Dr. Solomon Laktineh

Article

How to help an anxious child, from a pediatrician of 45 years

What childhood anxiety actually looks like, the well-meaning mistakes most parents make, and the gentle, evidence-based path that actually helps.

Childhood anxiety is more common than ever, and more responsive to treatment than most parents realize. After forty-five years in pediatrics, I have watched the rise of pediatric anxiety from a quiet concern in a few families to one of the most common reasons parents reach out. The good news is that we know what helps.

What anxiety looks like in children

Children rarely say I am anxious. They say their stomach hurts. They refuse to go to school. They ask the same question many times in a row. They become tearful at drop-off long after most kids have settled. They avoid sleepovers, birthday parties, or being away from a parent. They worry out loud about things that have not happened yet. These are the daily fingerprints of anxiety in children.

The two most common, well-meaning mistakes

What to do

  • Validate the feeling, then gently coach toward the situation
  • Stay calm yourself, model handling discomfort
  • Break the feared situation into very small steps
  • Praise the brave try, not the outcome

What not to do

  • Dismiss the worry: just stop worrying about it
  • Rescue the child from every uncomfortable situation
  • Argue with the worry logically while it is hot
  • Promise that nothing bad will ever happen

The five-step approach that works

  1. Name the worry, with respect

    Use the child's words. 'You are worried about throwing up at school.' Naming a feeling reduces its intensity. Dismissing it makes it grow.

  2. Validate before coaching

    'That sounds really hard.' Empathy is not agreement. It is acknowledgment. Children cannot hear advice from a parent who has not first acknowledged the feeling.

  3. Break it into tiny steps

    If your child is afraid of school drop-off, the goal is not to walk in calmly tomorrow. The goal is to walk to the gate today, the door tomorrow, the classroom the day after. Tiny exposure beats one big push every time.

  4. Coach the body

    Slow breathing, especially long exhales. Cold water on the face. Walking. Anxiety is a physical experience. The body is often the fastest way in.

  5. Praise the brave try

    Not the outcome. 'You walked to the gate even though you were scared. That is brave.' This builds the identity of a child who can do hard things.

When to seek more help

If anxiety is keeping your child out of school, away from friends, or up at night for more than a few weeks, it is time to bring in a pediatrician and likely a child therapist trained in cognitive behavioral therapy. The earlier the right support arrives, the faster anxiety responds.

Frequently asked

How do I know if my child has anxiety or is just shy?
Shy children warm up. Anxious children tend to avoid, ruminate, ask for repeated reassurance, or have physical symptoms like stomach aches before the feared situation. Anxiety also tends to spread from one situation to many.
What is the worst thing I can do?
Two things: dismiss the worry as silly, or rescue the child from every uncomfortable situation. Both make anxiety worse over time. The middle path of empathy plus gentle exposure is the most effective.
Should I take my child to a therapist?
If anxiety is interfering with school, friendships, sleep, or daily functioning, yes. Cognitive Behavioral Therapy is highly effective for childhood anxiety.
Does anxiety in children require medication?
Sometimes, but not as a first step in most cases. Therapy and family-based strategies are usually tried first. Medication can be an excellent tool when anxiety is severe.
Can anxiety be inherited?
Yes. Anxiety has a strong genetic component. Anxious parents often have anxious kids. The good news is that the same skills that help your child usually help you too.

Related reading: anxiety help and consultations, back-to-school anxiety, and raising emotionally intelligent children. To talk specifically about your child, book a consultation.

Help your anxious child, calmly

A private 30-minute call. Walk through what you are seeing. Leave with one or two specific things to try this week.