Stress & anxiety

Are Learning and Attention Issues Risk Factors for Anxiety?

By Child Mind Institute, Understood Founding Partner

Are learning disabilities and attention issues risk factors for anxiety disorders?

Learning disabilities and attention issues like ADHD do put kids at higher risk for developing anxiety disorders. Kids are especially prone to worry before their learning disability or ADHD has been diagnosed. They don’t know what’s wrong. And parents often suspect they just aren’t trying hard enough.

This can create a lot of stress for kids. Once the problem has been diagnosed, parents can help kids manage their ADHD symptoms. Even so, anxiety may be an ongoing problem.

Of course not all kids who are anxious develop a full-blown anxiety disorder. Some kids are temperamentally more prone to anxiety than others. Some may be genetically at higher risk to develop a disorder. Learning and attention issues may create stressors that trigger an inherited risk.

Getting your child help for her learning and attention issues is the first step. But if you notice your child seems to worry excessively, it’s important to get help for that, too.

Learning Disabilities and Anxiety

In young children with an undiagnosed learning disability, anxiety might be triggered in preschool or kindergarten. That’s when reading readiness skills are introduced. A child may suddenly find herself struggling to keep up with other kids. She may be aware of her parents’ concern and anxiety.

Most learning disabilities are identified in grade school. Until a child is diagnosed, she may feel anxious about school. “Kids compare themselves to their peers and feel bad. But they don’t know why,” says Dr. Michael Rosenthal, a pediatric neuropsychologist at the Child Mind Institute. “They’ll say ‘I’m not as smart as the other kids. I don’t like school.’ They become resistant to doing the work. If unchecked it can blossom into a full-blown school phobia.”

Sometimes LD isn’t discovered until a kid reaches junior high or high school. Either the child has fallen through the cracks or she’s covered her weaknesses very well. But that doesn’t mean she hasn’t been suffering.

“Often I’ll hear older kids say, ‘I’ve always felt stupid,’” Dr. Rosenthal says. And while behavioral problems don’t go hand in hand with LD, if a kid has had low self-esteem for a long time and has been anxious about it, she may begin to act out. Adopting the role of class clown, for example, is a way for a kid who isn’t doing well academically to get positive feedback from her peers.

ADHD and Anxiety

Research shows that kids with ADHD are at higher risk than other kids for anxiety disorders. Acting impulsively, interrupting, and not being able to follow rules can result in negative feedback from teachers, parents and other kids. A child with ADHD is more likely to be teased or bullied. Such difficulties can trigger anxiety, especially if a child is already at higher risk.

How Do You Know If Your Child’s Anxiety Is Serious?

If your child’s thoughts and fears are making her life more difficult and are keeping her from doing things other children her age enjoy, it’s a good idea to get help. Other signs that her anxiety is beyond what’s typical:

  • Her worries are unrealistic.
  • Her worries are out of proportion to whatever’s triggering them.
  • She is extremely worried about embarrassing herself.
  • She feels that her worries are uncontrollable.
  • She avoids situations that might trigger her anxiety.

What Are the Symptoms of Anxiety Disorders?

Anxiety disorders take many forms, but these are the most common types and what the symptoms may look like:

Generalized anxiety disorder (GAD) is when kids worry about a variety of everyday things. Unlike adults, children with GAD may not recognize that their fears are extreme. In children the anxiety is often focused on performance in school or sports and may drive extreme studying or practicing. Signs of generalized anxiety disorder include:

  • Worrying excessively about everything, but particularly her own performance in school or other activities, or her ability to meet expectations
  • Frequently seeking reassurance in an attempt to calm fears and worries
  • Anxiety that makes her irritable and restless
  • Physical symptoms, including fatigue, stomachaches and headaches
  • Exaggerated fears about real-life issues like war, school shootings and street crime

Obsessive-compulsive disorder (OCD) is when a child is plagued by unwanted thoughts, images or impulses (called obsessions) that she attempts to control by performing compulsions (ritualized or repeated behaviors). Signs of obsessive-compulsive disorder include:

  • Ritualized or compulsive behavior such as repeated hand washing, locking and relocking doors, or touching things in a certain order
  • Extreme or exaggerated fears of contamination, family members being hurt or harmed, or doing harm themselves
  • Use of “magical thinking,” particularly in young children (“If I touch everything in the room, Mom won’t be killed in a car accident”)
  • Repeatedly seeking assurances about the future
  • Intolerance for certain words or sounds

Social anxiety disorder, sometimes called social phobia, is excessive self-consciousness that goes way beyond common shyness. Kids with social anxiety disorder are so worried about being judged negatively that they avoid doing or saying anything that may cause humiliation. Social anxiety disorder mostly affects adolescents, although it can also begin in childhood. Signs of social anxiety disorder include:

  • An excessive fear of criticism
  • (In young children) Throwing tantrums and crying when confronted with a situation that terrifies them, behavior that can be misunderstood as oppositional
  • Physical symptoms such as shaking, sweating, and shortness of breath that may significantly interfere with daily life
  • Anxiety that may occur well in advance of the dreaded situation

Kids with anxiety disorders respond well to behavioral therapy by itself, or in combination with medications. The earlier it’s treated, the better the outcome. Getting help can make a big difference for both your child and your family.

About the Author

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Child Mind Institute, Understood Founding Partner is dedicated to transforming mental health care for children everywhere.

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