What is childhood Anxiety? Anxiety in children is common. We explore the diagnosis, treatment and how to help a child with anxiety.

Understand the diagnosis, know what to do next and access resources

Having feelings of anxiety is a natural part of life. Part of a growing up is learning how to work through emotions of fear, worry and anxiety. However, when these emotions and concerns become too difficult for a child to handle they may be suffering from childhood anxiety and need additional help in managing their anxiety. Symptoms of anxiety in children are:

  • When the fear, worry, or anxiety is more than temporary
  • When the fear, worry, or anxiety does not go away
  • When the fear, worry, oranxiety gets worse over time
  • When your child is unable to function doing age appropriate tasks
  • When the fear, worry, or anxiety affects eating, sleeping and other normal functions for a child

We encourage parents to discuss with a child’s physician if issues are present before seeking out mental health services in order to rule out other conditions. Other conditions that may produce symptoms similar to anxiety may include low blood sugar, certain medications a child may be already taking, thyroid problems, etc. Your child’s doctor can usually make a good recommendation for mental health services that meet your child’s needs once a diagnosis is made.

There are many causes of anxiety, and parents should be aware if they are causing, influencing, or exacerbate the anxiety. Parent’s should not trivialize or minimize their child’s anxiety. If a child is anxious, that anxiety is very real to them. Minimizing and trivializing their anxieties, even if you believe they are not real, may create additional problems.

Do parent’s anxiety cause their children to have anxiety. This study says yes.


Anxiety diagnosis information

There are various anxiety disorders. Some anxiety diagnosis include: General Anxiety Disorder, Panic Disorder, Obsessive Compulsive Disorder (OCD), Post-traumatic stress disorder (PTSD), Phobias and Social Anxiety Disorder. Here we cover anxiety in general. Parents should know that anxiety can coexist with other psychiatric disorders, including, but not limited to major depression, bipolar disorder or substance abuse problems. There are similarities with anxiety and depression. If anxiety exists with other disorders there is a heightened risk of suicidal tendencies and impairment.

Diagnostic criteria

  • Excessive anxiety and worry, occurring more days than not for at least 6 months, concerning a number of events
  • The individual finds it difficult to control the worry
  • The anxiety and worry are associated with at least three of the following six symptoms (only one item required in children):
  1. Restlessness, feeling keyed up or on edge
  2. Being easily fatigued
  3. Difficulty concentrating
  4. Irritability
  5. Muscle tension
  6. Sleep disturbance
  • The anxiety, worry or physical symptoms cause clinically significant distress or impairment in important areas of functioning
  • The disturbance is not due to the physiological effects of a substance or medical condition
  • The disturbance is not better explained by another medical disorder

Diagnosis is confirmed. Now what?

Once your child’s anxiety diagnosis is confirmed, you can begin to learn strategies to help your child. Become familiar with the different anxiety treatment approaches and understand their strengths and weaknesses. Take the time to consider what anxiety solution would work best for your child. Most therapeutic approaches can be adapted and combined to provide your child with various tools to address the issue.


In addition to getting professional help, it is recommended that parents and children learn additional behavior skills at home to help the treatment work more effectively. By implementing behavior skills in your home, you and your child will be able to move more quickly through the treatment process and your child will improve.This includes the parenting skills and lessons on this website.

Behavior modification therapy and medication

Anxiety is typically treated using psychotherapy, medication or a combination of both. Parents should work closely with their physician to determine which approach is best and advocate, if necessary, for the treatment they feel would best help their child. Physicians have a great deal of knowledge about the techniques, but parents are the ultimate authority on their children and their personality. Combining both parties in treatment decisions will lead to longer lasting success.

Cognitive Behavioral Therapy (CBT)

In terms of psychotherapy, cognitive behavioral therapy (CBT) tends to be especially useful in the treatment of Anxiety. This approach works by teaching different ways of thinking, behaving and reacting to certain situations. If successful, the result is that the patient is then able to feel less anxious and/or worried. The Smarter Parenting skills and lessons are CBT focused and can help address anxiety issues. A variety of CBT interventions have shown promising results. These approaches vary widely in the type and combination used. Some examples include: self-monitoring, relaxation training, cognitive therapy, worry exposure and the practice of newly learned relaxation and coping skills. A review of the scientific literature showed that nearly half of patients treated with CBT showed a positive clinical response to treatment. Further to that, patients undergoing CBT were more likely to show a reduction in anxiety and depression. So, although CBT is generally accepted as the most effective treatment, there is not consensus on which specific CBT approach is most effective in the treatment of Anxiety.


If medication is used, prescribers typically rely on either anti-anxiety medications or anti-depressants. Anti-anxiety medications are potent, and although they may begin to work immediately, they should not be relied on for long term relief. Anti-depressants may also be helpful in the treatment of Anxiety. Patients who are prescribed these medications should be aware that they can take several weeks to begin working and can lead to side effects such as difficulty sleeping, headache or nausea. Parents should also ask questions about long-term effects of medication on their child and if research has been done on whatever medications they choose to use. Newer medications will not have enough information about long-term side effects. Parents should be informed before making a decision.

Additional support

Additional support can be found by joining a support group, discussions with a good friend, stress management techniques, meditation, exercise. These can be coupled with therapy and medication in order to help strengthen the overall effectiveness of treatment.

Children and families can benefit from using basic behavior skills. The recommended Parenting Skills are: Decision Making (SODAS Method) and Preventive Teaching.

Customizing Decision Making for Anxiety

Use the skill of Decision Making (SODAS Method) before doing any task or activity that may cause your child to be anxious and show them they have options on how to address their feelings. Watch the following video and learn more by visiting the Decision Making (SODAS Method) page.

Tips for parents when using this skill for Anxiety

  • Work on the SODAS assignment together with your child. Even though you are working together, let your child take charge and make the suggestions for options.
  • Practicing (role-playing) the chosen option is very important. Start simple and as your child is able to adapt, increase the intensity of the practice so it’s as close to the actual situation as possible.
  • Be patient. If your child struggles too much evaluate if the practice is too intense. If not, the option is not correct. You may have to do the SODAS again to come up with new options. Even though it looks good on paper it may not be effective in real life for your child to do.
  • Practice multiple times.

Customizing Preventive Teaching for Anxiety

The most effective thing a parent can do for their child who is struggling with Anxiety is to prepare them for what is to come and the situations that will make them anxious. Watch the following video and read the tips below on how to customize this skill to address your child’s Anxiety.

Tips for parents when using this skill for Anxiety

  • As much as possible, parents can prepare their child for what is to come before it happens by mentioning the upcoming event before the event and prepare them by reminding them of what they can do to manage their anxiety.
  • Avoid telling your child what NOT to do. This only encourages them to remember what they should not do. Focus on what they should do instead.
  • Decide how early you want to prepare them. Often, telling them too early may actually increase anxiety. As the expert on your child, decide on a time frame that will work with your child.

Using the other tabs, you’ll find additional resources for how to help a child with anxiety.

Smarter Parenting blog posts

My child freaks out over new experiences. Why?

How can I get my child on a schedule?

How to help your child deal with a new situation

5 ways to help and anxious child

How to use Preventive Teaching to help your child’s anxiety

The following resources may be helpful

The National Institute of Mental Health has specific information on Generalized Anxiety Disorder, Panic Disorder and Social Anxiety Disorder.

Pamphlet about Generalized Anxiety Disorder covers basic information and treatment options.

PDF of Statistics of Anxiety Disorder in children from the National Institute of Mental Health.

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