When Should I Worry About My Child’s Anxiety? A Decision Guide for Parnets
Your child seems anxious. But then again, all kids worry sometimes, right?
You don't want to overreact and make a big deal out of normal childhood worries. But you also don't want to ignore a real problem that could get worse.
So where's the line? When is childhood anxiety normal, and when does it become something that needs professional attention?
This is one of the most common questions parents in Columbia and throughout Mid Missouri ask us. And it's a good question, because the answer isn't always obvious.
Let's walk through how to tell the difference between typical childhood worries and anxiety that needs help. By the end of this guide, you'll have clarity on whether your child needs more support—and what to do if they do.
Understanding anxiety in elementary age children starts with knowing what's normal and what's not.
Normal Childhood Worries vs. Anxiety Disorders
All children worry. It's a normal part of development. But there's a difference between typical worries and anxiety that's become a disorder.
Normal childhood worries look like this:
Age 3-5:
Separation from parents (especially at drop-off)
Monsters, the dark, or loud noises
New situations or meeting new people
These worries come and go and don't significantly disrupt daily life
Age 6-8:
Scary things in the news or movies
Getting hurt or someone they love getting hurt
School performance or making mistakes
Being liked by peers
Natural disasters or danger (fire, storms, getting lost)
Age 9-12:
Social acceptance and peer relationships
Academic performance and tests
Physical appearance
Family issues (even if parents think they're hiding them)
Global issues like war or climate change
These are all typical worries for these age ranges. They're normal if:
They come and go rather than being constant
Your child can be reassured or distracted
They don't stop your child from doing age-appropriate activities
They match the developmental stage (it's normal for a 7-year-old to fear the dark; it's unusual for a 12-year-old)
Anxiety disorders look different:
Anxiety becomes a disorder when it's:
Excessive: Way more worry than the situation warrants or than other kids their age show
Persistent: Lasting weeks or months, not just a few days
Uncontrollable: Your child can't "snap out of it" even with reassurance
Impairing: It interferes with school, friendships, family activities, or daily functioning
Examples of anxiety disorders in children:
Generalized Anxiety Disorder (GAD): Excessive worry about many different things. The worry is hard to control and causes physical symptoms like stomachaches or trouble sleeping.
Separation Anxiety Disorder: Extreme fear of being away from parents or caregivers. Goes beyond normal developmental separation anxiety and interferes with school or activities.
Social Anxiety Disorder: Intense fear of social situations or being judged. Your child avoids social interactions or endures them with extreme distress.
Specific Phobias: Extreme, irrational fear of specific things (dogs, vomit, thunderstorms) that leads to avoidance and distress.
Panic Disorder: Unexpected panic attacks (sudden intense fear with physical symptoms like racing heart, trouble breathing, dizziness) and worry about having more attacks.
If your child's anxiety fits one of these patterns, it's worth seeking professional evaluation. Therapy for anxious children can help, even if they haven't been formally diagnosed.
Red Flags That Mean It's Time to Seek Help
You don't need a formal diagnosis to seek help. If you're seeing these red flags, it's time to reach out to a professional:
1. Anxiety is interfering with school
Frequent absences or tardiness due to anxiety
Refusing to go to school or having daily meltdowns at drop-off
Inability to participate in class (won't raise hand, speak, or present)
Declining grades due to anxiety about tests or perfectionistic behaviors
Visits to the nurse multiple times per week for anxiety-driven physical complaints
School is where children spend most of their time. When anxiety makes school impossible, it's a problem that needs intervention.
2. Social withdrawal or isolation
Your previously social child now avoids friends
Refusing invitations to birthday parties, playdates, or activities
Eating alone at lunch or staying inside during recess
Not participating in activities they used to enjoy
Saying things like "no one likes me" or "I don't fit in"
Friendships are crucial for elementary-age children's development. Anxiety that prevents social connection needs to be addressed.
3. Sleep is significantly disrupted
Taking more than 30 minutes to fall asleep most nights
Needing elaborate bedtime rituals that keep getting longer
Frequent nightmares or night wakings
Refusing to sleep alone or in their own bed
Exhaustion affecting mood, behavior, or school performance
Sleep problems don't usually resolve on their own. If anxiety is keeping your child up at night, therapy can help.
4. Physical symptoms are frequent and distressing
Multiple complaints per week with no medical cause
Missing school or activities due to physical symptoms
Your child is distressed by the physical feelings
Symptoms cluster around stressful events
Remember: anxiety-driven physical symptoms are real, not "faked." But if doctors have ruled out medical causes, the root issue is anxiety.
5. Avoidance is increasing
The list of things your child avoids is getting longer
They're missing out on normal childhood experiences
Avoidance is causing family conflict or logistical problems
You find yourself structuring life around your child's anxiety
Avoidance feeds anxiety. The more your child avoids, the worse it gets. Professional intervention can break this cycle.
6. Your child seems unhappy or says concerning things
Frequently tearful or sad
Expressing hopelessness ("Nothing will ever get better")
Making negative statements about themselves ("I'm worthless," "Everyone hates me")
Talking about not wanting to be alive (this requires immediate professional help)
Anxiety and depression often occur together. If your child seems persistently unhappy, don't wait to get help.
7. Family life is significantly impacted
Walking on eggshells to avoid triggering your child's anxiety
Siblings are resentful or neglected
Parents disagreeing about how to handle the anxiety
You can't go places or do things as a family
You feel exhausted and don't know what else to try
When one child's anxiety takes over the whole family, it's time for outside support.
What Happens if Childhood Anxiety is Left Untreated?
Some parents hope their child will "grow out of" anxiety. Sometimes that happens. But often, untreated childhood anxiety:
Gets worse over time: Anxiety feeds on itself. The more your child avoids things, the more anxious they become. The bigger the anxiety gets, the harder it is to treat.
Leads to additional problems:
Depression (anxiety and depression commonly occur together)
Social difficulties (missed opportunities for friendship and social skill development)
Academic struggles (anxiety interferes with learning and performance)
Low self-esteem (anxious children often develop negative beliefs about themselves)
Substance use in teen years (some teens use alcohol or drugs to manage anxiety)
Affects adult life: Childhood anxiety that goes untreated often continues into adulthood. Early intervention can prevent a lifetime of struggle.
Impacts the whole family: Untreated anxiety doesn't just hurt the anxious child. It creates stress for parents, affects siblings, and strains family relationships.
The good news? Childhood anxiety is highly treatable. The earlier you intervene, the better the outcomes. Most anxious children who get treatment improve significantly.
How Therapy Can Help Anxious Children
If you're concerned about your child's anxiety, you might wonder: What exactly happens in therapy? And does it really help?
Yes, it helps—a lot. Research shows that therapy, particularly Cognitive Behavioral Therapy (CBT), is highly effective for childhood anxiety disorders.
Here's what therapy does:
1. Teaches concrete coping skills Your child learns specific techniques to manage anxious feelings: deep breathing, progressive muscle relaxation, mindfulness, and grounding exercises.
2. Challenges anxious thoughts CBT helps children identify thoughts that feed anxiety ("Everyone will laugh at me," "Something terrible will happen") and replace them with more realistic, helpful thoughts.
3. Breaks the avoidance cycle Through gradual exposure, children learn to face their fears in small, manageable steps. This teaches their brain that feared situations aren't actually dangerous.
4. Builds confidence As children successfully manage anxiety and face fears, their confidence grows. They learn "I can handle hard things."
5. Gives parents tools Good child anxiety therapy includes parent coaching. You learn how to respond to anxiety in ways that help, not hurt. You learn when to push gently and when to provide support.
6. Addresses root causes If trauma is part of the picture, therapists trained in TF-CBT can help your child process those experiences. If perfectionism is the issue, that's addressed. Treatment is tailored to your child's specific needs.
What to expect:
Most children see improvement within 8-12 sessions, though some need longer. Therapy typically includes:
Weekly sessions (45-50 minutes)
Practice between sessions (homework)
Regular parent check-ins
Collaboration with teachers if needed
At Aspire Counseling, our therapists make therapy engaging for kids through play, games, art, and age-appropriate activities. Your child won't just sit and talk—they'll learn by doing.
Finding a Child Therapist in Columbia, MO and Mid Missouri
If you've decided your child needs help, the next question is: Where do I find a good therapist?
What to look for:
Specialized training: Look for therapists trained in evidence-based approaches like CBT, ERP (Exposure and Response Prevention), or TF-CBT (if trauma is involved)
Experience with children: Child therapy requires different skills than adult therapy. Make sure the therapist regularly works with kids your child's age
Good fit: Your child needs to feel comfortable with their therapist. Most practices offer initial consultations to assess fit
Parent involvement: Good child therapists involve parents in the treatment process
Clear treatment plan: The therapist should be able to explain what they're going to do and why
At Aspire Counseling, we check all these boxes.
Our team specializes in childhood anxiety, trauma, and related concerns. We use proven, evidence-based approaches and work collaboratively with parents every step of the way.
We serve families throughout Columbia, Jefferson City, Lee's Summit, and all of Mid Missouri through both in-person and telehealth options.
Our approach to childhood anxiety:
Therapists trained in CBT, ERP, and TF-CBT
Age-appropriate techniques that make therapy engaging
Regular parent sessions to keep you informed and equipped
Collaboration with schools when helpful
A warm, calm environment where children feel safe
We work with children dealing with:
Generalized anxiety
Social anxiety
Separation anxiety
Specific phobias
Panic attacks
Anxiety related to trauma or difficult life experiences
Perfectionism and performance anxiety
Your child doesn't have to struggle with anxiety. Help is available, and it works.
Take the Next Step: Get Help for Your Child Today
You've read this guide. You've thought about your child's anxiety. If you're still here, you probably know in your gut that your child needs support.
Trust that instinct.
You're not overreacting. You're not making a big deal out of nothing. You're being a thoughtful, caring parent who wants the best for their child.
Anxiety doesn't get better from waiting. It gets better from intervention. And the good news is, childhood anxiety responds really well to treatment.
At Aspire Counseling, we're here to help. Our team has helped hundreds of anxious children throughout Mid Missouri learn to manage their worries, face their fears, and feel like kids again.
We make it easy to get started:
Call us at (573) 328-2288 to speak with our Client Care Specialist. They'll ask about what you're seeing, answer your questions, and help you determine if therapy is the right next step.
Schedule a free consultation to meet a therapist and see if we're a good fit
Choose between in-person sessions (Columbia or Lee's Summit) or secure telehealth from anywhere in Missouri
Ready to help your child feel better?
Learn about our child anxiety therapy services throughout Missouri
Explore our comprehensive child counseling in Columbia, MO for anxiety, trauma, and more
Read more about what to expect in therapy
Your child is capable of so much more than anxiety allows them to do right now. Let's help them unlock that potential.
The anxiety you're seeing today doesn't have to be their future. With the right support, your child can learn to manage worry, face fears, and feel confident in who they are.
You've already taken the first step by educating yourself. Now take the next one. Call us today at 573-328-2288.
About the Author
Jessica (Tappana) Oliver, MSW, LCSW founded Aspire Counseling with a mission to provide exceptional, evidence-based therapy to children and families across Missouri. While Jessica provides clinical oversight and strategic direction, it's Aspire's team of child specialists who bring this mission to life every single day.
Madi has a gift for connecting with anxious elementary-age children and helping them build skills through play and evidence-based techniques. Her warm, engaging approach helps kids feel understood while learning to manage their worries. Kristi, our Senior Clinical Team Lead, brings years of experience treating anxiety disorders in children and ensures our team maintains the highest clinical standards. Ashley specializes in helping children navigate anxiety related to trauma, life transitions, and challenging experiences.
The Aspire team serves families in Columbia, Jefferson City, Lee's Summit, and throughout Mid Missouri with therapy that combines clinical excellence with genuine care.
