Anxiety in Teens and Tweens: Is My Child Anxious? What Next?


Guest Blog by Dr. Liz Matheis, a licensed Clinical Psychologist and certified School Psychologist who specializes in assisting children and their families with Autism, ADHD, Anxiety and  learning/behavioral disorders.

Anxiety. It’s something we all feel. In fact, it’s normal to feel anxious.  It’s our body’s way of letting us know that something is unsafe or harmful. It’s our body’s way of revving up our energy supply so that we can run or hide or think quickly on our feet.  But what happens when that anxiety is something that you feel often, like every day? And it can sometimes, or all the time, get in the way of what you or your children want to do? Then, it’s a problem.

What Does Anxiety Really Look Like with Children and Adolescents?

With children and adolescents, anxiety isn’t necessarily pacing or writhing your hands. It can look different. It can actually be confusing. What you might see is:

  • withdrawal

  • isolation

  • agitation

  • restlessness

  • inattention, poor focus

  • somatic symptoms – headaches, stomachaches

  • avoidance

  • tantrums

  • crying

Children who are anxious don’t always know that they feel anxious. They just know that they don’t like how they feel, they don’t know how to make it stop, and so they let you know how children know how to by. Instead, it’s very easy for parents and teachers to interpret anxious behaviors as negative behaviors and to want to create a behavioral plan or chart.

My mantra is: No Child Wakes Up and Decides to Be Behavioral. That’s not how it works. Instead, when you, as the parent, begin to notice a change in behaviors, that’s when your antennae should perk up. Instead of ‘fighting’ back, I recommend that you let your child know that you know something is different and to make yourself available as a parent to listen and sympathize. 

Here are some signs to look for that may be a sign of anxiety and emotional struggle:

•      refusing to go to school

•      having meltdowns before school about clothing, hair, shoes, socks

•       having meltdowns after school about homework

•       having difficulties with transitions within school, and between school and an activity/sport

•       having difficulty settling down for bed

•       having high expectations for school work, homework and sports performance

•       talking back, fighting rules, being ‘fresh’

It’s very easy as a parent to think that your child has a behavioral problem, an Oppositional Defiance Disorder even. However, look closer. There’s a strong likelihood that your child is anxious, very anxious.

Rule In and Rule Out

Yes, and the two complicate each other. Two very common disorders that are comorbid with anxiety are Attention Deficit Hyperactivity Disorder (ADHD) and Learning Disabilities (LD), and sometimes your child’s behaviors and complaints may look like ADHD or an LD but the truth is, it’s anxiety.

Often times, an anxious child is preoccupied with thoughts and appears to be distracted in class. Your child may be losing chunks of class instruction, which is often seen as being due to an attention disorder like ADHD.  And, when your child is losing instruction, she may not be able to complete school work. This is often mistaken for a learning disability.

The flip side is that your child may have ADHD or LD and is anxious about his weaknesses, thereby there is comorbid anxiety.

School Supports

So, now that you know what it is, how can you help your child at school?

There are three types of plans that your child may qualify for with anxiety an Intervention and Referral Service Plan (I&RS Plan), a 504 Accommodation Plan, or an Individualized Education Plan (IEP).

An I&RS Plan is created by your Guidance Counselor, Teacher, and your Principal who will sit down with you and review your child’s needs within the classroom. Within this plan, accommodations can be provided without a diagnosis. However, it is a short-term plan that will be reviewed again within 4-8 weeks. The goal is to get the ‘situation’ under control and to eliminate the plan. 

If your child is suffering from a peak in anxiety due to a new stressor, such as a move, death in the family, divorce, parent illness, or change in a parent’s work status, this is a good plan to have.

A 504 Accommodation Plan is another type of plan that requires a diagnosis. So you will need a formal document indicating that your child is suffering from anxiety and the specific anxiety disorder by name. This plan will also give your child accommodations in the classroom. It is reviewed annually. Through this plan, your child can also be provided with statewide testing accommodations, such as small group administration, providing extended time, having directions read to your child, etc).

An IEP is offered to your child when there is a need for an academic program because your child’s anxiety is interfering with his ability to access the curriculum.  Your child would potentially be eligible under the category of Emotionally Disabled (ED), or Other Health Impaired (OHI).

Your child’s academic program would provide supports to help complete assignments and participate in class due to anxiety or a possible comorbid learning disability.  For example, your child may need to have a special education teacher or a paraprofessional to help your child to make sense of assignments that are perceived as frightening and to break them down. Your child may need to have a quiet place within the school building where she can go when she feels overwhelmed and needs to decompress.

As a parent, we are always trying to figure out how to help our child function at their best. Sometimes, it just takes us a little time to figure out what is happening or going on. Be patient and forgiving with yourself. These are our babies and we are not objective about them. We are emotional.  If you are seeing some of these behaviors and symptoms with your child, you may have found your “why” answer.

Dr. Liz Matheis is licensed Clinical Psychologist and certified School Psychologist who specializes in assisting children and their families with Autism, ADHD, Anxiety and  learning/behavioral disorders.

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In her private practice, she has 4 therapists who provide after school and evening hours with a specialty in CBT, Art & Play Therapy, Marriage & Family Therapy, Grieving, Trauma, In Home Executive Functioning Coaching, and use of the Sand Tray Therapeutic Technique.

Dr. Liz and her team focus on well-aligned parenting styles via parent coaching, helping parents who are divorcing or divorced to maintain a co-parenting relationship, creating a  consistent home environment, and the establishment of boundaries and behavioral expectations in helping children and families to realize their fullest potential.  She also serves as an Educational Consultant to parents who are seeking to optimize their child’s IEP, and need support and advocacy to maximize their child’s special education program and related services.  As a former School Psychologist on the Child Study Team, Dr. Liz provides psycho-educational evaluations that are Child Study Team friendly.

Dr. Liz was trained at Fairleigh Dickinson University in Madison and Teaneck, where she earned her BA in Psychology, MA and Ph.D. in Clinical Psychology.

PLEASE NOTE: The writers of this article are not medical professionals. The information in this column is not intended and should not be construed as providing medical or psychological advice, but rather to offer readers information and provide a perspective to better understand the lives of themselves and their children. Articles on this website may be opinion based. The articles are not intended to provide an alternative to professional treatment or to replace the services of a physician, psychiatrist, psychotherapist or other licensed medical professional. If you do have health or safety concerns, please get in touch with a healthcare professional.