Anxiety in Elementary Age Children: What Parents in Columbia, MO Need to Know
If you're reading this, you're probably worried about your child. Maybe you've noticed changes in their behavior, endless questions you can't seem to answer, or tears every morning before school. You might be exhausted, frustrated, or wondering if you're doing something wrong.
Let us start by saying this: You're not doing anything wrong. And the fact that you're here, reading this article, searching for answers—that shows you're a good, loving, dedicated parent who cares deeply about your child's wellbeing.
At Aspire Counseling in Columbia, MO, we understand how challenging it can be to parent an anxious child. We offer child counseling, trauma therapy for kids, and specialized anxiety therapy for children ages 3 and up. Whether your child is showing signs of anxiety, has experienced trauma, or is struggling with school-related stress, our therapists use evidence-based approaches to help children—and their families—find relief.
In this guide, we'll help you understand what anxiety looks like in elementary age children, when it's time to worry, and how to get professional help. But first, let's talk about what it's like to be the parent of an anxious child.
You're Not Alone (And You're Not a Bad Parent)
Parenting an anxious child can be incredibly frustrating. And it's okay to admit that.
Your child asks you the same question for the hundredth time today, and you feel your patience wearing thin. They won't leave your side—not even to go to the bathroom—and you feel suffocated. They're crying and clinging to you before school drop-off, and you drive away feeling like a complete failure as a parent.
When you pictured parenthood, this probably wasn't what you imagined. You thought about teaching your child to ride a bike, helping with homework, and watching them make friends. You didn't picture the constant worry, the accommodation of fears, or the feeling of walking on eggshells to avoid triggering another meltdown.
Here's what we want you to know: Feeling frustrated doesn't make you a bad parent.
It makes you human. It makes you normal. Even great parents—loving, dedicated, wonderful parents—become exhausted when coping with an anxious child. The reassurance-seeking, the avoidance, the emotional intensity of anxiety—all of this takes a toll on the whole family.
That's exactly what we're here to help with. Our clinicians at Aspire Counseling care deeply about the wellbeing of families—not just children, but parents too. We're here to support your child in learning to manage their anxiety, and we're here to support you in navigating the challenges of parenting an anxious kid.
In fact, many parents find it helpful to see their own therapist while their child is in therapy. Sometimes parent anxiety and child anxiety feed into each other, and addressing both creates the best outcomes for everyone. If that resonates with you, mom's mental health matters too—and taking care of yourself isn't selfish. It's essential.
Now, let's talk about what anxiety actually looks like in kids.
What Does Anxiety Look Like in Elementary Age Kids?
Anxiety in children doesn't always look like worry. Sometimes it looks like behavior problems, physical complaints, or irritability. Many parents tell us they had no idea their child was anxious—they just thought they were being difficult or defiant.
Here are some of the most common signs of anxiety in elementary age children:
Physical Complaints Without Medical Cause
Frequent stomachaches, headaches, or feeling "sick" with no fever or clear illness. Kids often feel anxiety in their bodies before they can name it as worry. Your child might say their stomach hurts every morning before school, but the pediatrician can't find anything wrong.
Excessive Worry and "What If" Questions
Constant questions about things that might go wrong. "What if there's a fire drill?" "What if I miss the bus?" "What if you don't pick me up?" These questions come in waves, and no amount of reassurance seems to satisfy them for long.
Avoidance of Activities They Used to Enjoy
Your child suddenly doesn't want to go to birthday parties, refuses to participate in sports, or drops out of activities they loved. When anxiety is in charge, avoidance feels safer than facing the worry.
Clinginess and Separation Anxiety
They won't let you out of their sight. They follow you from room to room, won't sleep alone, or panic when you try to leave them at school or a friend's house. Even at ages 8, 9, or 10—when they should be more independent—they seem to need constant reassurance of your presence.
Sleep Difficulties
Trouble falling asleep, staying asleep, or nightmares. Anxiety often gets louder when everything else gets quiet. Your child might need you to stay in their room until they fall asleep, wake up multiple times during the night, or insist on sleeping in your bed.
Changes in Behavior or Mood
Increased irritability, emotional meltdowns over small things, or withdrawal from family activities. Anxious kids often have short fuses because they're already operating at maximum emotional capacity. One small frustration can trigger a big reaction.
School-Related Struggles
Refusing to go to school, crying at drop-off, or calling you from the nurse's office. Some kids develop school refusal—where anxiety makes it nearly impossible for them to attend class, even when they genuinely want to go.
Perfectionism or Fear of Making Mistakes
Your child gets extremely upset about small errors, erases their homework repeatedly, or won't try new things because they're afraid they won't be perfect. This is anxiety masquerading as high standards.
How Do Kids Act When They Have Anxiety?
Anxiety can look different depending on your child's age, personality, and specific triggers. And, every child is a little bit different. So, while we can share with you some common ways anxiety shows up across different age groups, please keep in mind that your child is unique:
Ages 3-5: Preschool and Early Elementary
Young children with anxiety often:
Cling to parents intensely, especially in new situations
Have frequent tantrums or meltdowns that seem out of proportion
Complain of tummy aches or "not feeling good"
Ask for constant reassurance ("You'll come back, right?")
Show fear of specific things (the dark, loud noises, separation from parents)
Have trouble transitioning between activities
Resist trying new foods, activities, or places
At this age, children don't have the words to say "I feel anxious." Instead, anxiety shows up through behavior. What might look like defiance or a "phase" could actually be anxiety.
Ages 6-8: Early Elementary Years
As children get a bit older, anxiety might look like:
Excessive worry about school performance ("What if I get a bad grade?")
Social anxiety around making friends or being embarrassed
Perfectionism about homework or activities
Physical complaints that keep them home from school
Avoidance of activities where they might fail or be judged
Difficulty separating from parents, even for sleepovers or playdates
Asking repetitive questions seeking reassurance
Kids in this age range are developing awareness of how others see them, which can fuel anxiety. They're also facing more academic and social demands, which can be overwhelming for anxious children.
Ages 9-12: Upper Elementary and Middle School Transition
Older elementary students with anxiety often:
Worry excessively about future events (tests, performances, social situations)
Show increased irritability, moodiness, or withdrawal
Avoid social situations or struggle with peer relationships
Develop specific fears or compulsive behaviors (possible OCD)
Experience panic attacks or intense physical symptoms of anxiety
Have difficulty making decisions (even simple ones)
Express worry about world events, illness, or harm coming to loved ones
At this age, kids may also start hiding their anxiety because they're embarrassed about it or don't want to seem "different" from their peers. You might not realize how much they're struggling internally.
What Triggers Anxiety in a Child?
Understanding what triggers your child's anxiety can help you know when and how to intervene. That said, we do need to acknowledge that there isn’t always a clear trigger. Sometimes, this can be incredibly frustrating for parents. Their child is clearly anxious but there is no clear “reason” or change.
That said, sometimes there is a clear change or trigger. Common triggers of anxiety in children include:
School-Related Triggers
Academic pressure, social situations, bullying, teacher relationships, fear of making mistakes, upcoming tests or presentations, or simply being in a loud, busy environment all day. School is one of the most common anxiety triggers for elementary age children.
Family Changes and Stress
Divorce or separation, a new baby, moving to a new home, financial stress in the family (even when parents try to hide it), or conflict between parents. Kids pick up on stress in the household, and it can amplify their own anxiety.
Traumatic Experiences
If your child has experienced something frightening or overwhelming—whether it's a car accident, medical trauma, abuse, witnessing violence, or natural disaster—anxiety might be part of their trauma response. Sometimes what looks like general anxiety is actually related to past trauma that hasn't been processed yet. This is where trauma therapy for kids can make a significant difference.
Temperament and Genetics
Some children are simply more prone to anxiety because of their temperament. If you or your partner struggle with anxiety, there's a genetic component that can make your child more vulnerable. This isn't anyone's fault—it's just how their brain is wired. And the good news is that anxiety is very treatable, even when it has a genetic component.
Big Life Transitions
Starting a new school, joining a new sports team, losing a loved one, or any major change in routine. Anxious children often struggle more with transitions because they crave predictability and safety.
Social Pressures
Peer relationships become increasingly important in elementary school. Anxiety can be triggered by fear of rejection, being left out, not fitting in, or social conflict with friends.
When Anxiety is Helpful vs. When It's a Problem
Here's something important to understand: Not all anxiety is bad. Some anxiety is actually protective and helpful.
Think about it this way: A child who feels slightly anxious about an upcoming spelling test will study and prepare. That's helpful anxiety doing its job—motivating them to take action and do well.
But when anxiety takes control, it stops being helpful. That same child might become so overwhelmed by worry that they can't finish the test, even though they studied. Or they might avoid studying altogether because thinking about the test feels unbearable. They might have a panic attack the morning of the test or refuse to go to school entirely.
Helpful anxiety:
Motivates preparation and caution
Is proportionate to the situation
Doesn't interfere with daily functioning
Goes away after the event passes
Helps kids learn and grow
Problematic anxiety:
Leads to avoidance instead of preparation
Is out of proportion to the actual risk
Interferes with school, friendships, family life, or sleep
Persists even when there's no clear trigger
Stops kids from doing things they want or need to do
When anxiety crosses the line from helpful to harmful, that's when professional support can make a real difference.
When Should I Worry About My Child's Anxiety?
This is one of the most common questions we hear from parents: "How do I know if this is normal worry or something more serious?"
Here's a helpful guideline: If anxiety is persistent and interfering with your child's daily life in any significant way, it's worth seeking help.
Look for patterns where worry is affecting:
School Attendance or Performance
Your child is missing school frequently because of anxiety
They're struggling academically, not because of ability but because anxiety is getting in the way
They're avoiding participation in class or school activities
You're getting calls from the school about behavior or emotional struggles
Sleep
Trouble falling asleep or staying asleep most nights
Nightmares or night terrors
Needing you present to fall asleep, even at ages when they should be more independent
Waking exhausted despite adequate time in bed
Family Life and Daily Functioning
Frequent meltdowns or emotional outbursts
Significant avoidance affecting family activities (won't go on outings, refuses certain restaurants or places)
Conflict with siblings or parents related to anxiety
Everyone in the family is walking on eggshells to avoid triggering the child's anxiety
Friendships and Social Development
Your child is isolating themselves or avoiding social situations
They're having trouble making or keeping friends
They're being left out or excluded because of anxiety-driven behavior
They express loneliness but won't take steps to connect with peers
Physical Health
Frequent complaints without medical cause
Using physical symptoms to avoid school or activities
Changes in eating habits or significant weight change
Regression in developmental milestones (like toileting accidents in an older child)
You don't need to wait until things are in crisis. Early intervention often means faster progress and less suffering for your child. If you're questioning whether your child's anxiety is "bad enough" for therapy, that's usually a sign that it's worth at least getting a consultation.
How is Anxiety in Kids Diagnosed?
You might be wondering: How do professionals actually diagnose anxiety in children? And do you need a formal diagnosis to get help?
Here's how it works: A therapist or mental health professional will typically:
Conduct a Comprehensive Assessment
This involves talking with you and your child separately and together to understand:
What symptoms you're seeing
When the anxiety started and how it's progressed
What triggers the anxiety
How it's affecting your child's daily life
Your child's developmental history, medical history, and family background
Whether there are any traumatic experiences that might be contributing
Observe Your Child's Behavior
The therapist will watch how your child interacts, talks about their worries, and responds to questions. With young children, they might use play or drawing to understand what's going on.
Rule Out Other Concerns
Sometimes what looks like anxiety is actually something else—or anxiety might be co-occurring with other issues like ADHD, depression, learning disabilities, or autism. A thorough assessment helps identify the complete picture.
Consider Different Types of Anxiety
There are several anxiety-related diagnoses that might apply to children, including:
Generalized Anxiety Disorder (excessive worry about many things)
Separation Anxiety Disorder (intense fear of being away from parents)
Social Anxiety Disorder (fear of social situations and judgment)
Specific Phobias (intense fear of specific things like dogs, storms, vomit)
Panic Disorder (recurrent panic attacks)
Obsessive-Compulsive Disorder (intrusive thoughts and compulsive behaviors)
Do You Need a Formal Diagnosis?
Not necessarily. At Aspire Counseling, we can begin helping your child even if they don't meet full criteria for a formal anxiety diagnosis. What matters most is whether anxiety is causing distress or impairment—not whether it fits perfectly into a diagnostic box.
However, having a diagnosis can be helpful for:
Insurance reimbursement (if you're seeking coverage)
School accommodations through a 504 plan or IEP
Understanding what you're dealing with and finding the right treatment approach
Getting Professional Help in Columbia, MO
If you've recognized your child in this article, you're probably wondering: What now? How do I actually get help for my anxious child?
What Therapy for Anxious Children Looks Like
At Aspire Counseling, we use evidence-based treatments that are proven to help children with anxiety. This typically includes:
Cognitive Behavioral Therapy (CBT). This is the gold standard treatment for childhood anxiety. CBT helps kids understand the connection between their thoughts, feelings, and behaviors. They learn to identify anxious thoughts, challenge them when helpful, and choose different responses. It's practical, skill-based, and kids usually start seeing improvements within a few weeks.
Exposure therapy. This involves gradually, gently helping your child face the situations they've been avoiding—with support and at a pace that works for them. It might sound scary, but it's actually one of the most effective tools we have. For example, if your child has school anxiety, we might create a step-by-step plan for getting back to the classroom comfortably.
Play-based approaches for younger children. For kids ages 3-7, we often use play, art, and creative activities to help them express and work through their anxiety. Young children don't have the language to talk about complex emotions, so we meet them where they are.
Parent coaching and involvement. We'll teach you how to respond to anxiety in ways that are supportive without reinforcing avoidance. Research shows that when parents are involved in treatment, kids make faster progress and maintain their gains longer.
Who The Child Therapists at Aspire Counseling Help
We work with children ages 3 and up at Aspire Counseling. Our therapists are trained to use developmentally appropriate approaches—whether that's play-based work with preschoolers or more direct conversation with older kids.
We offer therapy for anxious children both in-person at our Columbia office and online throughout Missouri. We also work with children who have experienced trauma, offering specialized trauma therapy when anxiety and trauma are intertwined.
Taking Care of Yourself While Supporting Your Child
Here's something else to consider: If you're struggling with your own anxiety while trying to help your anxious child, you're not alone. Many parents find that their own anxiety increases when parenting an anxious child—or that they realize they've been managing anxiety themselves for years.
There's no shame in seeking support for yourself. In fact, it often helps your child's treatment go better when you're also getting the help you need. If you're wondering whether therapy might be right for you, these resources might be helpful:
Sometimes family members also need guidance on how to support a parent who's struggling with anxiety. If that's relevant for your family, this article on how to cope with an anxious mom can provide helpful perspective.
How to Get Started
If you're ready to get help for your child—or if you're still not sure and want to talk through what you're seeing—we're here.
Contact Aspire Counseling by phone or through our website. Let us know a bit about what's going on with your child and what you're hoping therapy can help with. We'll match you with a therapist whose training and style fit your child's needs, and we'll get you scheduled for a first appointment.
Most families begin to notice changes within the first few weeks as their child learns new skills, practices facing feared situations with support, and gradually builds confidence.
Child Counseling in Columbia: You're Already Taking the First Step
If you've read this far, you clearly care deeply about your child's wellbeing. You're educating yourself, looking for answers, and considering getting professional help. That's exactly what a good parent does.
Anxiety in children is treatable. With the right support, your child can learn to manage worry, face their fears, and get back to enjoying their childhood. And you can learn how to support them without feeling overwhelmed or frustrated all the time.
You don't have to do this alone. At Aspire Counseling in Columbia, MO, we're here to help your whole family find relief, confidence, and peace.
Reach out today and let's start helping your child—and you—feel better.
Aspire Counseling offers anxiety therapy for children ages 3 and up in Columbia, MO and online throughout Missouri. Our therapists are trained in evidence-based approaches including CBT, play therapy, and exposure therapy. We create a warm, affirming environment where every child and family can heal and grow. If you're a parent struggling with anxiety yourself, we offer counseling for adults too—because taking care of yourself isn't selfish. It's essential.
