As a parent, there are many times that you may become frustrated with your child.  Most times, that frustration will come when you’ve asked them to do something and they simply don’t do it.  It could be the easiest thing in the world, like putting your dirty clothes in the laundry basket when you take them off.  But what do you do when it’s as basic as taking a shower?

Outright Defiance:

Quite naturally, as parents, we assume that the failure to do what you’re told or to do what you know is routine is just defiance.  What parent isn’t guilty of assuming that their child is just simply being defiant and willfully disobedient?  Especially when the task is so simple.  It happens.

When we reduce it to defiance and disobedience, we chalk it up to the age of the child, tantrums, their friends, everything but what it actually could be.  Don’t get me wrong, at times, it is just oppositional behavior.  But when you see a pattern of this, it could be more. 

What Is It, If Not Defiance?:

Sometimes the problem isn’t so simple.  The problem is sometimes more complex than defiance.  At times, the problem is anxiety.  Other times, the problem is depression.  Still other times, the problem is both.

What is Anxiety: 

Look, I’m a parent, too.  To accept that a child, with virtually no trauma in their history, who has a loving family that surrounds them daily and all of the things and experiences that would inspire envy in a large proportion of the adult population, has anxiety is a hard pill to swallow.  But children do experience anxiety, and many times, that anxiety is experienced in profound ways.

The DSM-IV¹American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed., Text Revision). Arlington, VA: Author. defines anxiety as the anticipation of a future threat.  Anxiety is associated with vigilance in preparation for future danger and cautious or avoidant behaviors.  Conversely, the DSM-IV²Id. defines depression as a sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function.³Id.

According to the CDC, 7.1% of children aged 3-17 have diagnosed anxiety; and,  3.2% of children in the same age group have diagnosed depression.⁴Center for Disease Control. (2020 September 12). Anxiety and Depression In Children: Get the Facts. https://www.cdc.gov/childrensmentalhealth/features/anxiety-depression-children.html

While both anxiety and depression can be caused by other conditions, such as trauma, that’s not always the case.

Children Are Experiencing Increased Rates of Anxiety and Depression:

When children face large amounts of worry and fear, some due to family or home life and some due simply to never outgrowing the typical childhood fears and worries (i.e., separation and fear of the dark), it has the ability to impact their home, school, and social life.

I’m not going to go into the litany of anxiety and depression disorders.  Frankly, that’s not my wheel-house.  What I will say is in children, manifestations of anxiety and depression can present in a number of ways.  Additionally, according to the DSM-IV⁵American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed., Text Revision). Arlington, VA: Author., the anticipatory anxiety may occur sometimes far in advance of the upcoming situation, like the night before a big test, or in the weeks before a project is due or grades come out.  Similarly, depressive symptoms can last long after the triggering event occurs.  Moreover, they don’t always manifest themselves where the situation will occur or has occurred.  Simply put, it shows up when it’s time to take a shower, brush their teeth, clean their room, or just sit and have a conversation with siblings and parents.

What Happens To Children With Anxiety and/or Depression:

Do you remember what it was like to be in school?  The pressure to make good grades, the pressure to conform, the pressure to not stand out?  Couple that with the ever-present reality that your social faux pas can be broadcast in real-time for the world and your peers to see, and replay from now until perpetuity, and you can see the landscape your children have to play and learn in.

Consider that children the world over, in response to the novel COVID-19 pandemic, have found themselves cut off from their peer groups, their daily routines, and activities that have the ability to counter depressive thoughts and feelings.  They have been forced into a kind of solitary confinement in some circumstances without any opportunity to weigh-in or participate in the decision-making related to safer at home orders.

Let’s face it.  It’s tough to be a kid and the incidence of anxiety and depression in children grows with the development of each new social media platform and each new natural disaster that we have faced–and we’ve faced a great many in 2020! But what do those conditions actually look like?

What Anxiety and Depression Look Like In Children:

For some children, anxiety will look like:

• Fear and worry, almost compulsive in their discussion;
• Irritability and angry outbursts, about even the tiniest things;
• Trouble sleeping and fatigue;
• Muscle aches and pains;
• Headaches and stomach aches;
• Difficulty concentrating and completing tasks;
• Poor memory;
• Slow reactions and even exaggerated reactions (think, their startle response);
• And more.

Similarly, for some children, depression will look like:

• Feelings of sadness, hopelessness, and irritability a great portion of the time;
• Mild functional impairments to complete incapacity and inability to attend to self-care routines;
• Lethargy and sluggishness;
• Inability or unwillingness to engage in normal discourse and communication;
• Lack of focus and inattentiveness;
• Low motivation and engagement;
• Changes in eating or sleeping patterns (both sharp increases and sharp decreases in either);
• Self-harm, self-destructive, self-sabotaging behaviors;
• And more.

Think about it.  If school gave you anxiety (that test, lunchtime in the cafeteria, changing for physical education, reading aloud, that presentation), and you’re not sleeping because you have insomnia or not eating because you have a stomach ache or just feeling achy all over because your muscles are in a constant state of tension, do you think you would be motivated to do chores?  Do you think that you would be able to sit and concentrate long enough to complete homework?  And if you did do the homework, do you think you would complete it as efficiently as you would if you had been eating properly, resting for the appropriate amount of time, and feeling physically good?  And if you lacked engagement and motivation, would you be able to force yourself to complete these mundane self-care tasks?  The answer is probably ‘no’ to all of those questions.

And, left unaddressed, the cycle of anxiety, shame, and sadness continues.

So how do you help?

Get the Help of a Medical Professional:

First, get your child’s primary care provider involved.  Obtain a full evaluation of your child, as he may be struggling with something else entirely or in addition to anxiety or depression.  It is important to obtain a careful evaluation to get the best diagnosis and treatment plan for her.

Get the School Involved:

Immediately thereafter, engage the school for their assistance and support.  Under the Individuals with Disabilities Education Act (IDEA) (2004), children are entitled, with limited exception, to a free and appropriate public education (also called “FAPE”), including those children with one (1) of the thirteen (13) categories of disabilities outlined in the IDEA (2004).

Broadly, the State, under the Child Find provision of IDEA (2004), must have policies and procedures in place to ensure that children with disabilities residing in the state who are in need of special education and related services are identified, located, and evaluated.  It must also ensure that children with one of these disabilities, with limited exception, has an individualized education program (IEP) or individualized family service plan (IFSP) that provides supportive services and/or program modifications “to enable the child

• (i) To advance appropriately toward attaining the annual goals;
• (ii) To be involved in and make progress in the general education curriculum in accordance with paragraph (a)(1) of this section, and to participate in extracurricular and other nonacademic activities; and
• (iii) To be educated and participate with other children with disabilities and nondisabled children in the activities described in this section….”⁶Individuals with Disabilities Education Act, 20 U.S.C. § 1400 (2004)

Such program modifications and support services could include both academic services and activities and nonacademic services and activities.

This may include residential placement, assistive technology, and extended school year services.

Nonacademic and extracurricular services and activities may include counseling services, athletics, transportation, health services, recreational activities, special interest groups or clubs sponsored by the public agency, referrals to agencies that provide assistance to individuals with disabilities, and employment of students, including both employment by the public agency and assistance in making outside employment available.

Ultimately, the IEP or IFSP will determine the most appropriate service or activity for your child, but the possibilities for creatively supporting your child are almost limitless and will impact your child positively both in and outside of the school.  After all, education is not limited to academics, it contemplates the whole child.

Teamwork for the Benefit of the Children:

Listen, I know there’s a perceived stigma attached to the idea of special education; but, as parents, we desire to build our children up so that they can be multi-faceted, confident, independent, contributing members of society.  We place our whole hearts into this endeavor.  At different times of their lives, that’ll mean recruiting others to assist in the task.  

Each year consists of approximately 6,000 waking hours and children spend roughly 1,000 of them in school, not including after-school programming or extracurriculars.  That is a significant period of time with those who are tasked with their education, why not enlist them in helping you and your child navigate life when they’ve met a challenge?  

The next time you find yourself getting frustrated with your child because another chore has not been completed or they’ve neglected basic self-care routines, consider that it may be more than defiance.

If you believe that your child may need additional support or an IEP and you don’t know where to start, call the Law Office of Erika A. Williams at (866) 495-3796 to schedule a consultation or case evaluation.

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