Anxiety is an inevitable part of human development. However, for many children, anxiety goes beyond occasional worry and becomes a daily struggle that interferes with their happiness, school performance, and relationships. In fact, anxiety disorders are the most common mental health issue among children and adolescents, affecting millions of children worldwide. In the United States alone, nearly 1 in 8 children aged 3 to 17 has been diagnosed with an anxiety disorder. Among teenagers, the rates are even higher—about 32% of teens experience an anxiety disorder, and around 8% suffer from severe symptoms.

Different types of anxiety present with varying levels of frequency. Specific phobias (e.g., fear of animals or the dark) are the most common, affecting as high as 20% of children. Social anxiety disorder, characterized by extreme self-consciousness and fear of judgment, impacts around 10%. Separation anxiety and generalized anxiety disorder (GAD) are also prevalent, particularly among younger children.

These disorders often begin early. The median age of onset is just 11 years old, and symptoms can persist into adulthood if left untreated, increasing the risk for depression, substance abuse, and impaired functioning.

How Can I Recognize the Signs of Childhood Anxiety?

You may recognize anxiety in your child when they report frequent worry (“what if”) and rumination thoughts. However, childhood anxiety often shows up in other ways that are easy to miss or misinterpret.

Common signs include:

• Physical complaints like headaches, stomachaches, or fatigue
• Avoidance of activities or social interactions
• Trouble sleeping or concentrating
• Irritability or emotional/behavioral outbursts
• School refusal or frequent visits to the nurse’s office

Each type of anxiety disorder also has its own specific characteristics. For example:

• Children with social anxiety often fear speaking up, being called on, or participating in group activities.
• Those with obsessive-compulsive disorder (OCD) may engage in repetitive behaviors like excessive hand washing or checking locks due to intrusive thoughts and irrational fears.
• Children with selective mutism may speak freely at home but become silent in school.

What Treatments Work?

The good news is that anxiety disorders are highly treatable, and early intervention can make a big difference.

Cognitive Behavioral Therapy (CBT) is the gold standard in treatment for childhood anxiety of all kinds. It helps children recognize and begin combating anxious thoughts, learn strategies to tolerate physical manifestations of anxiety, and gradually face their fears through exposure exercises. Research shows that CBT has a strong and lasting impact, especially when tailored to the child’s age and anxiety type.

Another evidence-based treatment option, SPACE (Supportive Parenting for Anxious Childhood Emotions), is a parent-based treatment program designed to help children with anxiety disorders. Rather than focusing on the child, SPACE works by guiding caregivers to reduce accommodation behaviors—actions taken to help a child avoid anxiety triggers—which can inadvertently reinforce anxiety. Parents and caregivers learn supportive responses that communicate both empathy and confidence in their child’s ability to cope.

Lastly, school-based interventions can help anxious children to feel supported and apply coping strategies in real-life settings. A clinical psychologist may help to consult with teachers to implement anxiety-reducing strategies, support behavior plans, and improve communication between home and school environments.

Looking Ahead

Despite its high prevalence, childhood anxiety often goes unrecognized or untreated. Effective therapies exist, and by recognizing your child’s symptoms and supporting them in seeking evidence-based treatment, we can help your child thrive in spite of their anxiety. If you are concerned your child may be demonstrating some of these symptoms and/or you are seeking support as a parent or caregiver of an anxious child, the American Institute for Cognitive Therapy can help! We have clinicians with specialized training and experience in providing evidence-based treatments for children and their caregivers, and would be happy to help support your family.