm not afraid. It's just dark. There's nothing in here that can hurt me."

*Be realistic. Parents should keep in mind that some fears are normal at just about every stage in children's development. While parents can't teach their children to be totally fearless (nor should they), they can help their children learn to confront and deal with their fears so that the fears don't take over children's lives. Parents should also remember that it is normal for fears to recur, and it is also normal for children to "trade in" old fears for new ones.

*Avoid activities that can scare children. Parents with especially fearful children should avoid scary activities like watching scary movies (especially close to bedtime) and telling scary stories.

*Don't scare children into obedience. Parents should be careful not to unnecessarily scare their children to get them to obey. For example, it is not a good idea to say something like, "Stay by my side in the store or a kidnapper might get you." Such statements can create unnecessary fear in children.

*Don't overprotect. Parents who overprotect their children are often setting them up to be fearful. Children must occasionally experience fear to be able to cope with it effectively. This does not mean that parents should go out of their way to introduce potentially scary things to their children. Rather, when children are confronted with things that scare them, instead of whisking them away and immediately making things better, parents should offer support and help their children confront their fears instead of avoiding them.

*Praise and/or reward non-anxious (unfearful) behavior. Starting when children are very young, parents should praise their children's masterful behavior. Parents should praise their children when they try new things, and exhibit responsibility and independence. Parents who are helping their children overcome a specific fear should praise each progressive step they take towards confronting the fear. Parents can also set up a reward system, with specific behaviors resulting in rewards. Such a reward system should be set up and discussed with children in advance.

*Take steps to help children overcome fear. There are many things that can be done to help children confront and overcome their fears:

>Teach relaxation skills. Relaxation skills can help children release tension caused by anxiety. There are various specific relaxation techniques that professionals can teach children. Some techniques involve having children use their imagination to recall or develop positive and relaxing images (e.g., playing outside, being at the beach). Other relaxation techniques involve teaching children to systematically tense and relax various muscle groups. These relaxation techniques must be practiced on a daily basis to be most effective. What relaxation technique is chosen is usually not critical. What is important is that it is comfortable for the child, that it works, and that they stick to it. Parents who think their children might benefit from training in these relaxation techniques should ask their children's health care provider for a referral to a professional who is qualified to provide this training.

>Teach ways to counter anxiety. There are things that parents can teach their children to do when they experience anxiety to counteract it. For example, parents can encourage their children to listen to music when they are anxious or fearful, because music tends to have a calming effect on children. Or, parents can show their children how to distract themselves from their fears. This can involve an engrossing activity like counting pennies, naming all the children in one's class at school, naming all one's favorite foods, etc.

>Gradually desensitize. Parents should encourage their children to confront their fears gradually. The key here is gradual exposure. Parents should let their children set the pace. They should not force their children to do anything they are not comfortable with. For example, a child who is afraid of dogs can begin by reading a book about dogs. Once he feels comfortable, he can then move on to the next step, which could be watching a movie about dogs. The next steps could involve viewing a neighborhood dog that is fenced in, then watching a parent play with a puppy, and the final step could be the child actually touching or handling a puppy himself with a parent nearby. Once the child feels comfortable with the puppy, he or she can move on to interacting with larger dogs. Professional assistance may be necessary to desensitize effectively.

*Seek professional help if problems persist. While most fears in children are both a normal part of development and very common, in some instances fears can become a problem. If fears (either one specific one or being fearful in general) interfere with children's and/or their families' everyday life and continue even though parents have taken steps to help their children cope with them, it is probably a good idea to seek professional help.