The US Preventive Services Task Force, an independent panel of primary care and prevention experts, issued its final recommendations on October 11, 2022. Published in JAMA magazinestates that all children and adolescents between the ages of 8 and 18 should be screened for anxiety, regardless of whether they have symptoms. It follows a systematic review that assesses benefits.
The Conversation asked Elana Bernstein, a school psychologist who studies child and adolescent anxiety, to describe the task force’s recommendations and what they mean for children, parents, and providers. rice field.
1. Why is the Task Force recommending that young children be screened?
About 80% of chronic mental illnesses appear in early childhood, it is often years after the problem occurs that help is finally sought. In general, recommendations for screening for mental health disorders are based on research showing that young people typically do not seek help independently. their parents When teacher We are not always adept at pinpointing problems or knowing how to respond.
Anxiety is very common Mental health issues affecting children and adolescents. According to epidemiological studies, 7.1% of children are diagnosed with an anxiety disorderHowever, studies show that between 10% and 21% of children and adolescents suffer from anxiety disorders and 30% of children At some point in your life, you experience moderate anxiety that interferes with your daily life.
This indicates that many children experience disabling levels of anxiety, even without being formally diagnosed. well-established evidence base For the treatment of childhood anxiety.
The task force evaluated the best available studies and concluded that despite gaps in the evidence base, the benefits of screening are clear.Untreated Anxiety Disorders in Children increase the burden to the public health system. Therefore, from a cost-effectiveness perspective, screening and preventive treatment for anxiety are cost-effective, but, as the Task Force noted, the harm is negligible.
The Task Force’s recommendation to screen children by age 8 is driven by research literature.and the typical age of onset Anxiety is one of the earliest A panel of all childhood mental health diagnostics also noted the lack of accurate screening tools available to detect anxiety in younger children. They concluded that there was insufficient evidence to recommend screening for children aged 7 years and younger.
Anxiety disorders can persist into adulthood, especially early-onset disorders or disorders left untreated.People who experienced anxiety as children are more likely to deal with it in adulthood, along with other mental health disorders. like depression and a decline in overall quality of life. The task force considered these long-term effects when making its recommendations and noted that screening children as young as 8 years of age may reduce the preventable burden on families.
2. How can caregivers identify anxiety in young children?
In general, it is easier to pinpoint anxiety when a child’s symptoms are behavioral, such as refusal to go to school or avoidance of social situations. recommended screening in primary care settings such as In-school screening for mental health problemsincluding anxiety.
Fortunately, over the past three decades, significant advances have 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 children, parents, and teachers, and how children function in school, home, and the community. provides a complete picture of
Anxiety is called an internalized trait, and people around you may not see the symptoms. This makes accurate identification more difficult, but certainly possible. Therefore, psychologists recommend including children in the screening process whenever possible, based on their age and development.
Nearly two-thirds of young people actually receiving treatment for mental health problems receive those services at schoolmaking school-based screening a logical practice.
3. How is the screening done?
Universal screening of all children, including those without symptoms or diagnoses, is a preventive approach to identifying at-risk youth. This includes those who require further diagnostic evaluation and those who would benefit from early intervention.
In both cases, the goal is to reduce symptoms and prevent lifelong chronic mental health problems. This is what the task force emphasized in its recommendation statement.
Diagnostic evaluation is more detailed and costly, while screening aims to be simple, efficient, and cost-effective. Screening for anxiety in a primary care setting may include completion of a short questionnaire by the child and/or parent similar to the methods below. Pediatricians screen children frequently for attention-deficit/hyperactivity disorder, or ADHD.
The Task Force does not recommend a single method or tool, or a specific time interval, for screening. Advised to apply to children or situations. The task force noted multiple available screening tools such as: Screening for Child Anxiety-Related Emotional Disorders and the patient health questionnaire screener For Generalized Anxiety Disorder to pinpoint anxiety. These assess general emotional and behavioral health, including anxiety-specific questions. Both are available free of charge.
4. What do caregivers look for when screening for anxiety disorders?
Symptoms in children vary depending on the type of anxiety. For example, social anxiety disorder involves fear and anxiety in social situations, whereas specific phobias involve fear of specific stimuli, such as vomiting or thunderstorms. and children usually do not fit neatly into one category.
However, psychologists usually observe some common patterns regarding anxiety. These included negative self-talk, such as “I’m going to fail my math test” or “Everyone will laugh at me,” and difficulty regulating emotions, such as tantrums, anger, and increased sensitivity to criticism. Other typical patterns include behavioral avoidance, such as reluctance or refusal to participate in activities or interact with others.
Anxiety can also manifest as a physical symptom with no underlying physiological cause. For example, children may complain of stomachaches, headaches, or general malaise. In fact, research suggests that identifying young people with anxiety in a pediatric setting is Identifying children with medically unexplained physical symptoms.
The distinction that screening aims to make is to identify the magnitude of symptoms and their impact. In other words, how much do the symptoms affect the child’s daily life? Some anxiety is normal, actually necessary, and helpful.
5. What are your recommendations for supporting children with anxiety?
The key to an effective screening process is linking to evidence-based care.
The good news is that there are decades of high-quality research showing how to effectively intervene to reduce symptoms and help anxious youth cope and function better. These include both medications or treatment approaches like cognitive-behavioral therapy. Studies Show It’s Safe And Effective.
This is an updated version of . Article first published on May 13, 2022.
