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Sunday, May 29, 2022

Why a US task force is recommending anxiety screening in children 8 and older

The US Preventive Services Task Force released a draft statement in April 2022 recommending screening for anxiety in children and adolescents ages 8 to 18. This recommendation – which is still open to public comment – is timely, given the impact of the COVID-19 pandemic on children’s mental health. The Conversation asked Elana Bernstein, a school psychologist who researches children’s and teen anxiety, to explain the task force’s new draft recommendations and what they might mean for children, parents, and providers.

1. Why is the Task Force Recommending Young Children Investigated?

About 80% of chronic mental health conditions emerge in childhood, and when help is finally sought, it is years after the onset of the problem. In general, recommendations for screening for mental health disorders are based on research showing that youth do not typically seek help independently, and that parents and teachers are always aware of how to correctly identify problems or respond. are not skilled in

Anxiety is the most common mental health problem affecting children and adolescents. Epidemiological studies indicate that 7.1% of children are diagnosed with anxiety disorders. However, studies also estimate that 10% to 21% of children and adolescents struggle with an anxiety disorder and that 30% of children experience moderate anxiety that interferes with their daily functioning at some point in their lives.

This tells us that many children experience anxiety at a level that interferes with their daily functioning, even if they are never formally diagnosed. Additionally, there is an established evidence base for the treatment of childhood anxiety.

The opportunity to potentially prevent chronic lifelong mental health conditions through a combination of early detection and evidence-based treatment certainly informs the task force’s recommendation. Untreated anxiety disorders in children result in additional burdens on the public health system. So from a cost-benefit perspective, the cost-effectiveness of screening for anxiety and providing preventive treatment is favorable, whereas, as the task force pointed out, the disadvantages are negligible.

The task force’s recommendation for screening children under 8 years of age is inspired by the research literature. Anxiety disorders are most likely to first appear during the elementary school years. And the typical age of onset for anxiety is the highest of all childhood mental health diagnoses.

Anxiety disorders can persist into adulthood, especially with disorders that have an early onset and are left untreated. People who experience anxiety in childhood are also more likely to deal with it in adulthood, as well as have other mental health disorders such as depression and decreased overall quality of life.

Discussion of the difference between general anxiety and worry.

2. How can care providers identify anxiety in young children?

Fortunately, over the past three decades, considerable progress has been made in mental health screening tools, including anxiety. Evidence-based strategies for identifying anxiety in children and adolescents focus on gathering observations from multiple perspectives, including the child, parent, and teacher, to provide a complete picture of the child’s functioning at school, at home, and in the community Can you

Anxiety is said to be an intrinsic symptom, meaning that the symptoms may not be observable to those around the person. This makes accurate identification more challenging, although certainly possible. Therefore, psychologists recommend involving the child as much as possible in the screening process based on age and development.

In general, it is easier to correctly identify anxiety when the child’s symptoms are behavioral in nature, such as refusing to go to school or avoiding social situations. While the task force recommended screening in primary care settings, the research literature also supports screening at school for mental health problems, including anxiety.

Of young people who are actually treated for mental health problems, about two-thirds receive those services in school, making school-based screening a logical exercise.

3. How will the screening be done?

Universal screening for all children is a preventive approach to identify at-risk youth. This includes those who may require further clinical evaluation or who would benefit from early intervention.

In both cases, the aim is to reduce symptoms and prevent lifelong chronic mental health problems. But it is important to note that a screening does not equal a diagnosis. Diagnostic evaluation is more thorough and cost-effective, whereas screening aims to be concise, efficient and cost-effective. Screening for anxiety in a primary care setting may include the completion of short questionnaires by the child and/or parent, in the same way that pediatricians often screen children for attention-deficit/hyperactivity disorder, or ADHD. .

The task force neither recommended a single method or tool for screening nor did it specify a specific time interval. Instead, it pointed to several tools such as The Screen for Child Anxiety Related Emotional Disorder and the Pediatric Symptom Checklist. These assess general emotional and behavioral health, including questions specific to anxiety. Both are available at no cost.

A youth anxiety psychologist who experienced severe anxiety as a child talks about how to raise children who can overcome anxiety.

4. What are care providers looking for when screening for anxiety?

A child’s symptoms can vary depending on the type of anxiety. For example, social anxiety disorder involves fear and anxiety in social situations, while specific phobias involve the fear of a particular stimulus, such as vomiting or thunder. However, many anxiety disorders share symptoms, and children usually do not fit neatly into one category.

But psychologists usually see a few general patterns when it comes to anxiety. These include negative self-talk such as “I’m going to fail my math test” or “everybody will laugh at me,” and emotion regulation difficulties, such as tantrums, anger, or increased sensitivity to criticism. Other typical patterns include avoiding behavior, such as a reluctance or refusal to participate in activities or interactions with others.

Anxiety can also show up as physical symptoms that lack an underlying physical cause. For example, a child may complain of abdominal pain or headache or general malaise. In fact, studies suggest that identification of youth with anxiety in pediatric settings may be through the identification of children with medically unexplained physical symptoms.

The distinction we are aiming for in screening is to identify the magnitude of symptoms and their impact. In other words, how much do they interfere with the child’s daily functioning? Some anxiety is normal and is, in fact, necessary and helpful.

5. What are the recommendations for helping children with anxiety?

The key to an effective screening process is to combine it with evidence-based care. One strategy that is clearly supported by research is for schools to establish a continuum of care that includes universal screening, schoolwide prevention programming, and evidence-based treatment options.

The good news is that we have decades of high-quality research demonstrating how to effectively intervene to reduce symptoms and help anxious youth to cope and function better. These include both medical and nonmedical interventions such as cognitive behavioral therapy, which studies show to be safe and effective.

World Nation News Desk
World Nation News Deskhttps://www.worldnationnews.com
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