Federal panel: screen American kids regularly for anxiety

BOSTON, Mass. — The pandemic, school violence, academic pressure and social media — no wonder American kids are feeling more anxious. That led a federal panel to recommend this week, for the first time, regular anxiety screening in children from ages 8 to 18.

In a draft document, the U.S. Preventive Services Task Force stated such screening would have a “moderate net benefit.” The panel is not advocating screening for kids younger than eight — in part, because of insufficient evidence screening that age group would give accurate information.

“That’s very valid,” said Neha Sharma, D.O., a child psychiatrist at Tufts Children’s Hospital who runs the hospital’s Pediatric Mood and Anxiety Clinic. Sharma suggested regular screening would likely steer many pediatric patients in a proper therapeutic direction.

“The way that kids describe their worries is through headaches, through stomach aches,” she said. “So they actually go down the path of medical work-ups, which is often not as necessary as appropriate treatment for anxiety.”

And spotting anxiety disorders early — and treating them — can spare children and their families potential heartache later on.

As the task force noted, childhood anxiety can lead to future anxiety disorders and depression — and worse.

“Untreated anxiety is also associated with substance abuse,” Sharma said.

Another value of early anxiety screening is that it can sometimes uncover a treatable issue that’s causing the anxiety, Sharma said.

“Half of my job is to figure out whether anxiety is the main problem... or is the child having anxiety because of a learning disability or are there other issues — bullying or trauma,” Sharma said. “A very simple screening can tell you so much about the level of support your child may need. And if they don’t need it, that’s great.”

Screening for anxiety involves the use of clinical questionnaires that can be administered during a child’s yearly wellness visit. But there are also some signs of anxiety parents can be aware of.

“The number one thing about anxiety, especially in kids, is avoidance,” Sharma said. “When there’s a pattern of avoiding certain things, certain behaviors, certain environments — that would be the cue.”

Parents might especially suspect a developing anxiety disorder if the child is avoiding an activity or environment he or she previously embraced — such as playing outside or going to school.

That is not to suggest that “anxiety,” in and of itself, is not a normal human reaction. In fact, it can be totally reasonable for a child to feel anxious from time to time.

“In some ways, it’s part of evolution,” Sharma said. “We are supposed to be anxious about things that scare us, that are scary for our life. So there’s a piece about anxiety that’s supposed to be about survival. But the key is that if somebody’s anxious when there is no threat, then that’s a problem.”

The USPS Task Force is taking public comments on the recommendation for routine anxiety screening for 8 to 18-year-olds through May 9, 2022.

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