Anxiety and fear in children

Parents teach their children to be cautious of real dangers, such as fire or crossing the road. In these situations, a degree of anxiety is useful because it helps protect the child from harm.

Children can also be fearful of situations or objects that adults do not find threatening. The sources of fear often change as a child matures. For example, a fear of the dark or of monsters under the bed may give way to fears of burglary or violence.

Teasing a child for being afraid, or forcing them to confront a frightening situation, does not work. Instead, help your child by taking their feelings seriously, encouraging them to talk about their worries, telling them the facts, and giving them the chance to face their fears at their own pace and with your support.

Why some children are more fearful#

Some children are naturally more fearful than others. Contributing factors may include:

• genetic susceptibility, where some children are generally more sensitive, which can lead to generalised anxiety
• stressful events, such as parental separation, an injury or a hospital stay

Common fears for babies#

By around 6 or 7 months of age, babies have formed strong attachments to their parents or caregivers. Being separated from their special people, even briefly, can cause considerable anxiety and crying. Many babies also prefer the exclusive company of their special people so much that they go through a phase of being afraid of strangers. Babies grow out of this in time.

Suggestions for helping your baby cope with separation anxiety and fear of strangers:

• when possible at home, take your baby with you from room to room, or talk to them when you are out of sight
• tell your baby when you are leaving the room or going out, and announce your arrival when you return; this helps them learn to trust you
• let your baby get to know new people from the safety of your lap, and show them that you are comfortable with the new person
• if your baby is anxious, reassure them with a calm and confident expression

Leaving a baby to “cry it out” will only make their anxiety worse.

Common fears for toddlers#

Children aged around 2 to 3 years are only just learning to cope with strong feelings such as anger. A common fear for a toddler is being overwhelmed by powerful emotions. Toddlers also have a limited understanding of size and space, so they may develop seemingly irrational fears, such as falling down the plughole or the toilet.

Suggestions for helping your toddler:

• encourage your child to talk about their fears and anxieties
• appreciate that a fear like falling down the plughole feels genuine, because young children do not yet understand size and space
• do not force your child to confront what they fear, as this may make things worse; help them get used to it slowly
• accept that you may need to help your child avoid the feared object for a while

Common fears for children of primary school age#

As a child learns more about the world, the list of things they fear tends to grow. Some fears are real and some are imaginary. Common fears include the dark, burglary, war, death, the separation or divorce of their parents, and supernatural beings such as ghosts and monsters.

Suggestions for helping your child:

• let your child know that you take their fears seriously
• give truthful information on topics such as death or war, and let them know you are willing to answer questions
• encourage your child to face the object of their fear one step at a time, at their own pace; for example, with a fear of dogs you might start with pictures, then a small, gentle dog that is held still, so the child decides how close to get
• allow your child some control; for example, if they are afraid of intruders, make shutting and locking their bedroom window one of their night-time responsibilities

Daily routines and rituals give a child a sense of stability and security, and may ease general anxiety.

Fear of the dark#

Many children are afraid of the dark. Toddlers and preschoolers tend to fear unfamiliar things they do not understand or cannot control. Their active imaginations, and their difficulty telling reality from fantasy, mean they may believe monsters are under the bed or in the wardrobe, waiting to appear once the light goes out. If not addressed, a fear of the dark can linger and disrupt bedtime and sleep.

As with other fears, it is important to respond with sympathy and understanding. Do not ridicule or dismiss your child’s feelings, or become frustrated and angry. The first step is to accept their feelings as real and respond sensitively.

Suggestions include:

• ask your child to tell you about their fears and what exactly makes them afraid
• show that you understand their fears, even though you do not share them
• reassure them that they are safe and explain that there are no such things as monsters
• avoid checking in the cupboard or under the bed, as this may suggest you believe monsters could be there
• if the fear is about intruders, it may help to show your child the security measures around the house, such as locks (but never lock a deadlock while people are inside, as it may block escape in a fire or other emergency)
• ask your child what would help them feel more secure, and offer your own suggestions, such as a special toy or comforter at bedtime
• find out whether the fear of the dark comes from other worries; some children fear their parents separating or dying, and this can feel worse when they are alone in the dark, so talk honestly about such issues

Practical steps#

• establish a relaxing, predictable bedtime routine, which helps reduce anxiety
• put a nightlight in the room, or let some light filter in from the hallway
• give your child control where you can, such as a bedside lamp they can switch on themselves; use a low-wattage bulb
• make sure their television viewing and reading are appropriate to their age, as news footage, films or scary books can easily frighten a child
• look around the room at night from their perspective; is there a picture or toy that casts a creepy shadow in the half-light?
• make sure your child gets plenty of physical activity during the day, as regular exercise helps reduce stress
• do not make a fuss about the fear in front of your child or others, and do not make fun of or belittle it

There are many books on managing childhood fears, for both parents and children.

Reinforce positive behaviour#

Allow your child to take small steps towards overcoming their fear and praise each achievement. When they manage a step, such as staying in bed after you tuck them in, reward them. Toddlers respond well to simple reward systems, such as stickers or stamps on a wall chart.

When to seek professional help#

Sometimes a child is so fearful that it interferes with their daily life and play. Seek professional help if you feel your child is particularly burdened by fears or phobias. Children can be taught to manage their own anxiety, and parents can learn strategies to help.

Key points#

• Some anxiety is useful because it helps protect a child from real danger.
• A common fear for a toddler is being overwhelmed by powerful emotions.
• Do not force a child to confront what they fear, as this may make things worse.
• Handle a child’s fears, including fear of the dark, with sympathy and understanding.
• Seek professional help if fears or phobias interfere with your child’s daily life.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).