Signs of Anxiety in Children and How Parents Can Help

Common signs of anxiety in children include worry that does not go away, stomachaches or headaches, trouble sleeping, irritability, and avoiding places like school². Some fear is a normal part of growing up, but when worry lasts, shows up in many situations and gets in the way of daily life, it may be an anxiety disorder^{3, 5}. The good news is that childhood anxiety is very treatable, and parents can play a big part in helping^{6, 8}.

What does anxiety in children look like?

Anxiety is a feeling of fear, dread and uneasiness⁴. Everyone feels it sometimes. In fact, some fears are expected at certain ages. Young children often have short-lived fears of the dark, storms, animals or strangers⁵. These usually fade as a child grows.

An anxiety disorder is different. The anxiety does not go away, it is felt in many situations, and it can get worse over time³. It can start to get in the way of schoolwork and relationships³.

Anxiety is one of the most common mental health conditions in childhood. Based on U.S. data from 2023 to 2024, about 11% of children ages 3 to 17 had a current anxiety diagnosis¹. If your child is struggling, you are far from alone.

Anxiety can take different forms. The CDC describes several common types in children²:

• Separation anxiety: being very afraid when away from parents or caregivers.
• Specific phobia: extreme fear of one thing or situation, such as dogs, insects or going to the doctor.
• Social anxiety: being very afraid of places with people, such as school.
• Generalized anxiety: ongoing worry that is hard to control and gets in the way of daily activities.
• Panic disorder: repeated, sudden waves of intense fear with a pounding heart, trouble breathing, dizziness, shaking or sweating.

Signs of anxiety in children to watch for

Anxiety does not always look like fear. Children often cannot put their worry into words, so it may show up in their bodies and behavior instead. Watch for:

• Worry or fear that seems out of proportion to the situation
• Constant worries about family, school, friends or activities⁵
• Irritability, anger or meltdowns, especially before a feared event²
• Trouble falling asleep or staying asleep²
• Frequent stomachaches, headaches or tiredness with no clear medical cause²
• Avoiding school, parties, sports or other everyday activities⁴
• Needing a lot of reassurance, or asking "what if" questions over and over
• Clinging to a parent or getting very upset at drop-off²

Some anxious children are quiet, obedient and eager to please, so their anxiety is easy to miss⁵. Others keep their worries to themselves². A calm, well-behaved child can still be struggling on the inside.

What the research says helps

Cognitive behavioral therapy (CBT) is the best-studied treatment for anxiety in children. CBT is a type of talk therapy. It teaches children to notice anxious thoughts, find more helpful ways of thinking, and slowly face their fears in small, manageable steps². This gradual practice is called exposure.

A large Cochrane review looked at 87 studies with almost 6,000 children and teens⁷. After treatment, about 49% of young people who received CBT no longer had their main anxiety disorder, compared with about 18% of those on a waiting list⁷. The review found no clear evidence that one way of delivering CBT works better than another, such as group versus individual sessions, or sessions that include parents⁷. It also found little evidence that CBT works better than usual care or other active treatments, so it is not the only option⁷.

The American Academy of Child and Adolescent Psychiatry (AACAP) recommends that CBT be offered to children and teens ages 6 to 18 with common anxiety disorders⁶. It also says that certain medicines, called SSRIs, have considerable research support as safe and effective short-term treatments⁶. For some children, especially when anxiety is severe, combining CBT with medicine may work better in the short term than either one alone, although the research on this is still limited⁶. A health care provider can help you decide whether medicine should be part of the plan².

Parents are part of the solution

Research suggests that changing how parents respond to anxiety can help a lot. Loving parents can easily fall into what experts call family accommodation. That means changing family routines to help a child avoid what scares them. Examples include sleeping with a child who has separation anxiety, or not inviting guests over because a child has social anxiety⁸. Accommodation can calm a child in the moment, but over time it can keep anxiety going⁸.

One study tested a program for parents only, called SPACE (Supportive Parenting for Anxious Childhood Emotions)⁸. In SPACE, parents learn to reduce accommodation and respond with support instead. The study included 124 children ages 7 to 14⁸. The parent-only program worked as well as CBT delivered directly to the child, and parents in both groups reported less parenting stress⁸.

AACAP also notes that family-based work can support a child's treatment by reducing parents' own anxiety and teaching parenting skills that ease anxiety⁶. For very young children, involving parents in treatment is especially important².

What you can do at home

These steps will not replace professional care, but they can make a real difference day to day.

1. Listen and name the feeling. Say something like, "You feel scared about the sleepover. That makes sense." Naming the feeling helps a child feel understood.
2. Show confidence in your child. Pair support with belief: "This is hard, and I know you can handle it." This tells your child you understand the fear and believe they can cope.
3. Notice where you accommodate. Write down the ways your family works around the anxiety, such as answering the same worried question again and again, or letting your child skip activities. Pick one small change to start⁸.
4. Encourage small brave steps. Instead of avoiding a fear completely, break it into tiny steps. A child afraid of dogs might first look at pictures, then watch a dog from across the street. Facing fears gradually is a core part of treatment².
5. Praise effort, not just results. Notice when your child tries something hard, even if it does not go perfectly.
6. Take care of your own stress. Children learn by watching how adults handle worry. Getting support for yourself also helps your child⁶.

When to get help

Talk with your child's pediatrician or a mental health professional if:

• Worries or fears are strong and last more than a few weeks
• Anxiety is getting in the way of school, sleep, friendships or family life⁵
• Your child avoids school or activities they used to enjoy
• Physical complaints keep coming back and a doctor has found no medical cause
• Your family is changing more and more routines to work around the fear⁸
• You simply feel unsure, worried or stuck

The first step is a careful evaluation, so the right diagnosis can guide the right treatment². The U.S. Preventive Services Task Force recommends anxiety screening for children ages 8 to 18, so you can ask about it at your child's next checkup².

If your child ever talks about wanting to die or hurting themselves, call or text 988 right away for free help, 24 hours a day².

How we help at HSCF

At Healthy Solutions for Children and Families, our bilingual team works with children and their parents on worry, fear and avoidance, in English or Spanish. Our psychotherapy for children includes approaches like cognitive behavioral therapy and play therapy, and our workshops and talks for parents offer tools to respond to your child's worries with support and confidence. To learn more, contact us.

Sources

1. Centers for Disease Control and Prevention (2026). Data and Statistics on Children's Mental Health. Centers for Disease Control and Prevention (CDC).
2. Centers for Disease Control and Prevention (2026). Anxiety and Depression in Children. Centers for Disease Control and Prevention (CDC).
3. National Institute of Mental Health (2024). Anxiety Disorders. National Institute of Mental Health (NIMH).
4. National Library of Medicine (2023). Anxiety (MedlinePlus). MedlinePlus, U.S. National Library of Medicine.
5. American Academy of Child and Adolescent Psychiatry (2023). Anxiety and Children (Facts for Families No. 47). American Academy of Child and Adolescent Psychiatry (AACAP).
6. Walter HJ, Bukstein OG, Abright AR, Keable H, Ramtekkar U, Ripperger-Suhler J, Rockhill C (2020). Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders. Journal of the American Academy of Child & Adolescent Psychiatry. DOI: 10.1016/j.jaac.2020.05.005.
7. James AC, Reardon T, Soler A, James G, Creswell C (2020). Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database of Systematic Reviews. DOI: 10.1002/14651858.CD013162.pub2.
8. Lebowitz ER, Marin C, Martino A, Shimshoni Y, Silverman WK (2020). Parent-Based Treatment as Efficacious as Cognitive-Behavioral Therapy for Childhood Anxiety: A Randomized Noninferiority Study of Supportive Parenting for Anxious Childhood Emotions. Journal of the American Academy of Child & Adolescent Psychiatry. DOI: 10.1016/j.jaac.2019.02.014.