Our Blog
From Tummy Aches to Tantrums: The Many Faces of School Anxiety
June 17th 2025 / Assessments / By Randall Symes
When School Complaints Signal Deeper Issues
That morning ritual is all too familiar for many parents: the complaints begin as soon as the alarm sounds. “My stomach hurts.” “I feel sick.” “I can’t go to school today.” What appears at first glance as simple avoidance or perhaps a minor illness often masks something deeper and more complex – school anxiety.
School anxiety isn’t just about refusing to go to class. It’s a genuine emotional response that manifests in surprisingly diverse ways, from physical symptoms that could fool even the most discerning parent to behavioral changes that transform your usually confident child into someone you barely recognize.
As specialists in child psychology at Randall Symes Psychological Services, we’ve guided hundreds of families through this challenging terrain, and we’re sharing our insights to help you recognize when ordinary school jitters have evolved into something that demands attention.
When Anxiety Wears a Physical Disguise
The body speaks volumes when words fail. For many children, school anxiety first appears not as expressed fear but as mysterious physical ailments. Those recurring stomach aches that consistently appear on Monday mornings but mysteriously vanish on weekends. The headaches that develop during breakfast but resolve once the school bus has departed without them. The sudden fatigue that only seems to strike during the school week.
These physical manifestations aren’t imaginary – they’re your child’s nervous system responding to perceived threats. The brain-gut connection is powerful, and anxiety triggers very real physical discomfort that children often lack the emotional vocabulary to explains
Physical symptoms may also include disturbed sleep patterns that further compound the problem. Children anxious about school often struggle to fall asleep the night before, creating a cycle of sleep deprivation that amplifies emotional vulnerability. Parents report children waking repeatedly to check the time or experiencing vivid nightmares about school scenarios. This sleep disruption alone can manifest as irritability and difficulty concentrating – problems that can
be mistakenly attributed to behavioral issues rather than their root cause: anxiety.
Beyond the Physical: Emotional and Behavioral Signs
While some children’s anxiety shows up in their bodies, others reveal their distress through behavior. The morning meltdowns that escalate with each minute closer to departure time. The tearful drop-offs that leave both you and your child emotionally drained. The increasingly elaborate excuses that demonstrate surprising creativity but troubling avoidance.
Pay attention to subtle shifts, too. Is your once-social butterfly now withdrawing from friends? Has your confident student become paralyzed by perfectionism. Does your child seek constant reassurance about scenarios that might unfold at school?
Another common but often misunderstood manifestation is school refusal – a pattern more complex than simple defiance. Children refusing school aren’t typically being oppositional for its own sake; they’re avoiding overwhelming distress. This avoidance might look like negotiation (“I’ll go tomorrow, I promise”), manipulation (“I’ll be so good if you let me stay home”), or outright defiance (“You can’t make me go!”).
Social anxiety adds another dimension to school distress. For some children, the academic aspects of school pose no problem, but the playground becomes a battlefield. Navigating complex social hierarchies, understanding unspoken rules of interaction, and managing rejection require sophisticated emotional skills. Children struggling in this realm might avoid group activities, eat lunch alone, or report frequent conflicts with peers.
Understanding the Triggers
School anxiety rarely emerges without cause. Common triggers include:
Academic pressure: In our achievement-oriented culture, children absorb messages about success and failure early. The fear of not measuring up academically can become overwhelming, particularly as standardized testing increases.
Social challenges: Bullying is an obvious trigger, but even subtle exclusion or friendship difficulties can generate significant anxiety. In our practice, we’ve found that children often downplay these interactions to parents, making them harder to identify as anxiety sources.
Transition points: Moving from elementary to junior high, changing schools, or returning after extended absences can trigger anxiety even in previously confident students. These transitions represent multiple unknowns and require significant adaptation energy.
Specific school-related fears: Some children develop specific fears related to school – using public restrooms, changing for gym class, speaking in front of groups, or separating from parents. While these may seem manageable to adults, they can become debilitating for children.
Home stressors: Sometimes school anxiety reflects stress originating at home. Parental conflict, financial strain, or family illness can deplete a child’s coping resources, making ordinary school demands feel overwhelming.
Differentiating Between Sensory Processing and Behavioral Issues
Acknowledging school anxiety doesn’t mean surrendering to it. The good news is that anxiety responds remarkably well to proper intervention. Start by validating your child’s feelings without reinforcing avoidance. “I understand you’re feeling worried, and that’s okay. I’m here to help you work through it.”
Establish consistent routines that provide predictability and security. The known is always less frightening than the unknown. Create calming morning rituals that include ample time for preparation without rushing – anxiety and time pressure are a volatile combination.
Work with your child’s teachers to create an environment where mistakes are viewed as learning opportunities rather than failures. Many educators welcome parent partnerships in supporting anxious students. Consider small accommodations that might make big differences –
a check-in with a favorite teacher, a quiet space for regrouping, or a photo of family tucked into a backpack pocket.
For many children, developing practical coping strategies makes all the difference. Simple techniques like deep breathing, positive self-talk, or visualization can empower children to manage anxious moments independently. Practice these tools during calm periods so they’re accessible during stressful ones.
Creating a “worry plan” can also be effective – help your child identify specific worries and develop concrete strategies for each. For instance, if your child worries about not understanding classroom instructions, the plan might include permission to ask the teacher for clarification or having a designated classmate who can help.
Gradual exposure often proves more successful than forced confrontation. If your child is refusing school, work with school personnel to create a step-by-step return plan. This might begin with attending for a single class period or even visiting the empty classroom after hours, gradually building tolerance for longer periods in the anxiety-provoking environment.
When Home Strategies Aren't Enough
Sometimes, despite your best efforts, school anxiety persists or intensifies. This isn’t a reflection of parenting failure but rather an indication that professional support may be beneficial. When anxiety significantly interferes with attendance, when physical symptoms persist despite medical clearance, or when your child’s distress extends beyond school to multiple settings, it’s time to consider seeking help.
Professional assessment can determine whether your child’s anxiety is part of a broader pattern requiring intervention. Some children with school anxiety may be experiencing generalized anxiety disorder, social anxiety disorder, separation anxiety, or even depression. Others may have undiagnosed learning differences that make school genuinely challenging, with anxiety developing as a secondary response.
Cognitive-behavioral therapy (CBT) has proven particularly effective for school anxiety. This approach helps children identify anxious thoughts, evaluate their accuracy, and develop more helpful thought patterns. For example, catastrophic thinking (“Everyone will laugh if I give the wrong answer”) can be replaced with more balanced thinking (“Most kids are focused on their own work, not mine”).
Family therapy may also play a role, particularly when family dynamics unintentionally reinforce anxiety. Parents with their own anxiety histories may need support in managing their responses to their child’s distress. Learning to strike the balance between empathy and encouragement often requires skillful guidance.
The Long View: Anxiety as Opportunity
While supporting a child through school anxiety can be extraordinarily challenging, there’s an important silver lining to consider. Children who learn to manage anxiety in supportive environments develop resilience that serves them throughout life. The child who overcomes school anxiety with proper support isn’t just learning to attend school; they’re learning they can face fears and emerge stronger.
Take the First Step Today
At Randall Symes Psychological Services, we specialize in helping children understand and overcome school anxiety. Our comprehensive assessments identify the specific triggers and patterns unique to your child, allowing us to develop targeted strategies that address the root causes rather than just the symptoms.
Our evidence-based approach combines individual work with family support, ensuring that parents have the tools they need to reinforce therapeutic gains at home. We also coordinate with school personnel to create consistent support across environments.
Don’t let school anxiety steal another day of learning and connection from your child. Contact us today to schedule a consultation and begin the journey toward confident school attendance. Your child deserves to experience education as an opportunity rather than an ordeal, and we’re here to help make that possible.
Call 780-555-1234 or visit our website to book your appointment and help your child rediscover the joy of learning.
Schedule an Assessment
Contact us to make an appointment
To address your child’s challenges, our tailored psychological assessments provide the information needed to get your child on the right path.
Parents and caregivers do not need a referral from a physician to make an appointment. Please contact us now to get started.