Dear David Coleman: My four-year-old son is showing signs of anxiousness
Q My four-year-old son is showing signs of anxiety over the last few months, which has escalated the last few weeks.
He chews on things non-stop (his clothes, blankets, teddies, anything he can get his hands on). He has also started putting his hands over his ears when noise irritates him. He talks about feeling sick a lot and going to the doctor. He has spent a fair amount of time in hospitals since he was a baby and up until now, he has taken it all in his stride. Any advice on how to deal with this anxiousness would be much appreciated.
David replies: I wonder if, in fact, your son is anxious, or if his recent behaviour maybe reflects some other issues? For example, the fact that he talks about feeling sick or going to the doctor could just make sense, given that he has spent a lot of time in hospital. It could be his way of connecting back into those experiences since they may have been a large part of what he considers to be "normal" life. It is not necessarily the case that he is worried about being sick, it may be that he almost expects to be sick and to eventually be back in hospital.
The chewing could be for any number of reasons. It may be that he likes the sensory stimulation. It may be that he uses it to self-soothe (a bit like thumb-sucking for other children). Again, given the frequency with which he was in hospital, the objects he started chewing may have had that role of being transitional objects he relied on for comfort when away from home. It may be that it helps him to focus or concentrate. It may also be that it relieves some kind of tension or even anxiety. What is most likely, however, is that no matter why it started, it has probably now developed into a behavioural habit.
What might link it most closely to a sensory-related function for him is the fact that he also seems to be irritated by certain noises, to the extent that he tries to block his ears. Before pursuing too many psychological angles for his behaviour, I would suggest that you bring him to an occupational therapist (OT) to get their opinion.
If these behaviours are anxiety-based, which is a possibility, given the changes in his environment with the frequent hospital stays, then a period of stability and consistency of environment will help - as will talking regularly to him about his experience of change, and helping him to voice the feelings through the empathy that you offer.
If it is the case that the visits to hospital will need to continue, then it will be your warm and consistent presence that will offer him the most security.
Perhaps as he is getting older, he is more aware and can anticipate more, whatever procedures occur in hospital. Because of his age, he may still just need lots of minding.