The importance of early intervention for child anxiety

ASU professor says catching anxiety early can get children on a healthy mental road to adulthood

November 10, 2015

Children experience anxiety just like the rest of us, whether they’re too nervous to raise their hand in class or to ask a crush out on a date. But not everybody knows what it’s like when those tendencies interfere with daily life, making simple things like going outside or speaking to strangers nearly impossible.

Armando Pina, an Arizona State University associate professor in psychology, says early intervention into a child’s anxiety is important to getting him or her on a healthy mental road to adulthood. Pina has been researching and implementing anxiety-prevention strategies for children in grades 3-5 for the past five years with a program called REACH for Success. Download Full Image

Question: Why it is important to catch anxiety issues early on in a child’s life?

Answer: Targeting anxiety early is important because when ignored it can affect grades, school performance, social and interpersonal skills, and life outcomes. The longer one waits, the more at risk a person is for developing depression and even substance-use problems. In addition, when anxiety becomes a disorder and a more severe problem, it is more difficult to treat and cure. There is no cure for anxiety disorders, but they can be prevented.

Q: You say interventions can be important at specific ages. What might those interventions be, and what could they help overcome?

A: When children are small and show excessive shyness, the intervention of choice is to provide parents with parenting skills to help kids come out of their shell. When kids are older, like in elementary school, the skills taught by our program (REACH for Success) are the recommended approach, but if kids become more severe or are just excessively anxious then they also need medication. Unfortunately, we do not know enough about the long-term effects of medications for kids who are anxious. We just don’t know what it does to a child’s brain as the child grows up into adulthood.

Q: What are the goals of the interventions?

A: The goal of intervening early is to reduce risk and improve resilience. In other words, help kids learn to face their fears gradually and give them tools to do it effectively. Many kids want to be brave and want to feel less anxious, but they don’t know how to conquer their anxiety.

Q: Left untreated, anxiety in children can lead to issues in what areas of development?

A: Anxiety can lead to fewer friends, isolation, poor grades, school refusal, depression and using substances to self-medicate the anxiety. The sad part is that while anxiety is one of the most common problems in kids, other issues like aggression get more attention. All these child problems are important and need to be targeted. We should not ignore the quiet, shy child in the back of the classroom — we need to help that child as much as the one who is acting out on the playground at school.

Pina works in the Department of Psychology, which is a unit of ASU's College of Liberal Arts and Sciences.

Skip Derra

Director, Media Relations and Strategic Communications

480-965-4823 skip.derra@asu.edu

Why children's worries should be everyone's worries

Most people have had times in their life when they’ve been too nervous to raise their hand in class or ask a crush out on a date.But not everybody knows what it’s like when those tendencies interfere with daily life, making simple things like going outside or speaking to strangers nearly impossible.That’s what can happen to someone whose anxiety disorder goes untreated, according to Arizona ...

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Professors working to prevent child mental disorders at ASU find that treating anxiety early can yield great results

Most people have had times in their life when they’ve been too nervous to raise their hand in class or ask a crush out on a date.

But not everybody knows what it’s like when those tendencies interfere with daily life, making simple things like going outside or speaking to strangers nearly impossible.

That’s what can happen to someone whose anxiety disorder goes untreated, according to Arizona State University associate professor of psychologyThe Psychology Department at ASU is part of the College of Liberal Arts and Sciences. Armando Pina.

“Anxiety is a normal emotion that everyone experiences. But sometimes anxiety gets a little bit out of control. And sometimes it gets very out of control. And once it begins to get out of control or impair kids, then it begins to affect other areas of their lives,” he said.

Pina has been researching and implementing anxiety prevention strategies for children in grades three through five for the past five years with a program called REACH for Success.

“This is one of the most common problems in kids, period,” said Pina. “The prevalence of anxiety ranges from something like eight to 12 percent, and as high as 35 percent in adolescents.”

The program was developed as part of a grant funded by the National Institute of Mental Health.

Through REACH, Pina and fellow researchers work with local school districts to distribute materials and train teachers and school psychologists on how to use them to prevent and treat symptoms of anxiety in at-risk children.

The trial time for the program at each school is six weeks long and is comprised of six, 20 minute sessions in which students utilize materials such as board games or a mobile applicationPina’s team worked with associate professor Kevin Gary and assistant professor Ashish Amresh in ASU’s Ira A. Fulton Schools of Engineering to develop the app. — which has just recently begun testing in schools — to learn tools necessary for coping with anxiety.

After the six week trial, children showed significant reductions in worries, improvements on emotion displays and expressions, and more confidence in coping with stressful situations at school.

Armando Pina (third from left) and his team at ASU's
Department of Psychology have worked to implement
the REACH for Success program at local schools to
help children cope with symptoms of anxiety.

Photo by Ryan Stoll

When they were evaluated a year later, the results were even better; the children showed greater reductions in anxiety (as rated by the child and their parent/s), even fewer body signs of anxiety (such as their heart beating fast, sweating, stomachaches) and better social skills. The children showing the most reductions in worries also began to perform better when taking tests.

The program, said Pina, is unlike any other before it.

“We now have a streamlined, simple, quick way to help kids that can be used in the schools. This program was designed for delivery in the schools by school staff because when we leave, we want them to still be able to do it,” he said. “And we have results that show that it works.”

It also addresses the issue of anxiety at a time that is most crucial.

“Third graders, fourth graders, fifth graders … that’s a developmental period where kids are changing really fast, and that’s really the best time (to intervene),” Pina said, because, “anxiety typically doesn’t go away by itself. And it interferes with kids’ abilities to make friends, to develop meaningful relationships with peers, to develop social skills.

“These kids, if you don’t help them, go on to develop depression and many of them become addicted to substances.”

The issue of children’s mental health in general is something Pina believes everyone should care about.

“Whether you have kids or not, kids are going to grow up and they’re going to move society forward," he said. "They’re going to be your doctors, they’re going to be your teachers; that’s the future. It’s very simple.”

With that in mind, Pina is looking forward to attending an upcoming fundraising event at Phoenix Children’s Hospital.

The event is being hosted by the Institute for Mental Health Research, with co-sponsorship from ASU’s Department of Psychology, and will feature a lecture by prominent child psychiatrist Judith Rapoport.

Rapoport, chief of the child psychiatry branch of the National Institute of Mental Health (NIMH), will discuss important research advances that are improving the treatment of children with mental health disorders.

“It’s a good cause that supports faculty and researchers and families, not only that are linked to ASU but to the community in general,” said Pina. “It’s a good, solid community event.”

“An evening with Judith Rapoport” will take place from 6 to 8 p.m., Thursday, Nov. 5, at the Phoenix Children’s Hospital, Mel Cohen Conference Room in the Rosenberg Children’s Medical Plaza.

For the past five years, Armando Pina and his team of researchers at ASU have been working to treat and prevent childhood symptoms of anxiety disorders in local schools. The program they have developed, REACH for Success, is unlike any other before it; it is streamlined, easy-to-use and, according to Pina, it works.

Photo courtesy Armando Pina

REACH board games like this one, called "Worryheads," (also pictured above) help teach children tools to cope with anxiety by having them come up with solutions to everday problems.

Photo courtesy Armando Pina

The recently developed mobile application for REACH allows children to access anxiety-coping tools at the touch of a screen.

Photo courtesy Armando Pina

Various tools, such as "relaxation," guide children through exercises to assist in coping with anxiety.

Photo courtesy Armando Pina

Children can use the app to write entries in a diary, teaching them valuable tools for coping with anxiety that they take with them throughout their lives.

Photo courtesy Armando Pina