well good morning like to introduce our first speaker of the day it's amanda ms inskeep she's a licensed clinical social worker and her passion is helping children of any age learn how to express themselves positively and appropriately regardless of the situation and also help parents to be able to communicate and understand what their children are going through so today a man is going to be speaking on how to speak with the  the anxious child so thank you yes q thank you very much dr steve and you can hear me very well on the camera great so yes we're talking about anxiety today and this presentation is pretty specific t children but that's not to say that there may not be some things to take away that are appropriate for adult relationships as well so speaking about childhood anxiety  to i think it's important to first define anxiety and talk a little bit about what's the purpose of anxiety and why do we feel anxiety so obviously this is the definition of anxiety anxiety a feeling of worry nervousness unease typically about an imminent event or something with an uncertain outcome so we all know the feeling you know when we get we start to get the butterflies in our stomach lee we start to we are we worry about maybe a new job that we have or a difficult conversation with our spouse and worry about health concerns and how does anxiety feel to you anybody want to to help out here yeah how does it thing you gotta go you gotta do something yet we're actually going to talk about that on the next slide a little bit more right ok so increased heart rate increased heart beat you know sometimes people get sweaty and you know they're they're sweating they're hot they're overheated and they need to have that adrenaline rush they need to pace around or move do something right restlessness sometimes stomach pains also difficulty sleeping so now you know you what i imagine what that feels like to a child a little being in this huge world of uncertainty having all of these feelings all of this you know this blood pumping through th this tightness in their test what they don't understand what's going on what is this i don't i don't know what's going on what's happening to me talk a little bit about the purpose of anxiety and fight a fight or flight so why do we feel anxious what is the reason for feeling anxious anxieties our body's way of responding to stressors in our environment when we feel any type of impending danger our stress hormone cortisol is released our heart be quickened blood rushes through our body our muscles tense up this is our body's way of preparing ourselves to stay in either fight the perceived danger or to run away from it is kind of what you're talking about the adrenaline rush i got to go but i do something and you can understand how maybe you know thousands and thousands of years ago when we were all case people and were walking through the the forest in the woods were presented with running into a bear how that response would be immensely helpful for us you know that our blood starts pumping the heart starts pumping our muscles get tense for ready we're either going to fight or we're go when we were you know obviously cave people and having to deal with the dangers in our everyday environment in current society the perceived events which triggering sidey respond to pic do they typically do not require the fight or flight response but that's how our bodies react to it this fight or flight response and the build up of cortisol in our system can frequently make our lives more difficult and obviously the same goes  children as well who don't understand and know how to deal with that so let's talk a little bit more about child having a childhood anxiety and what it looks like one in eight children suffer at some point in their childhood  very age appropriate at that point in time to get upset when mom leaves the room or if dad has to go to war or go or if they're being dropped off at daycare the child cries or tantrums regardless of who is with them it's completely normal and common and part of development from about one to three years of age at around four or five if the child continues to have significant issues separating from the caregiver there may be that that may be the age where it starts to become a little bit more of a problem and when you think about separation anxiety in around that age what happens at five years old they're going to school right exactly so you can understand how that could be a problem when they're crying clinging to their parent making excuses complaining of stomach aches at school and they've been asked to come home early refused to go to school at all and not only is that affecting the child and how they're learning and developing but also the parent because you have to you have to move on with your day have to go to work you have to do with your so you're planning to doing is planning to do as well and that's very difficult to do if there's a child who will not will not go to school without crying cleaning or complete refusing to go then as you the child gets a little older they may develop a social anxiety as you go into the later elementary middle school and early teenage years maybe they feel at this point in time they separate well from their caregivers but they're having difficulty making friends as school keeping in maintaining friendships outside of school they are extremely fearful of participating in class you know that fear that anxiety that comes on when they have to go in front of the class to answer a math problem or raise their hand when called on  difficulty in group situations and what typically happens at that point i see is that the children shut down they fade illness they make excuses they don't want to go to school  grades drop and sometimes you know as children get older and go into the teenage years they're able to hide that a little bit more if they're skipping class if they're you know not going to school the parents might not always know right away may take a little while to figure out ok there's a problem here this something is not right this type of anxiety can significantly impair the child's school attendance and performance as well as their ability to make and maintain friendships which is an important part of the social development as well also when talking about school it's important now to address testing anxiety which is definitely on the rise the child feels overwhelmed with anxiety symptoms when having to when testing he or she is unable to concentrate forget easily in some cases can even get to the point of having a panic attack although these forms of anxiety can show up at any age they're typically as i stated earlier more problematic in their teenage years because teenagers are obviously better at hiding it and able to get away with it they have the ability to skip class to avoid s social situations and oftentimes the parents don't find out until there's detentions or suspensions and now we've already gone down that road we're already at a significant issue and problem we're guy release of that age it's really important to remember though that this anxiety is real to you worrying that the girl next door at that sitting at the table next to you is talking about to or having to demonstrate a math problem is one of the teams that worry some are as much of a big deal but to them they're feeling all of those feelings that you talked about earlier they're feeling their their chest tighten their feeling their heart race they're feeling their sweaty palms and not knowing how to address it their stress hormones are on high alert and it's just as worrisome is as we were talking about running into the barren littlewoods so how do we help and that's  i think it's important to first talk about what not to do and i gave you a little handout with a little more information as we go into some helpful things and how to talk to the child to help  address what is not as helpful to them so when you say that you're anxious or you're feeling upset what's the first thing that somebody typically would say to you and many how what would they say are right ok anybody else relax calm down it's ok it's fine it's not that big of a deal and how do you feel when someone says exactly usually more upset that typically doesn't help us right and we know what how what if somebody said to you tell me more about that what's that feel like to you  they're interested right maybe make you feel a little more calm confident right the same goes for children children do not have the experience and the coping skills that adults have so we must give them the tools for them to be able to overcome the obstacles in their lives themselves and i think that's an important point to to talk about that notice i said them to overcome it themselves not  to do it for them so what not to do yell scream punish them if you don't go to school right now if you don't stop this right now you're not going to do this you're not going to get to do that be little or demean and that's not important it doesn't matter your farai we all just said we all talked about how that's not helpful for us in this ignore and then they'll get over it they're fine you know everything's going to be fine it's it's not a big deal for make promises don't worry i promise you everything's going to be all right i promise you nothing's going to happen can you can you make good on that promise me be a nun and what happens if something does happen you promise me what to do and this goes this is the start of your hand out there number one listen invalidate their feelings give them the words to express themselves if you're dealing with a child if you're talking with a child who's anxious he's too young to understand how to say give them the words teach them feeling words early everyone laughed at me because my now four year old will if he gets upset i blurry for the little good but he's able to tell me how he's feeling because i started him really early with wow you you look at that right now are you disappointed that you didn't get to how to say these things and how to express the for themselves find out why they're feeling anxious it looks like you are afraid are you scared you look worried are you upset sometimes it takes us saying this all over an over and over again ten times in jail a child finally feels hard and can come to the point it's something i'm worried i'm stressed and nervous or i'm sad a lot of times with the young ones i'm sad because they don't have the feelings ok i have you larry to express well i'm actually worried about what's going to happen when you leave or remember that time that mom got in a car accident i don't want her to leave  so the feeling hurt is the very is the most important part of the first that listen validate feeling so that they feel hurt and that you kind of touched on that a little bit about you know i feel cared for when people say i feel like it's caring response but even if you have to say johnny you look worried are you feeling scared five times ten times it's worth it once johnny feels that you're there for him you're giving him your full attention you want to understand how he's feeling and not just to get him over it and moving on you actually want to know what's going on for him then he'll be able to calm down enough to vocalize his anxiety and be certain at this point time to listen without judgment if we said before and i not only that big of a deal for you but to them that's their whole world next the next step is to repeat what they're saying give them the word so after you've listened johnny said i'm upset and scared i'm nervous i hear that you're upset right now i hear you don't want to go to school i hear you're nervous that someone's going to pick on you for your you're glad your new glasses repeat back what they're saying that will help them again feel like they're heard and you understand you understand and you're there for them at this point it's really important to also show empathy say to say to johnny this must be difficult for you no one likes being teased and being made fun of i understand why you would be scared why you would not want to go to school at this point khandaan a little bit he's able to talk with you a little more still feeling anxious that understands that you're there to help you are there listening you are there to do whatever you can to to solve this situation next part is to give them this a little bit of time in to help them through it by offering a solution to the anxiety not the problem at this point in time when does that mean that means teaching coping skills let's take a few minutes sit down take some deep breaths with me let's can you count to ten back let's for an older child that's why don't you go and listen to some music for a little while do you want to write about this you know there's different ways that you can depending upon the age of the child gives them the tolls to help themselves yet again going back to what i said earlier we want them to be able to do this for themselves as they are growing and developing it in order of their learning things we're teaching them to do for themselves not doing it for them to teach them the coping skills help them through it take the day for us with them count backwards from ten whatever works for you the child that you're with to that help doesn't through it and at that point time hopefully you have a contract you have a child who is able to work on the solution to the problem once the child is khon come up with a solution or compromise give the child the tools he or she needs to deal with the problem should it come up but first see if the child can figure out their own solution so for example using the who might tease you what could you do in this situation who could you talk to who would you tell how would you feel after you talk to them see if they can solve the solution on their own first and sometimes you may not get the appropriate answer and that's the part where you can you make this suggestion as well do you think you could talk to a teacher with teacher is is very good at listening with teacher is help happy to help you so at that point time you may have to use your adult was them to be able to help the child come up with the right solution but having the child can help with the solution process and not interfering  doing it for them gives them a sense of self a sense of independence and a sense of pride in themselves as well so being able to be there to help if they need to help  letting them do do it for themselves is important and then practice practice practice like any skill coping skills need practice to you're not going to be the best tennis player the first time that you go to try tennis you're not going to be the best at calming yourself down when you're feeling anxious if this is the first time you're feeling anxious in the first time you're trying these new skills so practice with your child when they're calm when before they before they're feeling anxious any point in time throughout the day you could always practice these things and you can role play as well if johnny subset about bob is teasing is going to tease him to it can i pick on you for a minute i'm go be bob for a minute can you be johnny  case so i'm going to pretend to tease you and if you can just respond how you think would be appropriate to respond to so this is what how i would practice or role play with the child and say ok i'm going to tend to be bob at this point in time you respond how we talked about and how what we went over and let's see how we can do so we're at lunch and we're eating our lunch ok says hey look at johnny's new glasses he looks as stupid because that's what the child told me he was worried about bob saying and you know johnny i actually am very smart because now i work this great so and so the idea is to practice so that the child feels comfortable in that situation and this can you know this is definitely a skill that you can apply to any situation as an adult to when you're feeling nervous or worried about it practicing go over it with somebody roleplay it with the child in the child will feel confident knowing that i have a response to that i knew what to do next it's one thing for you to tell them and to say ok even if they say well i can tell mrs smith or i can say i'm not stupid i'm really smart  they going to in that moment remember and be able to not have that russia things i come over them so that they forget everything when you practiced it and when you roleplay it they're able to feel more confident in that moment so hopefully those solutions and those tools that you have gone over with them previously they're able to use add and then the last part is to speed their cheerleader at that point wow that was such a great response you did awesome i know you're going to do great you can handle it all i'm so proud of you and then talk about how do you feel at this point do you feel better going do you feel better about going to schools  fun things that might happen today school so at this point time the child's come down and thought of some solutions you're redirecting and thinking about more positive things and ok so what next now that you've discussed the situation what can you do to help prevent it from happening again how do we help prevent the anxiety from coming back from a different situation number one i talk to your child regularly how did school go today did you did anyone say anything about your glasses how do you feel what did you do what were some good things that happened give me give me two good so one bad anything like that talk regularly if you have that open communication that's ongoing the child will be able to want to have the words to express these things to you and to know that you're there to to work with them and help them through this if worry is ongoing especially for younger children one way to help them understand to talk about it is to label or personify the feelings and this for example ok so for example is it we're going to keep nervous nellie at home today where is the we're coming back are you starting to feel the butterflies in your tummy and it's important to not do this in a demeaning or belittling way we're not talking down to the child when we say these things we're helping the able to express how they're feeling in a way that they can separate themselves from the feeling in their ngs sidey and then obviously like we talked about before the coping skills are very important practice practice practice take deep breaths with your child count that to backward choose progressive muscle relaxation help them tense up their muscles and and releasing and relax them if they're old enough to teach him to recognise their thoughts and to question  if they're being rational in their thoughts have a game plan work together with your child to determine what they can do to help themselves feel better when confronted with difficult situations in which they fee to when it is anxiety too much how do you know that there is a serious problem and when do you seek out help for that winnings id symptoms significantly impact your daily life if you  routinely late for appointments because of your child's anxiety or any able to go to work you miss work the child misses school and there is a change in your child's grades even if they're not failing are once a b student is now getting seasoned in days there's something going on there there's a problem is that the teacher is that the child we don't know but we should probably investigate a little bit more you know that your child is spending less time with their friends does not want to attend sporting activities one attends sleep overs just stays at home more often is and his or her room are often that's also a red flag sometimes there's physical signs of anxiety persist throughout time difficulty sleeping more than just one night we're talking over the course of a couple months repeated stomach aches or diarrhea sometimes can be a sign that you have an interest child with  you even a significant amount changes in weight the child in their weight their child all the sudden is his gaining a lot of weight or losing weight sometimes hair loss can be a sign of anxiety any change in your child's behavior that concerns you you can call and talk to a therapist most therapists are great about talking over the phone briefly discussing what are your concerns what's the what's going on with your child some will even meet for the first session for free and tell you if you know your child would be appropriate for a place there be art therapy or cognitive behavioral therapy if any of these could help your child learn to effectively manage their anxiety so that it no longer going to do these things and not help then absolutely the child is going to you know have difficulty in struggle in that situation of course we hope that a good teacher would pick up on that and hopefully get the child services in the school there are school social worker school counselors therapists that go to school but that's not always a guarantee i mean some children are better at hiding it than others  difficult age they say that the idea of death being really permanent in children understanding death comes at around seven seven to eight so for the younger child it's much more difficult to for them to grasp and to understand really what's going on the and so as a as there's definitely steps and things that you can do to help the child not feel anxious about the situation the number one suggested intervention at that age would be to role play and to go through the child's experience and if they don't even necessarily remember all of it to help fill in those blanks for them the more they tell the story the more sure yeah one chair able to kind of separate and put that aside i think that takes a lot of emotional maturity as well to be able to do that once your able to separate put it aside and then move on and go through the