Camp Kidpower Aims to Help Preschoolers Combat Anxiety

Last month for the first time, the US Preventative Services Task Force recommended screening for anxiety in children and adolescents aged 8 to 18 years.

The recommendation is the result of a spike in mental disorders among young children attributed, in part, to the COVID-19 pandemic and increased awareness about mental health, in general. “If screening for anxiety is done at a younger age, treatment can be more effective before it becomes a bigger problem, potentially avoiding some of the more serious issues, like depression and substance use, that can crop up later in life,” says Kate Fitzgerald, MD, a Columbia psychiatrist with expertise in pediatric obsessive-compulsive and anxiety disorders.

Dr. Fitzgerald is leading a study called Camp Kidpower, which enrolls children ages 4-6 exhibiting signs of anxiety in a camp-like program to find out whether structured games or child-led play can reduce their symptoms. Dr. Fitzgerald began the research while she was at the University of Michigan and continued it at Columbia after assuming the Ruane Professorship of Child and Adolescent Psychiatry earlier this year. She is also director of pediatric clinical studies in the Center for OCD and Related Disorders and director of research in the Children’s Day Unit at the New York State Psychiatric Institute.  

How common are anxiety disorders in preschoolers? 

Anxiety disorders can affect children of all ages. A 2014 paper published in the Journal of Clinical Adolescent Psychology revealed that nearly 20 percent of preschool-age children (2-5 years) meet the criteria for at least one anxiety disorder, which may range from social anxiety to separation anxiety. Since the pandemic, rates of anxiety disorders have risen even higher.

How do you know when anxiety in a young child is something of concern? What are the telltale signs and symptoms?

A little bit of anxiety is normal and even beneficial because it shows that kids care. A healthy level of anxiety can help motivate us to try harder, which results in growth. But anxiety winds up being a cause for concern if it consistently gets in the way of doing the typical “jobs” of being a kid. Anxiety-inducing activities often involve meeting new people, going to school, trying something they have never done before, or going somewhere new. When faced with these types of situations, an anxious child may cry, hide, or have a temper tantrum. Young children may also express anxiety physically (e.g., complaining of a stomachache) when they are worried or asked to face their fears.

What kind of anxiety disorders exist in young children?  

At this age, they present in separation, social, and generalized anxiety disorders; specific phobias; or sometimes, obsessive compulsive disorder.

Why is early intervention key and how do treatments for preschool anxiety work? 

Early onset anxiety can get in the way of development because it prevents kids from participating in everyday experiences and learning skills that they need to mature into healthy adults. Early treatment can prevent anxiety from worsening and leading to other problems, including depression and substance abuse later in life. If anxiety does not resolve with encouragement from mom, dad, or teachers, within a few weeks, then it becomes important to treat.

Gold standard treatment involves helping anxious preschoolers practice facing an irrational or excessive fear to learn that the fear won’t come true. This process is called “exposure”. For example, if the child is afraid of speaking to unfamiliar kids, a parent might help a child practice how to invite another child to play. Exposure based-therapy, however, is challenging for preschoolers and their parents since it requires children to “feel the fear and do it anyways.” Clearly, “doing it anyways” is challenging when it comes to fears, which may explain why as many as 50% of children who receive exposure therapy continue to experience clinical levels of anxiety symptoms.   

How does Camp Kidpower work?

At Camp Kidpower, trained counselors encourage children in developing “effortful control skills” that enhance their ability to shift attention and regulate emotions and behavior. They do this through a series of games, like Red Light-Green Light and Simon Says, and other kinds of activities designed to be fun and engaging while exercising effortful control “muscles” in the brain.

How does learning better emotional self-regulation help with anxiety?

The games at Camp Kidpower exercise children’s ability to inhibit inappropriate responses, shift from one action to another, remember goals, and self-reflect in the process. Our ultimate hope is that developing an increased capacity for emotional self-control will allow them to learn to better engage in anxiety-inducing situations and to overcome their fears. 

What can parents do at home to support their children who are suffering from anxiety?

Parents can encourage them to feel the fear and do it anyways! If the fear is excessive and getting in the way of life activities that a child wants and needs to do, then talk with them about this. Make a plan to practice challenging situations and make sure to praise your child for success.

Dr. Fitzgerald is currently recruiting families to participate in the next round of Camp Kidpower (sessions to begin in January 2023). If interested, please email kidpower@nyspi.columbia.edu, call 646-774-5632), or complete this form.