5 Warning Signs of Anxiety in Elementary Aged Kids
Your child used to love going to school. Now they complain of stomachaches every morning.
They used to be outgoing and confident. Now they seem nervous about everything.
They used to sleep through the night. Now they're crawling into your bed because they're scared.
If you're a parent in Columbia, Jefferson City, or anywhere in Mid Missouri noticing these changes in your elementary-age child, you're probably wondering: Is this normal? Or is something wrong?
Here's the truth: childhood anxiety is common, but that doesn't mean it should be ignored. When anxiety starts interfering with your child's daily life—school, friendships, sleep, or family activities—it's time to pay attention.
Let's walk through five key warning signs that your elementary-age child might be struggling with anxiety, what each one means, and when it's time to get help.
Understanding anxiety in elementary age children can help you know when your child needs support beyond what you can provide at home.
Warning Sign #1: Physical Complaints Without Medical Cause
One of the most common—and most overlooked—signs of childhood anxiety is physical symptoms that have no medical explanation.
What it looks like:
Your child complains of:
Frequent stomachaches, especially before school or activities
Headaches that come and go
Feeling dizzy or nauseous
Chest tightness or trouble breathing
Shakiness or "feeling weird"
You take them to the pediatrician. Tests come back normal. The doctor says they're healthy. But your child still feels bad.
Why this happens:
When children are anxious, their bodies go into "fight or flight" mode. Their nervous system releases stress hormones that cause real physical sensations. These aren't "made up" or "just for attention." Your child genuinely feels sick.
The problem is, young children often can't identify anxiety as an emotion. They don't think, "I'm feeling anxious about the spelling test." Instead, they feel it in their bodies and think, "My stomach hurts."
When it's a warning sign:
The physical complaints happen primarily before stressful situations (school, social events, bedtime)
Medical causes have been ruled out
The symptoms go away when the stressful situation is avoided
The complaints are frequent (multiple times per week)
What to do:
Start by validating what they're feeling: "I know your stomach really hurts. That's real."
Then gently explore what's happening: "I notice your stomach hurts a lot before school. What's school been like lately?"
If physical complaints are frequent and interfering with daily life, it's time to consider therapy for anxious children. A therapist can teach your child to recognize the connection between their feelings and their body, and give them tools to manage both.
Warning Sign #2: Avoidance of School or Activities
When anxiety takes hold, children start avoiding the things that make them anxious. This makes sense from their perspective—if something feels scary, why would they want to do it?
But avoidance makes anxiety worse over time, not better.
What it looks like:
Refusing to go to school or crying at drop-off
Making excuses to skip activities they used to enjoy (sports, playdates, birthday parties)
Asking to leave events early or not participate
Suddenly not wanting to do things alone (using the bathroom at school, going to another room in the house)
Finding reasons to stay home (claiming they're sick, "forgetting" permission slips, losing equipment)
Why this happens:
Avoidance is a classic anxiety response. When your child avoids something, they get immediate relief from their anxiety. That relief reinforces the behavior, so they avoid it again next time.
The problem? The more they avoid, the bigger and scarier the thing becomes in their mind. What started as mild nervousness about recess can escalate into full-blown school refusal.
When it's a warning sign:
The avoidance is increasing over time
It's causing problems (missed school, lost friendships, family conflict)
Your child can't explain a logical reason for avoiding
They seem distressed when forced to participate
What to do:
Don't force your child into situations without support, but also don't enable the avoidance. This is a tricky balance.
Instead of: "You're going to school no matter what." Try: "I know school feels scary right now. Let's talk about what makes it hard, and we'll work on making it easier."
Gradual exposure—facing fears in small, manageable steps—is the most effective treatment for avoidance. A therapist trained in treating childhood anxiety can help create a plan that works.
If your child has experienced something difficult or traumatic, avoidance might be connected to that experience. Learn more about trauma therapy for kids and how it helps children feel safe again.
Warning Sign #3: Excessive Worry About "What If" Scenarios
All children worry sometimes. But anxious children get stuck in worry loops they can't escape.
What it looks like:
Your child constantly asks "what if" questions:
"What if there's a fire drill and it's too loud?"
"What if I throw up at school?"
"What if you get in a car accident?"
"What if the teacher calls on me and I don't know the answer?"
"What if something bad happens to you while I'm at school?"
They want reassurance over and over. You answer their question, they feel better for a moment, then they ask again—or ask a slightly different version of the same question.
Why this happens:
Anxious children have overactive threat-detection systems. Their brains are constantly scanning for danger, even when they're safe.
"What if" thinking is their brain's attempt to prepare for every possible bad thing that could happen. The problem is, there's always another "what if." The worry never ends.
When you reassure them, it works temporarily. But it doesn't teach their brain that they can handle uncertainty. So they need more reassurance, creating a cycle.
When it's a warning sign:
The worries are excessive compared to other kids their age
They worry about things that are very unlikely to happen
The worries interfere with daily activities
Reassurance only helps temporarily, then the worry comes back
They have trouble shifting their attention away from the worry
What to do:
Instead of endless reassurance, try:
Acknowledging the feeling: "I can tell you're really worried about that."
Helping them evaluate the likelihood: "Has that ever happened before? How likely is it really?"
Building problem-solving skills: "If that did happen, what would you do?"
Setting limits on reassurance: "I'll answer this question one more time, then we're going to move on to something else."
Cognitive Behavioral Therapy (CBT) is highly effective for worry-prone children. It teaches them to challenge anxious thoughts and develop more helpful thinking patterns.
Warning Sign #4: Changes in Sleep or Eating
Anxiety affects the body's basic functions, including sleep and appetite.
What it looks like:
Sleep changes:
Difficulty falling asleep or staying asleep
Nightmares or night terrors
Wanting to sleep in your room or bed
Stalling at bedtime or needing elaborate bedtime rituals
Waking up tired even after a full night's sleep
Eating changes:
Loss of appetite or skipping meals
Eating significantly more than usual (using food for comfort)
Complaints that food tastes bad or makes them feel sick
New pickiness about food
Why this happens:
When the nervous system is on high alert, it's hard to relax enough to eat or sleep. Anxious children often can't "turn off" their brains at night. Their worried thoughts keep them awake, or they wake up from anxiety-driven nightmares.
During the day, anxiety can suppress appetite or cause nausea. Some children eat more as a way to self-soothe.
When it's a warning sign:
Sleep or eating changes have lasted more than a couple weeks
They're affecting your child's energy, mood, or growth
Your child mentions worries or fears related to sleep or eating
The changes started around the same time as increased anxiety in other areas
What to do:
Create calm, predictable routines. For sleep, establish a calming bedtime routine that's consistent every night. For eating, offer meals at regular times in a low-pressure environment.
If sleep or eating problems persist, talk to your pediatrician to rule out medical causes. If anxiety is the culprit, therapy can help address the root cause while you work on routines at home.
Warning Sign #5: Withdrawal from Friends or Activities
Elementary age children should be social, curious, and engaged with the world around them. When a child starts withdrawing, it's a red flag.
What it looks like:
Not wanting to play with friends
Turning down invitations to playdates or parties
Sitting alone at recess or lunch
Seeming uninterested in hobbies they used to love
Preferring to stay in their room or by your side
Looking sad, flat, or disconnected
Why this happens:
Sometimes anxiety makes social situations feel overwhelming. Your child might worry about saying the wrong thing, being judged, or not fitting in. Withdrawing feels safer than risking embarrassment or rejection.
Other times, anxiety is so draining that your child doesn't have energy left for fun activities. Everything feels like too much effort.
Withdrawal can also be a sign of depression, which often co-occurs with anxiety in children.
When it's a warning sign:
The withdrawal represents a significant change from their usual personality
It's been going on for weeks or months
Your child seems sad or says things like "no one likes me" or "I'm no good at anything"
They've lost interest in multiple areas of life
What to do:
Don't force socialization, but gently encourage connection. Invite one friend over for a low-key playdate at home. Do activities alongside your child that don't require talking.
Ask open-ended questions: "I've noticed you haven't been hanging out with Emma lately. What's going on?"
If withdrawal continues, especially if paired with sadness or hopelessness, seek professional help. This could be anxiety, depression, or both—and therapy can help.
Learn more about comprehensive child counseling in Columbia, MO and how it supports children struggling with anxiety and related challenges.
What to Do If You See These Signs
If you're recognizing your child in these warning signs, here's what to do next:
1. Talk to your child Use open-ended questions to understand what they're experiencing. Listen without judgment. Validate their feelings.
2. Rule out medical causes See your pediatrician to make sure there's no underlying health issue causing the symptoms.
3. Monitor the situation Keep track of when symptoms happen, how severe they are, and what triggers them. This information will be helpful if you seek professional help.
4. Try basic strategies at home
Create predictable routines
Teach simple relaxation techniques (deep breathing, progressive muscle relaxation)
Limit exposure to stressful media
Ensure adequate sleep, nutrition, and exercise
Spend one-on-one time with your child
5. Seek professional help if:
Symptoms have lasted more than a few weeks
They're getting worse, not better
They're interfering with school, friendships, or family life
Your child seems distressed or unhappy most of the time
You've tried home strategies and they're not helping
Early intervention makes a huge difference. Anxiety doesn't usually go away on its own, but it responds really well to treatment.
Finding Child Anxiety Therapy in Columbia and Mid Missouri
You don't have to navigate this alone. If your elementary-age child is showing signs of anxiety, professional support can make all the difference.
At Aspire Counseling, we specialize in helping children throughout Mid Missouri overcome anxiety using evidence-based approaches that really work. Our therapists are trained in Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and other proven methods for childhood anxiety.
We work with children in Columbia, Jefferson City, Lee's Summit, and surrounding communities through both in-person sessions and secure telehealth appointments.
Our anxiety therapy for children includes:
Age-appropriate techniques that make therapy engaging for elementary-age kids
Parent coaching so you know how to support your child at home
Skills your child can use for the rest of their life
A warm, calm environment where children feel safe and understood
Anxiety is treatable. With the right support, your child can learn to manage their worries, face their fears, and feel confident again.
Ready to help your child feel better?
Call us at (573) 328-2288 to speak with our Client Care Specialist about your child's anxiety
Learn more about our specialized therapy for anxious children in Missouri
Explore our comprehensive child counseling services for anxiety, trauma, and more
Your child doesn't have to struggle with anxiety. Let's help them find their confidence again.
About the Author
Jessica Tappana, MSW, LCSW is the founder and Clinical Director of Aspire Counseling. While Jessica oversees the clinical direction of the practice, Aspire's team of specialized child therapists—including Madi, Kristi, and Ashley—are the experts on the ground working directly with anxious children and their families every day.
Madi specializes in working with elementary-age children struggling with anxiety and trauma, using play therapy and TF-CBT to help kids feel safe and confident. Kristi, our Senior Clinical Team Lead, brings extensive experience in treating anxiety, trauma, phobias and OCD in children and supervises our team to ensure the highest quality care. Ashley works with children and teens dealing with anxiety, trauma, and life transitions, with particular expertise in helping kids who've experienced difficult things.
Together, the Aspire Counseling team serves families throughout Mid Missouri with trauma-informed, evidence-based therapy that helps children heal and thrive.
