| Simple Phobias
adults, simple phobias in children are overwhelming fears of specific objects such as an
animal, or situations such as being in the dark, for which there is no logical
explanation. These are very common among young children. One study reported that as many
as 43 percent of children aged six to 12 in the general population have seven or more
fears, but these are not phobias.
Often, these fears go away without treatment. In fact, few children who suffer from
fears or even mild phobias get treatment. However, a child deserves professional attention
if he or she is so afraid of dogs, for example, that he or she is terror-stricken when
going outside regardless of whether a dog is nearby.
Treatment for childhood phobias is generally similar to that for adult phobias.
Combined treatment programs are helpful, including one or more of such treatments as
desensitization, medication, individual and group psychotherapy, and school and family
consultation. Over time, the phobia either disappears or substantially decreases so that
it no longer restricts daily activities.
Separation Anxiety Disorder
As its name implies, separation anxiety disorder is diagnosed when children develop
intense anxiety, even to the point of panic, as a result of being separated from a parent
or other loved one. It often appears suddenly in a child who has shown no previous signs
of a problem.
This anxiety is so intense that it interferes with children's normal activities. They
refuse to leave the house alone, visit or sleep at a friend's house, go to camp or go on
errands. At home, they may cling to their parents or "shadow" them by following
closely on their heels. Often, they complain of stomachaches, headaches, nausea and
vomiting. They may have heart palpitations and feel dizzy and faint. Many children with
this disorder have trouble falling asleep and may try to sleep in their parents' bed. If
barred, they may sleep on the floor outside the parents' bedroom. When they are separated
from a parent, they become preoccupied with morbid fears that harm will come to them, or
that they will never be reunited.
Separation anxiety may give rise to what is known as school phobia. Children refuse to
attend school because they fear separation from a parent, not because they fear the
academic environment. Sometimes they have mixed fears--fear of leaving the parents as well
as fear of the school environment.
Children should receive a thorough evaluation before treatment is started. For some,
medications can significantly reduce the anxiety and allow them to return to the
classroom. These medications may also reduce the physical symptoms many of these children
feel, such as nausea, stomachaches, dizziness or other vague pains. Generally,
psychiatrists use medications as an addition to psychotherapy. Both psychodynamic play
therapy and behavioral therapy have been found helpful in reducing anxiety disorders. In
psychodynamic play therapy, the therapist helps the child work out the anxiety by
expressing it through play. In behavior therapy, the child learns to overcome fear through
gradual exposure to separation from the parents.
Formerly called elective mutism, but was changed in recognition of the fact that a
child does not choose, or elect, to be selectively mute. SM is still called Elective
mutism in other areas of the world. This psychiatric disorder most commonly found in
children, characterized by a persistent failure to speak, so as to be heard in select
settings which continues for a reasonable period of time, usually a month or two. These
children understand language use and have the ability to speak. In typical cases, they
speak to their parents and a few select others. Most do not speak in school or in other
social situations. Generally, most function normally in other ways, although some may have
additional disabilities. Most learn age appropriate skills and academics. Currently, SM is
a condition of severe anxiety or phobia. SM may be associated to a variety of things, but
the exact cause is unknown.