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The question: My 12-year-old daughter is very fearful. She won't go up to the second floor of our house after dark. She often wakes up at night and ruminates about things. I know this isn't normal, but how abnormal is it? And what should I do?

The answer: It is natural for children to experience anxiety or fearfulness at different points throughout childhood. Sometimes these fears are justified , like the child who avoids dogs after having been bitten. Fears that are irrational, however, can be frustrating. Parental strategies such as begging, pleading, lecturing or punishing the child often don't help and may make the phobia worse.

It is quite common and natural for a child to be afraid of the dark. Fears that keep a 12-year-old from going upstairs sound more severe than normal. The fact that her fear is impacting her ability to perform normal activities (by keeping her on the main floor after dark) is worrisome.

Reassuring the child that her feelings of anxiety are real and not frivolous is a good first step. It may also be reassuring for parents as well as their child to know that fears and anxieties are normal and often improve with time. Offering parental support and working with your child to find strategies to diminish the anxiety may be helpful. In cases like this, in which the symptoms are more pronounced, it would be wise to seek professional help. The availability of child mental-health services varies significantly among communities. Consider contacting your local mental health clinic or a child psychologist in your area. As always, your family physician or pediatrician should be able to help you access services. Don't procrastinate, as fears and phobias can get more ingrained the longer they persist.

Send pediatrician Michael Dickinson your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail website. Your name will not be published if your question is chosen.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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