What are Phobias in Childhood?
Phobias in childhood are a type of specific anxiety.
Specific phobias are intense fears about particular situations, objects, or animals. Phobias typically begin to appear in childhood between 7 and 10 years of age. Phobias do not typically go away on their own.
Consider what kind of anxiety your child may be experiencing. Fears that are more generalized across several different situations are not phobias. Many young children have some occasional fears, which is normal.
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Symptoms of Phobias in Childhood
- Worried thoughts: Saying, “There’s a monster under my bed!”
- Avoiding alone time: Expressing extreme fears of being away from caregivers
- Specific fears: Becoming extremely worried when parents go to the basement or walk across the street
- Getting paralyzed: Refusing to go to school or go outside over fears of storms or the wind
- Sudden changes in behavior: Becoming unwilling to do fun things the child used to enjoy over concerns about encountering the feared object
- Won’t go to bed: Struggling to sleep in their bedroom at night
- Visible signs of distress: Seeming physically upset, displaying a rapid heartbeat, red face, sweating, pacing, or acting extremely nervous
Phobias and media exposure
If your otherwise happy child starts exhibiting these signs, they may have been exposed to something scary recently. Consider whether the news has featured recent murders, kidnappings, or violent crimes. Unfortunately, these scary news programs are part of our world. If your child indicates a sudden fear after watching a recent event on television, you can help by listening carefully.
Remind your child, “Although crimes do happen, these news programs do not make it more likely to happen to you. Your school and home are safe places to be. If you need help with your fears, you can come to your parents or teachers. We will keep you safe.” Remind your child that although these are common worries, they are still highly unlikely events.
Sensationalized events in the news can do a lot of damage to our children without parents even knowing. Remember, imagined danger can have the same impact on our psyche and nervous system as actual danger. Once a child’s nervous system is aroused, it can make the fear feel very real, even if there’s nothing happening. The best way to handle this is to keep communication open. Often, using direct and reassuring language can help your child navigate these upsetting events.
Common Childhood Fears
- Fear of the dark: Complaining of the dark and unable to sleep
- Fear of dogs: Fearing dogs so much that they will not go to the park
- Fear of spiders (arachnophobia): Seeming to be unable to stop talking about spiders
- Fear of bugs: Showing intense fear of being bitten by a bug or stung by a bee
- Fear of elevators: Fearing riding the elevator, making you climb eight flights of stairs at the doctor’s office
- Fear of confined spaces (claustrophobia): Getting very distressed in small spaces like crowded rooms, elevators, buses, or trains
- Fear of injections: Becoming inconsolable before receiving an immunization
- Fear of weather: Refusing to go outside if it is windy or raining? Having a deathly fear of tornadoes or storms
- Fear of germs (germophobia): Having an intense fear of getting sick due to exposure to germs, commonly associated with Obsessive Compulsive Disorder (OCD) when compulsive hand washing rituals or cleaning rituals accompany the fear of germs
- Fear of natural disasters: Seeming obsessed over floods, fires, tsunamis, volcano eruptions, or the earth burning up in the sun
- Fear of separation: At certain young ages (8 months,18 months, and 24 months), it is typical for children to be afraid of separation from their parents. Infants and newborns are naturally resistant to separation from their parents. After the age of 2 or so, some children are still terrified of separation, which may result in a diagnosis of Separation Anxiety Disorder
- Fear of ghosts or monsters: Perhaps after watching a scary movie or YouTube video, the child is terrified of monsters; perhaps checking under the bed or in the closet incessantly
Causes of Phobias in Children
The three most common causes of phobias are a fearful first encounter, trauma, and sensory sensitivity.
Kids may not be naturally anxious but if they have an especially disturbing initial interaction with a certain object, they can develop a phobia. Kids who have traumatic experiences of various kinds can have phobias. Finally, kids who are especially sensitive to certain sounds or sensory experiences might develop phobias.
Why are these phobias happening?
Generally, the child felt threatened or had a specific negative experience with the feared object. This fearful first encounter has encoded in your child’s brain in a way that incites a sense of fear and a strong desire to avoid the situation in the future. For example, a child who is afraid of the wind may remember when they had to go into the basement for hours over a tornado warning.
A child who is afraid of dogs or snakes may have been threatened or attacked by an animal in the past. Some young people are simply scared of dogs because of the loud barking noise. These events may have been traumatic, and the child’s neurological system is extremely sensitive to that situation as it arises in the future. If a child is especially sensitive to certain sensory experiences, many events can be scary. A barking dog, fire alarm, siren, or safety drill at school may be extremely upsetting to a sensory-sensitive child.
Other kids may be afraid of monsters or ghosts after watching scary movies, TV shows, or videos. Often, these fears seem ‘out of the blue’ because the parents may not be aware of the event that caused the phobia in the first place.
Kids who have a history of trauma may also develop phobias of various objects or situations. For example, if the child experienced a criminal breaking into the home and hurting family members, a phobia around loud noises or unannounced visitors may develop. Although these fears make perfect sense, the phobia is more debilitating and extreme than a typical childhood fear.
Frequently Asked Questions About Childhood Phobias
What’s the difference between a typical childhood fear and a phobia?
Fears are typical upsets over everyday events; whereas, phobias are extreme and debilitating reactions to specific events.
Some fears are normal. Our bodies are conditioned to scan for threats in our environment and avoid them if we can. It is not unusual for a child to be a little scared of getting a shot at the doctor’s office. During a child’s development, it is common to be a bit afraid of loud noises, dogs, or flying on an airplane. However, phobias are much more intense than typical childhood fears.
Fortunately, even if your child’s fears have turned into a phobia, there are a lot of reasons to be optimistic. Phobias are common in children. Phobias are highly treatable, and most therapists are trained in this area.
Here are a few signs that a common childhood fear has turned into a phobia.
…You find yourself reorganizing your life to avoid flying because your child refuses to go on an airplane. You have to cancel family reunions or other events because of your child’s inconsolable reaction to flying.
…You wait in long lines for the nasal spray flu shot, even though it can be less effective than the shot. Your child nags and begs you not to go to the doctor, having huge meltdowns, or running off in the parking lot.
…You walk to a different park that is a mile away because there will be fewer dogs there. You know that seeing dogs means your child will run away shrieking and crying.
What do phobias look like?
A child with a phobia will have an extreme reaction, a tantrum, or panic symptoms. These symptoms may include hyperventilating, dry mouth, shaking, or sweating.
You will likely be able to see the fear visibly in your child. You may notice that they have wide eyes, cold, clammy hands, and a stiff posture. They may even be getting sick in the presence of the phobia, resulting in avoidance of the stimuli, a tummy ache, heart palpitations, chest pain, nausea, or headache. They may be tapping their feet, pacing, wringing their hands, or becoming red-faced or pale.
Some kids may even get sick in the presence of the phobia, resulting in a tummy ache, chest pain, nausea, vomiting, or headache. The child may start breathing really fast or feel short of breath. They may feel dizzy or lightheaded.
I’m getting so frustrated with my child’s reactions. What should I do?
When a child is experiencing extreme symptoms like these, parents are going to want to meet them with a lot of compassion. These fears are real and intense, even though they seem disproportionate to the situation.
The best thing you can do is to provide a ‘safe container’ for your child. That is, offer comfort and a listening ear without judgment or criticism. Focus on meeting your child’s needs at this moment. Often, under the right circumstances, the fears can pass in a matter of minutes. Of course, the more intense the fear, the harder it is to get it to pass by quickly.
As grandma used to say, “You can catch more flies with honey.” Be patient and gentle when your child is afraid. Reduce your words to something simple like, “I’m here for you” and “You are safe.” Even though this is not easy, an approach like this will help your child calm down more swiftly.
What To Do About Phobias in Children
Treatment includes gradual exposure paired with coping strategies, relaxation, and anxiety reduction. Having the help of a professional is often recommended, and research shows that phobias are relatively easy to treat, so that is the good news!
What is the best treatment for childhood phobias?
Clinicians use something called ‘gradual exposure with response prevention.’
…Gradual exposure is showing just a little of the scary thing at a time.
…Response prevention means to disallow the child from escaping the scary thing.
The gist of this technique is if you show your child just a little bit of the feared item at a time, the anxiety will start to go down. You will want to reassure your child that they are safe and teach them to stay calm rather than running away or hiding.
Why gradual exposure?
What’s happening here is a reinforcing feedback loop in your child’s brain. Let’s say the child is afraid of storms. If they run and hide in the basement, they don’t get a chance to face that fear. If they are outside and get hit by hail in a turbulent storm, the fear gets worse.
This is why therapists introduce the feared item very gradually. As soon as the child realizes they have successfully survived the feared situation, it loses its power. As they do this over and over again, they become less afraid of the stimulus. The more gradually and incrementally you introduce the feared item, the more likely this strategy will work.
Why response prevention?
If your child experiences fear and avoids the stimulus, it reinforces the phobia. They learn that getting away reduces their anxiety. So, you don’t want your child to ‘run away’ from the feared item because they will keep doing so to avoid feeling anxious.
Another type of response prevention is a child who is afraid of germs not being allowed to wash their hands right away. This therapeutic technique is ‘preventing’ the hand washing response so that the child can realize they didn’t instantly get sick after being exposed to the germs.
Over time, the child learns that they do not have to run away or perform a ritual to avoid the fear. Often, especially when kids have overly active imaginations, they will imagine the situation as much worse than it is. When they learn they are safe in the face of the feared situation, they become less and less afraid of it over time.
What to do about fear of dogs
If your child has a dog phobia, here’s where to start as a parent. You are going to want to use the exposure and response prevention method described above.
First, you could read books about dogs and look at pictures while noticing your child’s anxiety level. Do this over several weeks, spacing out the books until your child can read the books without worrying.
Then, watch a familiar dog from a distance without contact. Gradually move to getting closer and closer, making sure the “exposure” is safe and will not traumatize your child.
Next, let a familiar dog sniff your child. Work with your child to get comfortable petting the animal. Of course, you don’t want a child approaching unfamiliar dogs. So, this exercise is best with a neighbor or family friend where you know the dog well.
Although we don’t want our kids approaching unfamiliar dogs, you do want to be able to walk down the street without your child screaming and crying at the sight of an animal.
By exposing your child gradually to the feared animal, you may be able to reduce mild anxiety before it becomes more serious. This regular exposure to the feared object without escaping tends to ease anxiety over time.
Your child may begin to see that they feel better after enduring the feared animal and finding that nothing terrible happened. If, however, the child is already experiencing extreme distress, it may be time to seek out a professional therapist.
What to do about fear of the dark
Approach a fear of the dark similarly, with gradual exposure until your child is quite comfortable and relaxed. Each day or each week, gradually reduce the lights. Your goal is to ‘desensitize’ your child to the darkness.
Start with the lights on; then just a lamp; then a night light, and so on. Every time you reduce the lights a little, make sure your child is safe and calm. If you have to sleep in the same room for a while, go for it. Remind your child that they are safe. Congratulate them every time they endure a little more darkness. Remind them that it is healthy to sleep in the dark as we get better rest this way.
What to do about school refusal with younger children
If your child has developed a sudden fear of school, first try and discover why this is happening. For young children, sometimes the phobic reaction is about not wanting to be away from you. Other times, kids have a little social anxiety, and they feel threatened by the prospect of being around peers all day. In this case, they may dread a specific social situation and fear the entire school day as a result.
Validate your child’s feelings while helping them return to school. The longer your child is out of school, the harder it will be for your child to return. As a parent, this can get out of hand very quickly, so you will want to manage this issue right away.
If your child is afraid of being away from you…
This is a common issue in young children. Preschoolers and kindergartners are often scared to go to school. Here are some mindset shifts you will want to make to help your child with the fear of being away from you.
…A little ‘safe struggle’ is good for our growth, resilience and mental health
…Kids need to learn to be away from their parents because they will not be with you all the time
…Your fears will rub off on them. Work on your own anxiety. Remind yourself that the school is a safe place for kids, and their teachers are able to provide a different environment that you cannot
Once you have that down, you will want to ‘fade out’ your support. In the behavioral literature, we have a tool called ‘fading’. To use a fading technique, you are starting with a lot of prompts and then slowly pulling those back.
A prompt might be verbal, physical, gestural, or based on proximity. Here’s an example:
Verbal prompt: A verbal prompt might be, “Okay, Jack, it’s time for school. You can do it.”
Physical prompt: A physical prompt may be gently holding Jack’s hand or his shoulder to guide him toward the school building
Gestural prompt: A gestural prompt might be opening the car door and pointing toward the stairs for the school
Proximity prompt: A proximity prompt might be sitting with the child on the stairs of the school before expecting your child to go inside.
In my own clinical practice, I have seen parents use this technique to get their kids to go to school. This method works best during the Preschool Years and into early elementary school. The parent starts by reassuring the child verbally. Then, the parent drops their words and provides a physical prompt like holding the child’s hand. Next, the parent provides a gesture like pointing to the door. Finally, the parent sits with the child on the steps of the school or stands nearby as the child walks into the classroom.
Here’s why this approach works. When you are talking too much or providing too much support, the child becomes what we call ‘prompt dependent.’ You are the prompt. The child feels like it’s too scary without you. Because the child is so freaked out, you become nervous too. At that point, it feels really uncomfortable to walk away from the child.
In order to combat all this anxiety, you can start by providing a lot of support and encouragement. Then, gradually pull back. The more consistently and swiftly you use this approach, the better. Once the child is safely in the school building, you need to quickly walk out and not go back. The child will soon learn that they are safe and okay. If, instead, you continue to talk, encourage, and ‘rescue’ the child, the anxiety will only increase. If you are nervous about leaving, partner with one of the administrative professionals. You can call after dropping off your child to see if they made it safely inside. Stay with it and don’t give up, and things will start to get better.
If your child is afraid of being with other kids at school…
This fear of going to school is fairly common. Many kids worry about going to school for fear of having no one to talk to or no one to sit with at lunch. Fortunately, this is typically fairly easy to remedy.
The main solution to this problem is to create a strategy with your child. You will want to know the name of one or two kids your child likes and gets along with fairly well. These do not need to be close friends. Often, in the fall of the school year, kids will not have that many friends in the class. They may not know anyone very well.
In my clinical work, I have had a lot of success using this strategy for school refusal. I talk to the child about other kids in the class they know. I get a few names of peers. Then, the child and I roleplay a scenario.
Instead of picturing walking into this classroom full of strangers, we roleplay a scenario where the kiddo says ‘hi, Ella’ to a friend in the classroom. Then, in the roleplay, Ella says ‘hi’ back, and they sit down near each other. If you have dolls or action figures to use for the roleplay, that can be really helpful. That is generally all it takes. Once the child pictures knowing someone in the classroom, it doesn’t take much to get them to go to school.
As a parent, you can try the same technique. If you are having trouble, a therapist can help use a similar approach or design a treatment plan. As stated throughout this article, you do NOT want to let your child simply avoid going to school. Instead, work diligently on this issue and make sure your child goes to school, even if it is really tough at first. Over time, it gets easier.
What to do about school refusal with older children
The strategies provided above are generally fairly quick with a younger child. However, if you have an older child refusing to go to school, this can get really challenging. Sometimes, a new fear of going to school will emerge in adolescence or early adolescence. Your 7th grader or even your 10th grader may suddenly refuse to go to school. As stated, you do not want to let your child avoid school. The sooner you start and the more consistent you are, the better this will go.
Start with a predictable schedule. Write out your child’s schedule in a place they can see it, such as their bedroom. Write down their morning routine, for example, when they go to school, what happens after school, and the plan for the rest of the day. Try and stick to the schedule.
If your child has been avoiding school for a while, start with a gradual approach. On the weekend, drive by your child’s school. Talk through what it is going to look like on Monday. Remind your child that there will be a reward for going. Do not resort to threats if the child does not go. Instead, remove all reinforcement. That is, if they go, they made a choice to earn privileges. If they don’t go, they made a choice to not earn those rewards. That’s fine either way. Your job is to hold your ground.
Returning to school may look like this:
Monday: 2 hours in the morning
Tuesday: Until lunch
Wednesday: 2 hours before school ends
Thursday: All day
Friday: All day
As your child is returning to school, reward your child with praise, a sticker, or a prize for staying in school.
If at all possible, do not pick your child up before they know you are coming to get them. If, for some reason, your child comes home early, you do not need to punish them. Instead, make sure their time away from school is extremely boring. For example, no phones, no tv, no devices, no special snacks, no games, and no playtime outside. Stick with this for the entire day until bedtime.
Then, tomorrow is a new day. If your child gets up and goes to school, great! Reward that behavior. If not, no problem. Do not reward that behavior. If you are consistent with this, things will get better.
How to know if I am helping my child with phobias
Here is how to know if these strategies are working. If so, you will see that your child is less anxious when they are around their feared object or scary situation.
For example, your child may not love storms, but maybe now they can go outside for a short time on a breezy day. That is a sign of progress.
You will know these ideas are working if your child is starting to feel calmer around the feared object. For example, your child can now sleep in their room with a nightlight and the bathroom door open. These are signs of progress. As noted above, phobias are relatively easy to treat with a bit of support.
When to Seek Help For a Phobia
The fears mentioned in this article are overwhelming and atypical. They are fears that are out of proportion or developmentally inappropriate for the child’s age. Specific fears are only a problem if they significantly impact daily functioning and the ability to enjoy life.
The gradual exposure technique mentioned above may need the support of a professional counselor or psychologist, particularly if the fear is severe and significant. Your child may begin to feel better after just 5-6 sessions with a therapist using gradual exposure strategies.
Fears that seem debilitating, persistent, or exhausting may represent an actual psychological symptom worthy of diagnosis and treatment.
How is a phobia different from anxiety?
In the case of a phobia, a child is not generally anxious, just overwhelmingly afraid of something. This phobia often feels to parents like unreasonable fear, but when the feared object isn’t present, the child feels fine. If your child is scared of many things or nervous most of the time, it may be Generalized Anxiety rather than a specific phobia.
Example of a time to seek professional help
Your child may be so afraid of shots that everyone in the house dreads the annual doctor’s appointment. This child worries for months about the flu shot and often cries for hours or cannot sleep for fear of the shot. The fear leads to a refusal to go into the doctor’s office, a panic attack, or a meltdown at the thought. With therapy, your child can overcome this phobia of injections and experience the doctor’s office without that sense of dread. The good news is that phobias are generally temporary and highly treatable.
Further Resources and Professional Help for Phobias
- Psychotherapist or play therapist: to treat anxiety using exposure treatment in-vivo treatment (teaching your child to be exposed to the feared object and to slowly become calm and relaxed in the face of the object)
- School psychologist: to treat anxiety in the school setting, mainly if the fear is of something like storms that could crop up at school; to look at ways to adjust the setting to lessen anxiety, like an extra support person during tornado drills
- Psychologist or neuropsychologist: to conduct a full assessment to look at symptoms in a mental health context if there seem to be issues such as significant and persistent anxiety
Similar Conditions to Phobias
- General anxiety: anxiety that occurs in many contexts; not necessarily just in the presence of one or a few feared stimuli
- Self-esteem: anxiety that occurs in more than a few situations and is related to the judgments of others. Prolonged anxiety and perception of failure lead to decreased self-esteem and can lead to depression
- Socializing problems or social anxiety: anxiety related to social deficits and trouble reading social cues
References on Phobias in Children
Culbert, Timothy & Kajander, Rebecca. (2007). Be the Boss of Your Stress (Be The Boss Of Your Body®).
Green, Andi (2011). Don’t Feed The WorryBug.
Huebner, Dawn & Matthews, Bonnie (2008). What to Do When You Dread Your Bed: A Kid’s Guide to Overcoming Problems With Sleep (What to Do Guides for Kids).
Huebner, D. (2005). What to do when you worry too much: A kid’s guide to overcoming anxiety.
Kansas Technical Assistance System Network. Fading. https://www.ksdetasn.org/resources/929
Meiners, Cheri J. (2003). When I Feel Afraid (Learning to Get Along).
Peters, D.B. (2013). From worrier to warrior: A guide to conquering your fears.