Signs of Anxiety in Children: What Parents Shouldn’t Ignore | Dr Shaun Segal
Every child experiences worry, nervousness, or fear from time to time. Feeling anxious before starting a new school, taking an exam, performing in front of others, or visiting a doctor can be a normal part of childhood. However, when worry becomes persistent, intense, or begins interfering with everyday activities, parents may need to pay closer attention.
According to Dr Shaun Segal, recognising emotional and behavioural changes early can help parents understand when their child may need additional support. Anxiety in children does not always look like anxiety in adults. Some children openly describe feeling worried, while others communicate their distress through behaviour, physical complaints, sleep problems, irritability, or avoidance.
In this guide, Dr Shaun Segal discusses common signs of anxiety in children, when parents should be concerned, and when professional support may be appropriate.
What Does Anxiety Look Like in Children?
Anxiety can affect a child’s thoughts, emotions, behaviour, and physical wellbeing. The signs can also differ considerably depending on a child’s age, personality, circumstances, and development.
Dr Shaun Segal encourages parents to look for patterns rather than becoming alarmed by a single episode of worry.
For example, a child who feels nervous on the first day of school may simply be responding normally to an unfamiliar situation. However, a child who experiences severe distress about school repeatedly and begins avoiding attendance may require further assessment.
Here are some important signs parents should be aware of.
1. Excessive Worry That Is Difficult to Control
Frequent or excessive worrying can be one of the more recognisable signs of anxiety.
Children may worry about school, friendships, family members, health, making mistakes, being embarrassed, or situations that seem relatively minor to adults.
Dr Shaun Segal explains that the frequency and impact of these worries are important. Occasional worry is normal. Persistent worry that affects a child’s ability to relax, sleep, attend school, socialise, or participate in normal activities deserves attention.
Younger children may not always have the vocabulary to explain what they are feeling. Parents may therefore hear repeated questions seeking reassurance, such as whether something bad will happen or whether a parent will be safe.
2. Avoiding School or Social Activities
Avoidance can be an important behavioural sign.
A child who previously enjoyed school, birthday parties, sports, or other activities may suddenly become reluctant to participate.
According to Dr Shaun Segal, parents should try to understand what is behind a significant change in behaviour rather than immediately assuming that a child is simply being difficult.
A child might be worried about separating from a parent, interacting with other children, being judged, completing schoolwork, or dealing with another stressful situation.
When avoidance becomes frequent or significantly interferes with everyday life, parents should consider seeking professional advice.
3. Frequent Stomach Aches or Headaches
Anxiety does not only affect emotions. Children can experience physical symptoms as well.
Dr Shaun Segal notes that some children experiencing anxiety may frequently report stomach discomfort, headaches, nausea, a racing heartbeat, sweating, trembling, or feeling generally unwell.
Physical complaints should never automatically be assumed to be psychological. A paediatrician may first need to assess whether there is an underlying physical explanation.
However, if symptoms repeatedly appear around particular stressful situations—for example, before school or certain social activities—emotional factors may also need to be considered.
Dr Shaun Segal recommends discussing persistent or recurrent physical symptoms with an appropriate healthcare professional.
4. Changes in Sleep
Sleep and emotional wellbeing are closely connected.
Children experiencing anxiety may struggle to fall asleep, wake repeatedly during the night, have nightmares, or become reluctant to sleep alone.
Dr Shaun Segal explains that occasional sleep disruption is common, particularly during stressful periods. Persistent changes, however, can affect a child’s mood, concentration, energy, and ability to cope with daily activities.
A consistent bedtime routine and calm sleep environment may help some children. If sleep difficulties continue or significantly affect daily functioning, parents should discuss them with a healthcare professional.
5. Increased Irritability or Emotional Outbursts
An anxious child does not necessarily appear frightened.
Sometimes anxiety presents as irritability, frustration, anger, crying, or emotional outbursts.
Dr Shaun Segal encourages parents to consider whether a noticeable behavioural change could be communicating an underlying concern.
For example, a child may become unusually upset before school without being able to explain that they are worried about a classroom situation.
Rather than focusing only on stopping the behaviour, parents can try to understand what may be triggering it.
6. Constantly Seeking Reassurance
Children naturally look to parents for comfort. However, excessive reassurance-seeking can sometimes accompany anxiety.
A child might repeatedly ask whether they are safe, whether they made a mistake, whether a parent will return, or whether something bad will happen.
Dr Shaun Segal explains that repeatedly seeking certainty can indicate that a child is struggling to manage worries independently.
Parents can acknowledge the child’s feelings while encouraging them to express what specifically worries them. If reassurance-seeking becomes persistent or disruptive, professional guidance may be useful.
7. Difficulty Concentrating
Anxiety can occupy a significant amount of a child’s attention.
A child who is constantly thinking about something frightening or uncertain may have difficulty concentrating on schoolwork, conversations, or everyday tasks.
Dr Shaun Segal notes that concentration problems can have many causes, so they should not automatically be interpreted as anxiety.
Parents can consider whether difficulty concentrating occurs alongside other changes such as excessive worrying, poor sleep, avoidance, irritability, or physical complaints.
If there is a significant or persistent change in academic performance or concentration, discussing it with the child’s school and healthcare professional may help clarify what is happening.
8. Strong Fear of Making Mistakes
Wanting to do well is normal. However, some anxious children may become extremely concerned about making mistakes or disappointing others.
They may repeatedly redo schoolwork, avoid attempting something unfamiliar, become very upset about minor errors, or seek constant confirmation that they have done something correctly.
Dr Shaun Segal encourages parents to create an environment where mistakes are treated as a normal part of learning.
Children benefit from understanding that they do not need to perform perfectly to receive support and encouragement.
9. Changes in Eating Habits
Stress and anxiety can sometimes influence appetite.
Some children may eat less than usual when worried, while others may change their eating behaviour during stressful periods.
Dr Shaun Segal recommends paying attention to significant or persistent changes in appetite, particularly when they occur alongside changes in mood, sleep, energy, growth, or behaviour.
Changes in eating can have many causes, including physical health conditions, so professional assessment may be necessary.
10. Fear of Being Away From Parents
Separation concerns can be developmentally normal, particularly among younger children. The intensity and persistence of the behaviour are important considerations.
A child experiencing significant anxiety may become extremely distressed when a parent leaves, refuse to attend school, avoid sleeping away from home, or constantly worry that something will happen to a caregiver.
Dr Shaun Segal explains that when separation fears are unusually intense for the child’s developmental stage or interfere with everyday activities, parents should consider discussing the situation with a healthcare professional.
How Can Parents Help an Anxious Child?
One of the most valuable things parents can do is create opportunities for children to communicate without fear of criticism.
Dr Shaun Segal recommends listening carefully and acknowledging a child’s feelings. Telling a worried child simply to “stop worrying” may not help them understand or manage the emotion.
Instead, ask gentle questions about what they are experiencing.
Predictable routines can also provide children with a sense of stability. Regular sleep, balanced meals, physical activity, appropriate downtime, and supportive family interaction all contribute to overall wellbeing.
Parents should also model healthy responses to everyday stress where possible.
When Should Parents Seek Professional Help?
Parents do not need to wait until anxiety becomes severe before asking for guidance.
Dr Shaun Segal recommends seeking professional advice when anxiety is persistent, worsening, causing significant distress, or interfering with school, sleep, friendships, family life, eating, or everyday activities.
A paediatrician can help evaluate the child’s overall health and development and determine whether further assessment by a child psychologist, psychiatrist, or another qualified mental health professional may be appropriate.
Immediate professional help should be sought if a child talks about self-harm, suicide, wanting to die, or presents an immediate risk to themselves or someone else.
Supporting Your Child Starts With Paying Attention
Anxiety can look different from one child to another. While one child may openly talk about being frightened, another may complain of stomach aches, avoid school, become irritable, struggle to sleep, or constantly seek reassurance.
As Dr Shaun Segal emphasises, parents should pay attention to persistent changes and consider how much those changes are affecting the child’s everyday life.
Not every fear or worry indicates an anxiety disorder. Childhood naturally involves new experiences, uncertainties, and occasional fears. The important distinction is whether anxiety becomes persistent, disproportionate, distressing, or disruptive.
If you are concerned about your child’s emotional wellbeing, behaviour, sleep, physical symptoms, or development, Dr Shaun Segal can provide paediatric guidance and help determine appropriate next steps.
For more information about children’s health and paediatric care, visit the official Dr Shaun Segal website.
Medical disclaimer: This article is intended for general educational purposes only. It does not replace personalised medical or mental health advice, diagnosis, or treatment from a qualified healthcare professional.
