New Recommendations Say Anxiety Screening for Children Should Start at Age 8
Like adults, all children experience anxiety from time to time. In many cases, that’s a good thing: Anxiety is a natural emotion that protects us from harm.
But with a recent spike in mental health issues among children, a panel of experts has recommended that children as young as 8 get screened for excessive anxiety.
In a nutshell: The Task Force suggested that children between 8 and 17 years old should get tested for anxiety regularly, whether they show symptoms or not. Currently, these suggestions are open for the public to comment on, and the draft will be finalized later this year.
While the panel isn’t part of the U.S. government, it’s in charge of making recommendations for preventive care. And practitioners tend to take these recommendations seriously.
What does this mean for your child? And what’s the benefit of early screening?
The Mental Health Crisis Among Children
Before the pandemic, mental health concerns and conditions were already common in children. Here are some of the data:
- Between 2013 and 2019, 9.4% of children were diagnosed with anxiety, according to the Centers for Disease Control and Prevention (CDC).
- One in six children, ages 6 through 17, has a mental health condition, such as anxiety and depression, according to an analysis of a 2016 nationally represented sample.
The reason for these high numbers?
It’s a mix of factors, says Janine Halloran, a licensed mental health counselor who specializes in children and author of The Coping Skills for Kids Workbook. As Halloran notes, this includes:
- Improved recognition of mental health issues.
- Greater expectations and pressures for children to excel academically and athletically.
- Nonstop news coverage of scary, threatening events.
- A rise in social media use in children ages 8 to 12.
Of course, the pandemic has made everyone’s mental health more tenuous — and children have borne the brunt of it.
In January 2022, the American Psychological Association reported that “mental illness and the demand for psychological services are at all-time highs, especially among children.” In October 2021, the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association called children’s mental health “a national emergency.”
Emergency room visits for mental health-related issues also went up: Compared with 2019, visits between March and October 2020 rose 24% for 5- to 11-year-olds and 31% for 12- to 17-year-olds, reports the CDC.
Why the spike?
“I think COVID brought out pre-existing anxiety and exacerbated everyone’s mental health difficulties,” says Regine Galanti, a licensed clinical psychologist who specializes in treating children and teens and author of several books, including When Harley Has Anxiety: A Fun CBT Skills Activity Book to Help Manage Worries and Fears.
The pandemic also disrupted children’s day-to-day lives: With school and activity closures, mask mandates, concerns over health and safety, and disconnection from other caring adults, children had to contend with multiple, first-of-their-kind challenges.
In short: Because of these reasons, as Halloran and Galanti note, the unprecedented rise in anxiety (and other mental health conditions) makes complete sense.
How Early Anxiety Screening Can Help
As a parent or caregiver, you know your child best. But it can be tough to tell whether your child’s anxiety is a natural reaction or something to be concerned about. After all, Galanti says, “all kids get anxious sometimes, and 90% of kids will be afraid of something — loud noises, strangers, monsters, dogs, etc.”
When anxiety does become excessive, children may keep their anxious thoughts and feelings to themselves. Unlike other conditions, anxiety doesn’t always have obvious signs.
But an anxiety screening is a simple, quick way to “distinguish between typical anxiety and problematic anxiety,” says Galanti.
Both she and Halloran agree that early anxiety screenings can identify children who otherwise would be missed and get them the support they need.
Early identification and treatment are vital. For example, according to the Task Force’s report, the Oregon Adolescent Depression Project found that the first episode of anxiety tends to occur more frequently in children ages 5 to 12.
What’s more, an anxiety disorder that starts in childhood (or adolescence) increases the chances of anxiety in adulthood. Childhood anxiety may also boost the risk for future depression.
What Anxiety Screening Might Look Like
What can you expect from a screening at your pediatrician’s office?
Really, it depends. There isn’t one set questionnaire that screens for anxiety in children. Your pediatrician might ask you several questions about your child’s behavior, such as whether they:
- Have a tough time leaving your side.
- Worry a lot.
- Have nightmares.
- Struggle with sleeping alone.
- Experience physical symptoms when they’re anxious, such as stomachaches, shakiness, and difficulty breathing.
Your pediatrician may do the screening at your child’s wellness checkup (or during a regular visit, if you’re concerned).
The American Academy of Pediatrics offers tools for assessing anxiety for pediatricians to use.
Information to Keep in Mind
If you’re concerned that your child may be experiencing excessive anxiety, talk to your pediatrician about getting a screening.
But also keep in mind: “The screening process is not perfect,” Halloran points out. So if the screening doesn’t show an issue but you’re still concerned, keep discussing it with your pediatrician. And consult a mental health professional, she says.
Your child may be struggling with something else or have other conditions besides anxiety, such as attention-deficit hyperactivity disorder (ADHD), learning challenges, or sensory processing disorder, adds Halloran. A large-scale study found that from a young age, children with autism tended to have additional conditions, such as anxiety, behavioral problems, and depression.
Bottom line: An anxiety screening is a good first step in detecting potential problems before they escalate. But as Halloran notes, “Families should remember that this is a screening, not a diagnosis.”
Following up with a mental health professional for an in-depth evaluation can help you pinpoint underlying conditions and develop a plan that addresses these treatable issues.
Screening for Anxiety in Children and Adolescents. (April 12, 2022). U.S. Preventive Services Task Force.
Mental Health Surveillance Among Children — United States, 2013-2019. (February 25, 2022). Centers for Disease Control and Prevention.
U.S. National and State-Level Prevalence of Mental Health Disorders and Disparities of Mental Health Care Use in Children. (February 11, 2019). JAMA Pediatrics.
Common Sense Census: Media Use by Tweens and Tweens, 2021. (March 9, 2022). Common Sense Media.
Children’s Mental Health Is in Crisis. (January 1, 2022). American Psychological Association.
AAP, AACAP, CHA Declare National Emergency in Children’s Mental Health. (October 19, 2021). American Academy of Pediatrics.
Mental Health–Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020. (November 13, 2020). Centers for Disease Control and Prevention.
Screen for Child Anxiety Related Disorders (SCARED). (June 2019).Oregon Health & Science University.