Extreme Child Phobias: More Than Fear, Sometimes Dangerous, Even Deadly

Experts say a phobia in childhood can keep kids sick, homebound or in danger.

ByABC News
February 16, 2009, 11:19 AM

Feb. 17, 2008— -- A child absolutely refuses to leave the house after a dog bite; another won't leave her room if a cat is in the building.

In 2005, an 8-year-old U.K. girl in may have starved to death because she refused to open her mouth after a traumatic visit to the dentist.

Yes, children can have phobias too. By definition, a phobia is an extreme, life-disrupting fear, but experts say a phobia in a child can pose special challenges that make them harder to detect and perhaps more detrimental.

"I think we tend to minimize it because we say, 'oh they're just being a kid, they'll grow out of it,'" said Jennifer L. Hartstein, a child adolescent psychologist in New York City who specializes in treating anxiety and depression.

"Yet, the earlier you intervene, the better the prognosis is," said Hartstein.

Below is a list of extreme child phobias, with expert advice on how to recognize and help children facing debilitating fears.

British authorities started an inquest this week into the 2005 starvation death of Sophie Waller, according to reporting by the Daily Mail.

Her parents say Waller developed a phobia after a dentist accidentally cut her tongue during a routine visit when she was 4 years old.

By age 8, Waller was still afraid. According to the Daily Mail, her fears were so extreme that she refused to eat for three days when she learned that she had to go to the dentist again for a cracked tooth.

Her parents and doctors decided to send her to the hospital to pull the cracked tooth, but Waller's parents told the Daily Mail that the doctors decided to pull all eight of her remaining baby teeth at the hospital, instead of the one.

When Waller awoke, her parents said she would not open her mouth to speak or eat and had to be fed with a tube. She continued to refuse to fully open her mouth after she was released. Two weeks later, Waller died in her bed from starvation and dehydration, according to a local pathologist.

The tragedy of Waller's life may be twofold; perhaps the proper medical intervention could have kept her living, and perhaps a therapist could have treated her phobia.

Leo Coning was so terrified of eating solid food that he had to be fed with a tube while he slept, according to reporting by the Edinburgh Evening News.

Finally, by the time Coning turned 5, his family found a clinic in Austria that treated this very fear with controlled liquid food restriction and plenty of solid food. Within a few weeks, Coning was eating like a normal child.

Children may start with a fear of the dark, then get over it and develop a fear of monsters, and continue the cycle with more complex adult fears.

"[Studies] show that even cross-culturally, fears show this kind of progression," said Pincus.

Very young children are likely to have a detachment fear, or fear of the dark, said Pincus. Preschool-aged children fear animals, kids may fear monsters, and tweens or preteens begin to develop social fears and anxiety.

"You actually can notice that the natural progression of fears follows a line of cognitive development," she said.

Luckily, most children who are afraid of bees or the neighbor's Rottweiler grow out of it.

"They're not called a phobia unless it's outside the range of normal," said Pincus. "It can really change the course of a child's life in many ways."

Pincus once treated two brothers who developed a phobia of dogs; one who was bit by the dog and the other, who saw it happen.

She said the brother who watched had a notably more severe phobia, but "both of the kids were refusing to go outside." Apparently the thought of possibly running into a dog on the street or in a neighbor's yard had produced a phobia so severe that the brothers might as well have had agoraphobia.

Pincus estimated about 2 to 4 percent of children have a clinical level of fear that would warrant treatment.

But Hartstein says a true phobia can be worked out, and it could be an easier fear to overcome than many parents think.

Hartstein said many school phobias might be rooted in a more specific fear. Yet children may lack the sophistication to isolate why they are feeling afraid.

"Kids will generalize things much more," said Hartstein. "Kids may be afraid to go to school, because they may be afraid to go to the bathroom in the school."

"I had a girl who was acutely school refusing," said Hartstein. After much questioning, Hartstein realized her patient was actually fearing a bully in her class, but she had generalized the fear into a paralyzing physical reaction to the entire school.

"It went from being in the class, to being in the school, to just being on the block," said Hartstein. "She would stand there and hyperventilate."

"We had to do a lot of work on recognizing that it was a person, not just the class," she said.

In the end, Hartstein said the girl tried again with a different school. "Now she goes to school everyday," she said.

But those with emetophobia literally fear the act of vomiting and often severely restrict their lives just to avoid the possibility of getting sick. Adults with the problem have had trouble going to work, keeping friends or finding dates.

With children, the fear can interfere with school.

"They might refuse to eat certain things, they might restrict their food, they might be afraid to go in cars or public transportation after eating," said Pincus.

Pincus said that a phobia of vomiting is one of the more common phobias she treats, along with a thunder phobia.

"We've had kids afraid of seaweed, kids afraid of hiccupping, kids afraid of costumed characters," she said.

"I treated a child once who was so afraid of pigeons and couldn't go into any major city... she would start climbing on me, or on her parents, or on passersby to be safe," said Pincus. "The minute she walked outside, she used to watch the sky for pigeons in the area."

Using what Pincus calls a "bravery ladder," many anxiety experts ask children to research all possible facts about the object they fear. Then, little by little, the children face their fears until their anxiety dissipates.

"You don't actually have to teach people to relax, in fact it can interfere... the fears have to dissipate," she said. "You need to learn habituation -- you allow new learning to happen in the brain."

Although the pigeon phobia was severe while she had it, Pincus said it was not that difficult to treat.

"The girl who was afraid of pigeons, she went and studied in London," said Pincus. "She sent me postcards over the years of all the places she was with all the pigeons around her."

But having a food allergy may be one case for kids to develop a rationalized phobia.

"I had a girl, who I just treated who had a horrible peanut allergy. So basically she developed this incredibly irrational fear that every food that she had was going to have peanuts in that," said Hartstein.

Hartstein said that treating allergy phobias takes a little extra work to teach the child to take control of their diet and ask strangers a lot of questions about food.

However, for the most part, Hartstein said children's phobias can be easier to treat and have better outcomes than adults.

"You have to challenge the resistance in adults, where in kids are much more trusting," said Hartstein.