Communicating With Play: Helping Adults Recognize Separation Anxiety Disorder and Social Anxiety Disorder In Preschool Children

Senior Project submitted to The Division of Social Studies of Bard College. Despite well-founded and agreed upon evidence showing preschool-aged children experience anxiety (CDC, 2020), children ages 2-6 are continuously understudied, underdiagnosed, and undertreated for these disorders (NIMH, 2019). Researchers attribute this to the primarily cognitive, as opposed to behavioral symptoms of anxiety, communication deficits during the preschool years, and the nature of childhood amplifying already existing barriers to a diagnosis of anxiety. Because diagnosis is the first step to gaining access to mental health resources and early intervention mitigates symptoms and impaired functioning (Barstead et al., 2018), as well as preventing long-term negative outcomes (Hammen et al., 2008; Ramsawh et al., 2011), it is necessary to lift children’s voices to ensure every child receives the treatment they need. To successfully understand and help children experiencing anxiety, adults can use play, the language of childhood to communicate with children. Make-believe play has been shown to be the child’s version of talk therapy, transcribing internal thoughts and feelings of children into visible and verbal action (Segal, 1973). The history and development of play therapy literature suggest playing with children bridges the gap between the direct expression of adults and the indirect expression of children (Pehrsson, 2007). This analytical review will therefore include literature suggesting ways children with anxiety play differently than children without anxiety. Finally, based on this review, a tool will be developed specifically for parents and teachers to recognize separation anxiety disorder and social anxiety disorder through play behaviors and play themes at home and at school