Food Allergy Counseling: Your Middle School Child’s Food Allergy Fears

Being in Middle School* is a really interesting age for kids. It’s the time that they start becoming more independent in many aspects of their life. Physically they are growing and able to use their bodies in new, powerful ways; think group sports and competitions. Cognitively they are able to handle more complex information, more logic and reasoning; as well as more mature aspects of moral reasoning. Emotionally there are changes, too. In a deeply profound way, ten year old children start noticing and thinking about their place, their role in the larger, outside world.

For children with severe life threatening food allergies, many who have been told their entire lives they could die from a food allergic reaction, the prospect of a fatality takes on a whole new meaning at this age. “Like, I could die, die?”

While five year old children don’t need a more specific context (death doesn’t have the same meaning at that age), a Middle School aged child, who is more aware of the world and their place in it, needs a context for this information and fast. And at this age, they are able to cognitively and emotionally handle more information; in fact, they crave it.

As a food allergy counselor, I believe strongly in giving children information in an age appropriate way so they can integrate their food allergy diagnosis into their sense of self and become independent, self-aware teens with full lives and to continue that integration into adulthood.

One major issue Middle School aged children have is the separation of irrational fears about food allergies and the facts of food allergies. In my food allergy counseling practice, I help Middle School aged children learn how to separate irrational fears from real food allergy risks, a skill set they will need for the rest of their lives.

Firstly, we talk about the fears through drawings or writing stories. If I see them in my office (versus through video chat session), we may play a game to help them process and describe these fears. Fears can take metaphoric forms like fearing the family house might burn down, someone might break into their house or even feeling like there is a ghost following them. I have worked with children with all of those fears. These are essentially fears of the unknown and a profound feeling of a loss of control, which needs to be examined and managed.

I validate Middle School aged children's feelings and fears all along this process: food allergies are real, serious and our feelings around them can be scary. They (the feelings and the food allergies) are also manageable with information, facts and a plan.

Secondly, we explore how a Middle School aged child understands their food allergy diagnosis: what are the facts, as they understand them, what is their plan, as they understand it? Very often children at this age have only pieces of the picture of food allergies, usually the death piece, but not the fuller picture of what food allergies are, how they work in the body (or don’t work) and what a food allergic reaction and its progression looks like.

Many Middle School aged children don’t remember earlier infant reactions or have never had a reaction and were diagnosed through testing as an infant. Without memories they have overblown ideas of what can happen; and with memories they can have even more overblown ideas of food allergic reactions.

Grounding Middle School aged children in the reality of disease management in an age appropriate way can help them learn how to separate reality from fantasy; fact from fiction. Once we are able to introduce this concept to children, I work with them, giving them more tools to calm themselves when they feel anxious and ways to ground themselves in the facts of food allergies.

This is beginning: airing the fears and getting to the facts.

Here are parts twothree and four of this blog series on middle school aged children and anxiety around food allergies.

Here's an excellent post about anxiety, generally speaking, in children, by Karen Young.

*I'm using Middle School aged children to represent the middle school years 8-12.

NB: When fears are not managed, children can suffer or withdraw. If you witness troubling behaviors in your child, please have them evaluated by a local child psychologist, social worker or psychiatrist as well as your allergist and your pediatrician.


Great article! The more "tools" and information kids have, the more empowered they become. And when they feel more empowered, they are more confident and self-advocate for themselves better!

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