You may be thinking, “Eight is way too young” to have anxiety. But data shows about 7.1% of kids 3-17 have anxiety problems. For the first time, the US Preventive Services Task Force (USPSTF) recommends kids 8 and up be screened for anxiety.
The new recs say physicians should screen children 8-18 years old who don’t have a diagnosed mental health condition and who are not showing symptoms of anxiety (more details below). The group also reiterated their 2016 recommendations that children 12 and older should be screened for depression.
The goal is to reduce the number of children with mental health conditions who go undetected and untreated. FYI: The USPSTF noted it didn’t have enough research to recommend anxiety screening in children 7 and under or depression screening in children 11 and under. We read through the report to break down what you need to know. But first, a refresher on why they’re even focusing on anxiety in the first place...
What do we know about anxiety in children?
There are different types of anxiety disorders in children and teens: generalized anxiety disorder (GAD), social anxiety disorder, panic disorder, agoraphobia, specific phobias, separation anxiety disorder, and selective mutism.
Anxiety in kids is on the rise
CDC data shows about 5.8 million children 3-17 years old were diagnosed with anxiety, and about 2.7 million were diagnosed with depression between 2016 and 2019. But there are signs that mental health issues have gotten worse since the pandemic. Weekly visits to emergency departments in children 5-17 increased for self-harm, drug poisoning, and psychosocial concerns during 2020, 2021, and 2022 when compared to 2019. And last year, the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry called the mental health crisis in kids a national emergency. The AAP said doctors “witnessed dramatic increases in emergency department visits for all mental health emergencies, including suspected suicide attempts.”
Plus, the US Department of Health and Human Services published a study this year that showed the number of kids 3-17 years old diagnosed with anxiety grew by 29% from 2016 to 2020.
Mental health disorders like ADHD, anxiety, and depression are more common among older kids. One study that looked at the 2016 National Survey on Children’s Health found that anxiety was most common in kids 12-17 years old. Separation anxiety, selective mutism, and GAD are more common in younger kids (during preschool and early school years). Social anxiety and specific phobias usually happen in older kids.
Risk factors for anxiety
There can be genetic and environmental factors. Anxiety disorders can run in families, and having a close relative with a mental disorder could mean you’re at a higher risk. (PSA: That doesn’t necessarily mean someone will develop a mental disorder because their relative has one).
Environmental risk factors include things like parents’ separation, socioeconomic status, and traumatic events like child abuse or the death of a loved one.
Data shows certain groups (like sexual and gender minorities) are more likely to struggle with mental health issues. The 2022 National Survey on LGBTQ Youth Mental Health shows that 73% of LGBTQ people aged 13 - 24 experienced anxiety symptoms.
The panel’s report said adverse childhood experiences impact the likelihood of having anxiety, and racial discrimination plays a role. Those experiences could be “potentially traumatic events that, in the context of historic trauma and structural racism… can worsen mental health outcomes.”
What does screening for anxiety in children look like?
The panel gave very little direction here. So it’s up to the pediatrician.
There are a variety of questionnaires doctors can use; some screen for specific types of anxiety disorder, and others are broader. Two screening tools used to identify anxiety in kids include SCARED (not an intimidating name at all) and the Patient Health Questionnaire-Adolescent. The panel recommends pediatricians find a screening tool that best fits their practice.
The panel also didn’t say when or how often these screenings in children should take place. (Again, up to the doc to come up with a plan). But experts say they’ll most likely screen kids during their annual checkups.
Heads up: These screenings aren’t enough to officially diagnose a child with anxiety. The panel says there should be a follow-up assessment to confirm the results (either with your pediatrician or a mental health professional).
What can parents do to help their kids who may be struggling?
The new screening rec is for pediatricians. But parents know their kids best, and they play an important role when it comes to their kid’s mental well-being.
Talk to your pediatrician
Reach out to your pediatrician with questions about screening your kid for anxiety. Or any other concerns you have about your child’s mental health.
Know the signs that your child could be struggling
Anxiety symptoms could include:
Headaches or stomachaches
PS - We spoke to mental health experts about signs of distress in kids and how to know they need professional mental health support.
Keep open communication with your child
It’s important to not just talk but to listen.
“Kids are developing. There's a lot of things that they don't know yet, and they look to their parents to help them and as role models. [Having] good communication with your child teaches them that they can come and talk to you. So then when really serious things happen, they know that they [can] talk to the parent about it, and they figure it out together. You don't have to have all the answers as a parent, but you have to show up and be present,” said Lisa M. Horowitz, Ph.D., MPH, a pediatric psychologist and senior associate scientist at the Intramural Research Program at the National Institutes of Mental Health.
And it’s ok if kids choose to talk to another adult they trust (yes, it doesn’t have to be you). This could be an aunt or uncle, a school counselor, a coach, or a teacher.
New recommendations to screen all kids as young as 8 for anxiety highlight the mental health crisis in children and teens in the US. The hope is that pediatricians can use screenings to identify struggling kids earlier and get them help. In the meantime, there are ways for parents to support their children and make sure they’re getting the help they need.
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