How to spot signs of anxiety in school-aged children – CHOC

Worrying about many things can be normal for children. Your child might worry about the dark, loud noises, leaving their parents, trying a new activity, taking a test at school or speaking out loud in class. Most of the time children don’t experience these worries for a very long period of time. However, worrying can become a problem when the worries occur frequently, are difficult to manage or adjust to last awhile, or interfere with a child’s school, social or family life.

Anxiety and/or chronic worry in a young child can sometimes be hard to identify, says Dr. Courtney Kwan, a pediatric psychology postdoctoral fellow at CHOC. Parents should be on the lookout for changes in their child’s behavior or for responses that might be out of proportion to the situation.

Anxiety behavioral warning signs for school-aged kids

Some changes in behaviors that might be a sign of anxiety and/or worry in your child could be that your child is clingier to caregivers than usual. Your child might cry for longer periods of time when trying to separate from their caregiver or they might refuse to talk to or interact with their peers or adults. Your child might be trying to tell you that they are feeling anxious if they are trying to be the center of attention more often than usual and/or all the time. Sometimes a child might avoid starting homework or trying something new for fear that they are going to make a mistake.

“As adults, we sometimes say things like ‘I’m kind of nervous to ask my boss for a raise,’ but adults don’t always act on these thoughts by avoiding talking to our boss or refusing to go to work. In contrast, when our child makes a comment expressing their fear, our child is trying to tell us that they want us to ask about or follow-up about these fears,” says Dr. Kwan.

Anxiety verbal warning signs for school-aged kids

Your child might express fear about being teased for doing or saying something; about not getting a perfect score or acting perfectly; or about disappointing others. Sometimes when a child is anxious, they might express that they feel like they are not good enough or that they are dumb.

“Anxiety in an adult looks different than anxiety in a child,” says Dr. Kwan.

Anxiety physical and emotional warning signs for school-aged kids

For some children, anxiety can make them more irritable or sad, while adults may experience and be more aware of their uncontrollable and intrusive worries and thoughts. A child who is worried might express frequent stomachaches, headaches and nausea but have no idea what is making them feel that way. Additionally, anxious children sometimes have difficulties relaxing and be more fidgety or jittery.

When should I seek help for my child’s anxiety?

Caregivers can ask themselves: Is my child’s anxiety and/or worry making their lives more difficult? Is my child avoiding activities and situations more than usual? Has my child been experiencing more stomachaches and headaches that are not accompanied by other symptoms of a cold or sickness? Has my child been asking for reassurance almost daily when worried?

If your child is demonstrating any of these behaviors, they may benefit from your help. The following are some ways caregivers can help children with anxiety manage, navigate and perhaps even reduce their anxious distress.

Tips to help your anxious child

  • Encourage your child to do the things that them anxious instead of avoiding them. If your child attempts to approach an anxiety-provoking situation, praise and support your child’s efforts.
  • Teach your child relaxation strategies such as deep breathing or progressive muscle relaxation.
  • An anxious child also benefits from opportunities to observe a caregiver handling their own stressful or anxious difficulties in a positive and healthy way. This can model for your child how to stay calm in a feared situation.

If you notice that despite using these tips, your child continues to have difficulty managing or coping with their anxiety, your child may need support from a therapist or mental health provider.

For more information about ways to access outpatient mental health services to support your child’s mental health visit: 

Get mental health resources from CHOC pediatric experts

The mental health team at CHOC curated the following resources on mental health topics common to kids and teens, such as depression, anxiety, suicide prevention, trauma amd more.