Anxiety is a natural part of growing up, but for some children, it can become overwhelming – affecting their health, behavior, and everyday functioning. Recognizing when anxiety goes beyond typical childhood worries is crucial. That’s where a Childhood Anxiety Symptoms Checklist can help.

Unlike adults, children often struggle to express what they’re feeling, so anxiety might show up through physical complaints, avoidance behaviors, or emotional outbursts. Parents, teachers, and caregivers need a clear understanding of what to look for – especially since early intervention can dramatically improve a child’s quality of life.

This checklist, grounded in psychological research and clinical experience, outlines 15 of the most common signs of anxiety in children. If several of these symptoms appear consistently and interfere with daily life, it may be time to consult a professional. As a team of child and adolescent specialists at Wellness Road Psychology, we’ve helped many families navigate the path from uncertainty to clarity – and healing.

Let’s dive into what childhood anxiety looks like, why it happens, and how you can support your child effectively.

 

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Understanding Childhood Anxiety

What Is Childhood Anxiety?

Childhood anxiety refers to excessive fear, nervousness, or worry that persists over time and interferes with a child’s normal activities, relationships, and emotional well-being. While it’s normal for children to experience certain fears at different developmental stages – like being afraid of the dark or feeling shy on the first day of school – clinical anxiety goes beyond temporary nervousness.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), anxiety disorders in children include generalized anxiety disorder (GAD), separation anxiety disorder, specific phobias, and social anxiety disorder. Each has distinct symptoms, but all involve a level of fear or worry that’s disproportionate to the situation and difficult to control.

Children may not say, “I’m anxious,” but instead might say “I feel sick,” “I don’t want to go,” or act out behaviorally. This makes anxiety easy to miss or misinterpret as defiance, laziness, or even attention-seeking.

Very Important: The same disorder can look very different in a 6-year-old vs. a 12-year-old. Developmental context matters.

Why Early Detection Matters

When anxiety is identified early, children are more likely to respond well to treatment and develop resilience. Left unchecked, anxiety can impact every area of life –  from falling behind in school, to avoiding friendships, to developing physical symptoms like headaches or stomach pain.

Research shows that untreated anxiety in children can predict anxiety and depression in adulthood, poor academic performance, and increased risk of substance use disorders later in life (Costello et al., 2003).

Early detection also means parents can begin natural treatment options before anxiety becomes more entrenched. These can include cognitive behavioral therapy (CBT), parent coaching, mindfulness, and structured routines that help reduce stress triggers.

When in doubt, it’s better to assess than to assume your child will “grow out of it.”

Physical Symptoms

One of the most overlooked indicators of anxiety in children is physical discomfort. Unlike adults who may verbalize their worries, kids often experience anxiety in their bodies – and they may not even realize it’s anxiety.

These symptoms can be especially pronounced in school-age children and preteens, who are old enough to be exposed to academic, social, and performance pressures, but may not yet have the emotional vocabulary to express internal stress.

Here are four of the most common physical symptoms:

1. Stomachaches (Especially Before School or Events)

Children with anxiety frequently complain of stomach pain, especially on school mornings, before tests, or during field trips and after-school activities. School-age children might say “my tummy hurts” instead of “I’m nervous.” Preteens, facing more peer-related stress, may report these pains when anticipating bullying or public speaking in class.

Research published in the journal Pediatrics found that children with functional abdominal pain had a significantly higher risk of developing anxiety disorders in adolescence and adulthood. (Campo et al., 2014 – Pediatrics).

2. Headaches

Tension headaches often occur after a long school day, especially if the child has spent it trying to mask their anxiety. Preteens who are starting to feel the pressure of academic performance might complain of headaches before exams or during group work. Younger children might struggle to describe the sensation and just act irritable or lethargic.

3. Fatigue

Chronic anxiety can drain a child’s energy. A 10-year-old might appear sluggish getting out of bed on school days but seem fine on weekends. Preteens juggling extracurriculars and school demands may feel emotionally overloaded and physically exhausted, often mistaking this for “just being tired.”

4. Muscle Tension or Restlessness

School-age children with anxiety might clench their fists under their desk, grind their teeth at night, or constantly shift in their seat. Preteens may hold tension in their shoulders or neck, leading to posture issues or frequent complaints of feeling “tight” or uncomfortable.

Emotional and Cognitive Symptoms

While physical symptoms may be easier to spot, the emotional and cognitive signs of anxiety often reveal the deeper internal struggles a child is facing. These symptoms can appear as persistent fears, negative thinking patterns, or excessive worry that disrupts daily life. In school-age children and preteens, these thoughts often go unspoken – but their effects show up in behavior, school performance, and mood.

Here are four emotional and cognitive symptoms to watch for:

5. Excessive Worry About Everyday Situations

Children with anxiety may constantly worry about things most kids wouldn’t think twice about  –  getting bad grades, being late, or something bad happening to their parents. These worries can become all-consuming. A child might ask repeated “what if” questions or seek constant reassurance. Preteens may express concerns about the future, health, or even global events.

Studies have shown that children with generalized anxiety disorder experience persistent, uncontrollable worry that interferes with their functioning in multiple domains of life. (National Institute of Mental Health – GAD in Children)

6. Fear of Separation from Parents or Caregivers

Though some separation anxiety is expected in young children, persistent fear that extends into the school-age years may signal a problem. These children may dread school drop-off, panic when a parent leaves the room, or refuse to sleep away from home. Preteens may become unusually clingy, texting or calling parents repeatedly during the day.

7. Fear That Something Bad Will Happen

Children with anxiety often catastrophize – believing that the worst-case scenario will definitely happen. For example, a child might believe a parent won’t come home from work, or that failing one quiz means they’ll never succeed in life. These thoughts can create paralyzing fear and avoidance.

8. Perfectionism or Harsh Self-Criticism

Anxious children often set unrealistically high standards for themselves and feel intense shame or failure when they don’t meet them. A preteen might erase homework multiple times to get it “perfect,” or become upset over minor mistakes. They may call themselves “stupid” or “a failure” even when doing well, especially if comparing themselves to peers.

​​Behavioral Symptoms

When anxiety builds up internally, it often shows up in external behaviors. These behaviors can be confusing or frustrating for parents and teachers, especially when they seem like defiance or disobedience. In reality, many anxious children are doing their best to manage overwhelming internal distress through avoidance, rigidity, or outbursts.

Here are four behavioral symptoms that often point to underlying anxiety:

9. Avoidance Behaviors (School Refusal, Social Withdrawal)

Avoidance is one of the most telling signs of anxiety. A school-age child might suddenly refuse to go to school, pretend to be sick, or cry at drop-off. Preteens may begin to isolate, avoiding extracurricular activities, birthday parties, or even outings with family. These behaviors aren’t about laziness or antisocial tendencies – they’re often attempts to escape environments that trigger intense worry.

This can be especially true in cases of teenager anxiety, where peer interactions become more complex and emotionally charged.

10. Trouble Sleeping Alone or Frequent Nightmares

Anxious children may have a hard time falling asleep or staying asleep. They might insist on sleeping with a parent, request repeated check-ins, or fear the dark. Preteens, even those who were previously independent sleepers, may regress during stressful periods and experience recurring nightmares related to their fears.

11. Tantrums When Routines Change

Routine changes – like a substitute teacher, unexpected guests, or rescheduling an activity – can spark intense emotional outbursts in anxious kids. This isn’t always classic defiance; it’s a response to the discomfort of unpredictability. The inability to control their environment may trigger meltdowns that look like overreactions to others.

12. Restlessness or Fidgeting

A child who is constantly tapping their foot, rocking in their chair, or playing with their hair may not be bored – they may be anxious. Restlessness can be a form of self-soothing when the brain is flooded with adrenaline or worry. Preteens may mask this with behaviors like pacing, doodling excessively, or zoning out, especially in school settings where they feel overwhelmed.

Social Symptoms

Anxiety doesn’t only live inside a child’s mind or body – it often plays out in their social world. For school-age children and preteens, this can be one of the most painful and isolating aspects of anxiety. Social symptoms may be misinterpreted as shyness, disinterest, or poor social skills, when in fact they reflect deep internal distress about being judged, embarrassed, or rejected.

Here are three common social signs of anxiety:

13. Clinginess in New or Social Situations

Children with anxiety often show extreme hesitation in unfamiliar settings. They may hold tightly to a parent’s arm, avoid eye contact, or refuse to engage when meeting new people. Even older children and preteens can display clinginess, particularly when attending new classes, joining clubs, or trying new activities. This behavior can mask intense fears of being embarrassed or excluded.

14. Difficulty Making or Keeping Friends

Anxious children may want friends but find it hard to initiate conversations, join group play, or handle conflicts. Preteens might feel awkward, overthink social cues, or assume they’re not liked – leading to withdrawal. Without support, this pattern can evolve into social anxiety in college and beyond, affecting long-term confidence and relationships.

15. Reluctance to Speak in Public or Unfamiliar Settings (Selective Mutism)

Some children become so anxious in social environments that they stop speaking altogether – known as selective mutism. While they may talk freely at home, they might remain completely silent at school, birthday parties, or when speaking to unfamiliar adults. This silence is not defiance; it’s a protective response to overwhelming fear.

 

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When to Seek Help

Every child experiences anxiety from time to time – it’s a normal part of growing up. But when anxiety becomes persistent, intense, or starts interfering with daily life, it’s time to consider professional support. Knowing the difference between a passing phase and a more serious issue is key.

Here are a few red flags that suggest it may be time to seek help from a licensed anxiety therapist:

• Your child’s anxiety lasts for more than a few weeks and seems to be getting worse.
• Physical complaints (like headaches or stomachaches) persist without a clear medical cause.
• Avoidance behaviors interfere with school attendance, friendships, or family life.
• Your child is unable to enjoy things they used to love.
• You find yourself modifying your family’s routines just to prevent anxiety meltdowns.

If your child regularly checks this many boxes on the Childhood Anxiety Symptoms Checklist, it’s not about labeling them – it’s about opening the door to healing. Early intervention can make a dramatic difference in a child’s emotional development and resilience.

Even a brief conversation with a professional can help clarify whether what you’re seeing is normal or something that would benefit from structured support. Whether it’s through cognitive behavioral therapy, parent coaching, or natural treatment approaches, there are evidence-based options that really work.

 

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What Causes Anxiety in Children?

Anxiety in children is rarely the result of a single cause. It usually develops from a combination of genetic, environmental, and psychological factors. Understanding these influences can help parents respond with more empathy and less self-blame.

Genetic and Biological Factors

Anxiety tends to run in families. If a parent struggles with anxiety, there’s a higher likelihood that their child will too – not only because of shared genes, but also because of learned behaviors. Children may absorb anxious coping patterns from the adults around them.

From a biological standpoint, some children are born with more reactive nervous systems. Their fight-or-flight response is more easily triggered, making them more sensitive to stress. Studies show that children with an overactive amygdala (the brain’s fear center) may be more prone to anxiety disorders later in life (Sylvester et al., 2012).

Environmental Triggers

Life changes, trauma, or disruptions in daily structure can all contribute to anxiety. Examples include:

• Moving to a new home or school
• Loss of a loved one
• Divorce or family conflict
• Academic pressure or fear of failure
• Exposure to bullying

Even highly capable children can be thrown off by stressors they don’t yet know how to process. When these experiences pile up without support, anxiety can take root.

Personality and Temperament

Some children are naturally more cautious, sensitive, or perfectionistic. These traits aren’t bad – in fact, they often go hand-in-hand with thoughtfulness and empathy. But when combined with external stress or internal worry, they can become fertile ground for chronic anxiety.

Situational Anxiety

Certain situations may bring anxiety to the surface even in children who don’t typically struggle. For example, giving a class presentation or trying a new sport may lead to anxiety before an event. If the anxiety becomes persistent or causes the child to avoid participation, it may need professional attention.

 

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How Parents Can Support an Anxious Child

You don’t need to be a therapist to help your child manage anxiety. The way you respond in everyday situations can either increase their sense of safety – or intensify their fears. Below are science-backed strategies to improve communication, reduce anxiety triggers at home, and model emotional resilience.

Do’s and Don’ts in Communication and Daily Routines

✅ DO: Maintain Consistent Routines
Predictability helps reduce anxiety. Knowing what to expect – from wake-up times to mealtimes and bedtime – can give a child a sense of stability. If changes to the schedule are coming, give advance notice and walk them through what to expect.

❌ DON’T: Over-Schedule or Over-Accommodate
It’s tempting to shield anxious kids from discomfort, but constantly rearranging life to avoid anxiety triggers (e.g., letting them skip school repeatedly) can reinforce avoidance behaviors. Balance support with gentle nudges toward manageable challenges.

✅ DO: Be a Calm, Predictable Presence
Children often mirror the emotional tone of their caregivers. Speak in a steady, reassuring voice – even if your child is upset. Showing that you can handle their big emotions calmly helps them feel safe enough to process those feelings themselves.

❌ DON’T: Dismiss or Criticize Their Feelings
Avoid saying things like “stop overreacting,” “you’re fine,” or “it’s not a big deal.” While well-intended, these responses may make children feel invalidated. Even if their fear seems irrational to you, it feels real to them.

Tips to Model Calm Behavior and Validate Feelings

Name the Emotion
When your child is anxious, help them name it: “It sounds like you’re feeling really nervous about going to school today.” Research shows that labeling emotions activates the brain’s prefrontal cortex – making the feelings easier to manage (Lieberman et al., 2007).

Practice Co-Regulation
Regulate your own emotions in front of your child. Take a deep breath. Slow your speech. Sit beside them rather than above them. You’re teaching them, through your own nervous system, how to come back to a calm state.

Use “Brave Talk”
Instead of saying “Don’t worry,” try: “You’re feeling worried, but I know you can handle this.” This language balances empathy with confidence – and encourages a growth mindset around facing fears.

 

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Final Thoughts: Using This Checklist in Everyday Life

This Childhood Anxiety Symptoms Checklist isn’t a diagnostic tool – but it is a powerful guide. It helps parents, educators, and caregivers tune into the patterns, behaviors, and subtle signs that might otherwise go unnoticed. Used consistently, it can open the door to early support and lasting change.

If your child checks off several of these 15 symptoms – especially if they persist for weeks or are disrupting daily routines – it’s time to trust your instincts and explore professional help. Remember, anxiety is highly treatable, especially when caught early. Whether through therapy, school accommodations, or small changes at home, children can and do learn to manage anxiety and thrive.

Parenting an anxious child can be challenging, but you’re not alone. Support, tools, and expert guidance are available – and your attention to these signs is already an important first step.

 

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About Wellness Road Psychology

At Wellness Road Psychology, we specialize in helping children and families navigate anxiety, stress, and emotional challenges with compassion and evidence-based care. Our team includes licensed therapists experienced in working with children of all ages, from preschoolers struggling with separation anxiety to teens facing social pressure and perfectionism.

We believe that early support can change the trajectory of a child’s emotional life – and we’re here to guide that process every step of the way.

Book a free 15-minute consultation with one of our leading child therapists to get your questions answered, discuss your concerns, and learn what the right next step might be for your child.