How do you help a toddler with anxiety that doesn’t yet have “words”? How do you know what’s normal, what’s not, and what on earth are you supposed to do (especially as a first-time parent)? Last June, I found myself asking these same questions when a strange pattern of behavior in one of my two-year-old twins, Henry, emerged. He’d launch into unusually long tantrums with no apparent cause, kicking, occasionally banging his head for an average of 45 minutes to an hour of screaming nearly every day. We also couldn’t find anything to settle him down. After far too many consults, evaluations, observations, tests, and sleepless nights, we finally found the solution: occupational therapy. After a full year of intervention, I’m sharing the top three tools that have transformed my life with an anxious toddler, thanks to occupational therapy.
First, let’s dive into toddler anxiety. Lindsey Carney is a licensed occupational therapist (OT) and therapy manager at Sensory Solutions, which provides St. Louis families access to occupational, physical, and speech therapy. Lindsey treats a wide variety of children with developmental, behavioral, and sensory difficulties. As a pediatric OT, she aims to provide a “holistic approach to help children participate in their daily lives in a more supportive, meaningful, and functional way.” Because many toddlers can’t express what they’re feeling inside, their outward behaviors can be indicators (symptoms) of anxiety. While it’s entirely normal for a toddler to have a tantrum now and then, when children begin to have difficulty functionally participating in their daily lives, a deeper issue may be at play. Common behavioral symptoms of childhood anxiety include (but are not limited to):
- Intense tantrums or meltdowns lasting 45 minutes or more
- Sensory issues
- Sleep issues
- Intense separation anxiety
- Fear of new situations
- Sensitivity to loud noises or sounds
- Food aversions or picky eating
A telltale sign your toddler’s anxiety is impacting your daily life is if it affects your family in a negative way or prevents you from participating in your normal activities. For example, last year, we were not able to eat in restaurants, go to the library, or attend church without complete meltdowns.
How Occupational Therapists Can Help
Most children will experience anxiety at some point in their lives, and OTs equip caregivers with tools and strategies to handle the emotional rollercoaster of anxiety. She explains: “Occupational therapists can help by teaching children and their families how to manage the emotions during everyday stressors or triggers by adapting the environment and providing caregivers a calming toolbox with tips and tricks to help de-escalate the child more quickly. By helping toddlers with anxiety feel more in control of their bodies, it allows them to function in their everyday activities with more ease.” She also notes that early intervention for childhood anxiety is important as toddler’s brains are easier to rewire and allow them to adapt before entering school years.
Three Tools to Manage Toddler Anxiety ASAP
Have an anxious toddler? Here are the top three (OT approved) tools we use to manage our toddler anxiety in our home:
1. Small Whiteboard
- Use it to write the daily schedule (or just the next 3-4 items for the day).
- Even though they can’t read what you’ve written, giving kids a predictable structure helps them set expectations, stay on task, and reduces anxiety because they know what’s coming next.
- Every morning, I write down a few of the big anchor events and talk about them. I often write a preferred activity (like playing with a favorite monster truck) after a non-preferred activity (like helping put away the breakfast dishes).
2. Sand Timers/Hourglass
- Plastic sand timers are great ways for children to understand the concept of time visually.
- Extra-large timers are durable, often used in elementary classrooms, and come in a wide variety of increments: 1,2,5,10 and 30 minutes
- Sand timers are great to help keep kids on task and can serve as gentle reminders when transitioning to new activities.
- Best of all, they help with sharing. When my boys fight over a toy (which is hourly), I quickly whip out one of the two or 5-minute timers and the “sharing struggle” is solved, because the timer becomes the referee, not me.
3. Calming Box
- In a dedicated basket, toss several different toys your child can quietly play with (only pull it out when your child is upset)
- Other sensory box ideas: stress balls, soft pillows, blankets, spray bottles with water, soft sewing tape measures, rainsticks, or special musical instruments.
- We set aside a specific box of calming or sensory toys for Henry to play with when he’s upset. Inside we’ve placed items he finds soothing. Henry’s favorite go-to calming toy? Squishing spiky stress balls into an empty baby wipes container.
Toddler anxiety is, unfortunately, one of those big scary monsters parents face head-on. Fear not! There is hope. Occupational therapists are an untapped resource, and in my opinion, every child (and parent) can benefit from the methods they teach, regardless of whether they have an official diagnosis. If you sense any red flags or patterns in behavior that concern you, ask your pediatrician! Most pediatricians are more than willing to help you out in any way they can.
Have you worked with an occupational therapist with your little one? What were your biggest takeaways?