Infancy and Preschool

Anxiety first appears at about 7–8 months of age as stranger anxiety, when an infant becomes distressed in the presence of strangers. At about 12–15 months of age, toddlers show separation anxiety when parents are not nearby. Both of these reactions are typical and indicate that development is progressing as expected. In general, severe stranger and separation anxiety dissipate by the end of the second year of life. Anxiety at this age is primarily associated with fears of strangers, new situations, animals, the dark, loud noises, falling, and injury.

School Age

Up to about age 8, many causes of anxiety continue from preschool levels with a focus on specific, identifiable events. With age, sources of anxiety become more social and abstract, such as worrying about friends, social acceptance, the future, and coping with a move to a new school. Adolescents tend to become more worried about sexual, religious, and moral issues as they continue to develop. In the vast majority of cases, children and adolescents cope well with these situations and severe or chronic anxiety is not common.

The usual signs of anxiety differ between the anxious and non-anxious child primarily in degree, and may be shown in one or more of the following ways:

• • Excessive or atypical for age or developmental level

  • Inappropriate or excessive for the situation on a frequent basis

  • Have persisted for several weeks or months