When Should I Worry About My Child’s Anxiety? A Guide for Parents
"Is this normal?"
It's probably the question we hear most often from parents who reach out to us at Aspire Counseling. Your child is worried about something, and you're not sure if it's typical childhood anxiety or something that needs professional attention.
You don't want to overreact and rush them into therapy for something they'll grow out of. But you also don't want to wait too long and let them suffer unnecessarily.
So how do you know? When is worry just part of being a kid, and when does it cross the line into an anxiety problem that needs help?
This guide will help you make that decision. We'll walk through what's normal, what's not, and when it's time to reach out for professional support.
At Aspire Counseling in Columbia, MO, we offer child counseling and specialized anxiety therapy for children ages 3 and up. We understand that deciding whether your child needs therapy is a big decision—and we're here to help you figure out the right next step for your family.
Normal Childhood Worries vs. Anxiety Disorders
First, let's be clear: All children worry sometimes. Worry is a normal part of development and can even be protective.
A child who's slightly worried about forgetting their lunch learns to pack it the night before. A child who's a little nervous about the spelling test studies harder. A child who's cautious around strangers stays safer.
This is healthy, developmentally appropriate anxiety. It comes and goes, it doesn't interfere with daily functioning, and it helps kids learn to prepare and cope with challenges.
What Normal Worry Looks Like:
Temporary - The worry appears in response to a specific situation and goes away once the situation passes
Proportionate - The level of worry matches the actual risk or importance of the situation
Manageable - The child can be reassured, distracted, or can calm themselves down with minimal support
Doesn't interfere - The child still goes to school, plays with friends, participates in activities, and functions normally
Age-appropriate - Young children worry about separation from parents; older children worry about performance and peer relationships
For example, a seven-year-old who's nervous before the first day of school, asks a few questions, maybe needs extra reassurance at bedtime—but then goes to school and has a good day—is experiencing normal worry.
What Anxiety Disorders Look Like:
Anxiety becomes a clinical concern when it's:
Persistent - The worry doesn't go away, even after the triggering situation has passed. It's there most days, much of the time.
Out of proportion - The intensity of the worry doesn't match the actual risk. A child might be as anxious about a birthday party as you'd expect them to be about a serious threat.
Unresponsive to reassurance - No amount of reassurance seems to help. You answer their questions, but they ask again (and again and again).
Interfering with life - The anxiety is getting in the way of school attendance, academic performance, friendships, family activities, sleep, or eating.
Causing significant distress - The child is clearly suffering. They're having meltdowns, physical symptoms, or expressing that the worry feels unbearable.
Using that same example: A seven-year-old who's terrified before the first day of school, has a meltdown, refuses to get out of the car, or makes themselves sick with worry—and this pattern continues for weeks—is experiencing problematic anxiety.
Red Flags That Mean It's Time to Seek Help
If you're seeing several of these patterns, it's time to consider professional help:
Impact on School
Frequent absences due to anxiety-related complaints (stomachaches, headaches, "not feeling well")
School refusal - crying, pleading, or physically resisting going to school
Declining grades not because of ability, but because anxiety is interfering with focus or completion of work
Avoidance of participation - won't raise hand, won't present in front of class, skips activities they used to enjoy
Calls from school about behavioral issues, frequent nurse visits, or emotional struggles
Impact on Sleep
Difficulty falling asleep that goes beyond typical bedtime resistance (taking an hour or more most nights)
Needing you present to fall asleep when they're at an age where they should be independent
Frequent night waking with worry or nightmares
Early morning waking with anxiety about the day ahead
Exhaustion that affects their mood, behavior, and ability to function
Impact on Family Life
Walking on eggshells - The whole family is adjusting their behavior to avoid triggering the child's anxiety
Frequent meltdowns over situations that seem minor or manageable to you
Excessive reassurance-seeking that dominates family time and conversation
Avoidance affecting family activities - You can't go to restaurants, events, or outings because of the child's anxiety
Sibling relationships suffering because so much attention goes to managing the anxious child
Impact on Peer Relationships
Social isolation - The child has stopped seeing friends, declines invitations, or plays alone at school
Difficulty making or keeping friends due to anxiety-driven behaviors
Intense fear of social situations (birthday parties, playdates, group activities)
Expressed loneliness - They want friends but anxiety is getting in the way
Physical Symptoms
Frequent complaints of stomachaches, headaches, or feeling sick (with no medical cause)
Panic symptoms - racing heart, sweating, shaking, feeling like they can't breathe
Changes in eating - significant increase or decrease in appetite
Physical tension - clenched jaw, tight shoulders, frequent bathroom trips
Behavioral Red Flags
Avoidance is increasing - The list of things your child avoids is growing longer
Rituals or compulsions - Repeated behaviors they "have to" do to feel okay (possible OCD)
Regression - Behaviors they had outgrown are returning (bed-wetting, baby talk, extreme clinginess)
Emotional outbursts that seem out of proportion to the situation
If you're nodding along to several of these, your child would likely benefit from professional support. You're not overreacting—you're being a responsive, caring parent.
What Happens if Childhood Anxiety is Left Untreated?
This is the question that weighs on parents: "What if we don't get help? Will they grow out of it?"
Some children do naturally develop better coping skills as they mature. But for many children, untreated anxiety doesn't just go away—it evolves and often gets worse.
Short-Term Consequences:
Academic impact. Anxiety makes it hard to focus, absorb information, and perform under pressure. Kids fall behind not because they lack ability, but because anxiety is in the way.
Social struggles. Anxious children often miss out on important social learning opportunities because they're avoiding situations where they'd practice friendship skills. This can lead to loneliness and difficulty making friends.
Family stress. Living with an anxious child creates tension in the whole family. Parents disagree about how to respond. Siblings feel resentful of the attention the anxious child receives. Family activities become limited.
Reinforced avoidance. Each time anxiety leads to avoidance, the brain learns: "That situation is dangerous. Avoiding it kept me safe." This makes the anxiety stronger and the feared situation scarier.
Long-Term Risks:
Chronic anxiety into adolescence and adulthood. Research shows that childhood anxiety disorders often persist if untreated. The seven-year-old with separation anxiety can become the teenager with social anxiety, then the adult who struggles with generalized anxiety disorder.
Depression. Untreated anxiety is a significant risk factor for depression, especially as children enter the teen years. The constant stress of living with anxiety is exhausting and can lead to hopelessness.
Substance use. Anxious teenagers sometimes discover that alcohol or marijuana temporarily quiets the worry. This creates risk for unhealthy coping patterns and substance dependence.
Limited opportunities. Anxiety can shape life choices in limiting ways—avoiding college because of fear of leaving home, turning down job opportunities, missing out on relationships.
The good news? Early intervention dramatically improves outcomes. Kids who learn anxiety management skills early are much less likely to experience these long-term consequences.
You don't have to wait until things are in crisis. If anxiety is interfering with your child's life now, that's reason enough to get help.
How Therapy Can Help Anxious Children
Many parents worry that therapy will be too much for their child, too intense, or that talking about anxiety will make it worse. Let us reassure you: evidence-based therapy for childhood anxiety is highly effective and appropriate for young children.
What Therapy Looks Like for Anxious Kids:
Cognitive Behavioral Therapy (CBT) is the gold standard treatment for childhood anxiety. It's practical, skill-based, and kids usually start seeing improvement within weeks.
In CBT, children learn:
How thoughts, feelings, and behaviors are connected
How to identify anxious thoughts and challenge them
Coping skills they can use when anxiety shows up
How to face feared situations gradually (exposure therapy)
For younger children (ages 3-7), therapy often involves play, art, and creative activities. Kids this age don't have the language to talk about complex emotions, so we meet them where they are developmentally.
Parent involvement is key. You'll learn how to respond to anxiety in ways that are supportive without reinforcing avoidance. Research shows that when parents are involved, kids make faster progress and maintain their gains longer.
It's time-limited. Most children see significant improvement in 12-16 weeks of therapy. You're not committing to years of treatment—you're investing a few months to give your child lifelong skills.
Success Looks Like:
Your child attending school consistently
Re-engaging with activities and friendships they'd been avoiding
Using coping skills independently when anxiety shows up
Sleeping better and having fewer physical complaints
Your family life feeling calmer and less dominated by anxiety
Your child building confidence and trusting themselves to handle hard things
Finding a Child Therapist in Columbia, MO
If you've decided it's time to get help for your child, here's what to look for:
Qualities of a Good Child Therapist:
Training in evidence-based treatments (CBT, play therapy, exposure therapy)
Experience with your child's age group and presenting concerns
Warm, engaging style that helps kids feel comfortable
Collaborative approach with parents
Clear communication about treatment plans and progress
At Aspire Counseling, We Specialize in Childhood Anxiety:
We offer therapy for children ages 3 and up, both in our Columbia office and online throughout Missouri. Our therapists are trained in evidence-based approaches specifically for childhood anxiety, including CBT, play therapy, and when trauma is part of the picture, Trauma-Focused CBT.
We take the matching process seriously—we'll consider your child's age, personality, what they're struggling with, and what therapeutic approach is likely to work best. Then we'll connect you with a therapist whose training and style are a good fit.
For more comprehensive information about childhood anxiety, including what it looks like and what triggers it, read our complete guide: Anxiety in Elementary Age Children: What Parents in Columbia, MO Need to Know.
Trust Your Instincts
You know your child better than anyone. If something feels off—if the anxiety seems more intense or persistent than what you'd expect, if it's getting in the way of their happiness or ability to function—that's worth taking seriously.
You don't need to wait until you have a formal diagnosis or until things are in crisis. If you're worried enough to be reading this article, that's information worth paying attention to.
Getting help early doesn't mean you're overreacting. It means you're being proactive, responsive, and caring. It means you're giving your child the tools they need before anxiety becomes entrenched.
The worst that happens if you reach out and your child doesn't need therapy? You get reassurance and guidance from a professional. You learn some strategies to support your child at home. You establish a relationship with a therapist in case you need support later.
The worst that happens if you wait too long? Anxiety gets worse, becomes more entrenched, and takes longer to treat. Your child suffers unnecessarily. Opportunities are missed.
When in doubt, reach out.
Contact Aspire Counseling today online or by phone (573-328-2288) to schedule a consultation. We'll talk through what you're seeing, answer your questions, and help you determine whether therapy is the right next step for your child and family.
Related Reading
Want to learn more about childhood anxiety?
Anxiety in Elementary Age Children: What Parents in Columbia, MO Need to Know - Our comprehensive guide to understanding anxiety in kids, recognizing when it's a problem, and getting help.
Identifying Anxiety in Children and Teens - Learn how to spot the signs of anxiety at different developmental stages.
What Triggers Anxiety in a Child? Understanding Your Child's Worry - Explore common anxiety triggers from school stress to trauma to temperament.
If you're also struggling with anxiety as a parent:
Dealing With Anxiety as a Parent - It's completely normal to worry about your children. But when worry becomes excessive, it can take away from your ability to be present and effective as a parent. Many families benefit when both parent and child receive support—and it's common for us to see both. Taking care of your own anxiety isn't selfish; it's one of the best things you can do for your family.
About the Author
Jessica Oliver is the founder of Aspire Counseling and has extensive training in evidence-based treatments for anxious children, including CBT, play therapy, and exposure-based approaches. She worked with anxious children in both school settings and private practice before transitioning her clinical focus to offering trauma therapy intensives for adults.
Jessica knows firsthand how hard it can be to find quality counseling for children—which is why she's committed to hiring some of the best child therapists in the Columbia area. At Aspire Counseling, therapists like Madi, Kristi, and Ashley provide specialized, compassionate care for anxious children using the same evidence-based approaches Jessica was trained in.
While Jessica now focuses on intensive therapy for adults dealing with trauma, she remains deeply committed to ensuring that families in Mid-Missouri have access to excellent mental health care for their children. She believes every child deserves to feel calm, confident, and capable—and that starts with having the right therapist.
Aspire Counseling offers child anxiety therapy in Columbia, MO and online throughout Missouri for ages 3 and up. We use evidence-based treatments including CBT, play therapy, and exposure therapy. We also offer support for parents struggling with their own anxiety, because healing happens best when the whole family is supported.
