Attention & Behavior

Anxiety

When worry stops being a feeling and starts making decisions — including whether your child can walk into school.

If you're here because you're scared, that's okay. You're not alone, and noticing is the first act of advocacy.

Read as much or as little of this page as you have room for today. It will still be here tomorrow.

What this is

Understanding Anxiety

Anxiety is the most common mental health condition in children. At school it can look like perfectionism, refusal, stomachaches, anger, or a child who is completely fine until the moment they aren't.

School avoidance is anxiety's loudest form, and it responds badly to pressure and well to gradual, supported re-entry. If mornings have become a battle, that's a clinical signal, not a discipline problem.

Anxiety can qualify a student under Emotional Disturbance or Other Health Impairment, or be supported by a 504 plan. The label matters less than a plan with specific, written responses.

Could this be it?

Early signs, by age

None of these are a diagnosis, and no child shows all of them. This is a list to help you notice patterns and describe them clearly to someone who can evaluate.

Toddler & preschool

Extreme distress at separation beyond the usual adjustment period
Intense fear of specific things that doesn't fade
Frequent stomachaches or headaches with no medical cause
Rigid need for routines and sameness to feel safe

Early elementary

Nightly worry, trouble sleeping, wanting constant reassurance
Tears or tantrums before school; frequent nurse visits
Perfectionism — erasing holes in the paper, refusing to start
Won't raise a hand or speak in class even when they know the answer

Older kids & teens

Panic symptoms: racing heart, shortness of breath, feeling of doom
Missing school; falling behind then dreading return more
Avoiding presentations, tests, lunchrooms, or social events
Irritability and anger that's actually anxiety wearing a different coat

What to do next

In this order, when you're ready

1
Rule out medical causes, then get a mental health evaluation
Start with the pediatrician, then a child psychologist or psychiatrist. Cognitive Behavioral Therapy and exposure-based treatment have the strongest evidence base for childhood anxiety.
2
Tell the school in writing, even if you're not sure yet
Ask for a meeting to discuss supports and request an evaluation if anxiety is affecting attendance, participation, or learning. Attendance letters are much easier to head off than to undo.
3
Ask for a re-entry plan if school refusal has started
Gradual return with a specific safe person, a safe place, and a written plan beats "just get them in the building." Every day out makes the next day harder.
4
Stop over-accommodating at home, gently
Therapists will tell you the same thing: constant reassurance and rescue feel loving and quietly grow the anxiety. A good therapist will coach you through what to say instead.
5
Write down what you're seeing
Dates, examples, the exact words your child used, how long homework took. You don't need a diagnosis to keep a record — you just need a notebook. This becomes the backbone of every conversation that follows.
6
If your child is under 3, call early intervention today
IDEA Part C gives every state a free early intervention program for babies and toddlers from birth to age 3. You do not need a doctor's referral and you do not need a diagnosis — a parent can refer their own child. Search "[your state] early intervention Part C" or ask your pediatrician for the number. For ages 3 and up, the same law (IDEA Part B) makes your local public school district responsible, even if your child doesn't attend school there yet.
7
Put your request for an evaluation in writing
Email or hand-deliver a dated letter to the school principal and the special education director asking for a full initial evaluation, and say what you're worried about. Writing it down starts the legal clock. Ask for a copy of your Procedural Safeguards at the same time.
8
Talk with your pediatrician
A medical visit can rule things in or out — hearing, vision, sleep, iron levels, anxiety — and can open the door to outside evaluations and therapies that run alongside anything school provides.
9
Say it out loud to your child, gently
Kids usually already know something is harder for them. Naming it kindly — "your brain works in a particular way and we're figuring out what helps" — turns shame into a plan.

Try this at home

Small things you can do this week

These are everyday activities, not therapy or instruction. Ten warm minutes beats an hour that ends in tears — stop before either of you is done being pleasant.

Ages 5+5 min

Name it to tame it

Give the worry a name and talk about it as a separate character — "what's Worry telling you right now?" Externalizing turns a flood into something you can both look at.

Ages 4+3 min

Breathe out longer than in

In for four, out for six, hand on belly. Practice it on calm days at bedtime so it's available on hard ones — nobody learns a new skill mid-panic.

Ages 6+10 min

One brave thing, small

Choose something slightly scary and doable — ordering their own drink. Anxiety shrinks by approach in small doses, and reassurance alone tends to feed it.

These ideas are general parenting suggestions for families reading about Anxiety. They aren't therapy, instruction, or medical advice — follow the plan your child's team has set.

Looking ahead

When your child reaches their teens

Starting somewhere between 14 and 16, the IEP has to begin planning for life after school: postsecondary goals, independent living skills, vocational training, and connecting with adult services before school ends. Decision-making changes at 18, too.

Read the transition planning guide

Where to read more

Organizations we trust

These are national nonprofits, university centers, and government resources. Firm Footing isn't affiliated with any of them — we just think they're worth your time.

Your IEP meeting

Before, during, and after

An IEP meeting is a working meeting, not a verdict. You are a full member of the team, and you can ask for another meeting any time.

Evaluations to ask for

Name these specifically in your written request — a general request gets a general answer.

Social-emotional and behavioral rating scales from home and school
Mental health evaluation (school psychologist and/or outside clinician)
Functional Behavior Assessment focused on avoidance and escape patterns
Attendance and nurse-visit data review
Academic testing to see what's been missed while anxiety was in charge

Before the meeting

Ask for a copy of the draft IEP, the evaluation report, and any progress data at least a few days ahead. You are allowed to read before you decide.
Send a short list of your concerns and questions in writing before the meeting so they must be addressed on the record.
Write your own one-page "parent input statement" — who your child is, what's working, what isn't, what you want by the end of the year. Ask that it be attached to the IEP.
Bring someone: a partner, a friend, a note-taker, or an advocate. You are allowed to bring anyone with knowledge or special expertise about your child.
Check your state's rules on recording, and give written notice if you plan to record.

During the meeting

Ask each person to say what data they used. "What is that based on?" is a complete, polite question.
Slow the meeting down when a term goes by that you don't know. "Can you say that in plain language?" is your right, not an interruption.
Test every goal out loud: What exact skill? How will it be measured? What's the target number? Under what conditions? By when?
Check that the services page matches the needs page — every need described in the PLAAFP should have a goal, a service, or an accommodation attached to it.
If you disagree, don't refuse to sign in silence. Ask for your disagreement to be written into the meeting notes, and ask what the school proposes instead.

Services to ask about

Counseling as a related service with stated minutes
A written safe-person and safe-place plan available every day
Instruction in coping and self-regulation skills, taught explicitly
Behavior Intervention Plan built around anxiety, not compliance
Gradual re-entry plan with written steps if school refusal is present

Accommodations to ask about

Break card or pass to a designated adult, usable without asking permission out loud
Advance notice of tests, changes, fire drills, and substitutes
Alternative to presenting in front of the class
Testing in a small, quiet setting with extended time
Late arrival or reduced schedule during re-entry, written down
Homework and missed-work plan so returning doesn't mean drowning
No public correction or calling on without warning

After the meeting

Send a same-day follow-up email summarizing what was agreed and what's still open. A friendly written summary becomes the record.
Read the final IEP against your notes when it arrives. If something is missing or different, say so in writing within days, not months.
Calendar the progress reporting dates and ask for the actual data, not just "making progress."
If services aren't being delivered, ask for the service log in writing. Missed minutes can mean compensatory services.
If you disagree with the school's evaluation, you can request an Independent Educational Evaluation (IEE) at public expense — ask in writing.

Still not sure

Bring the document, or bring the question

If you already have an IEP or evaluation in hand, Decode My IEP will read it with you and flag the vague goals. If you just want to ask something out loud, Sprout answers in plain language.

Decode my IEP Ask Sprout a question

Related guides

Firm Footing is an independent resource. Nothing on this page is medical, psychological, or legal advice, and none of the organizations linked here are affiliated with us. Special education rules vary by state and district — your state's Parent Training and Information Center can help you with local specifics for free.