Behavior & Social

Early Signs of Anxiety in Toddlers and Preschoolers

Medically reviewed by Dr. Emily Torres, PhD, CCC-SLP · Pediatric Speech-Language Pathologist

Content reviewed against published AAP, CDC, NIH guidelines

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Behavioral development varies greatly from child to child. If you have noticed early signs of anxiety in toddlers and preschoolers, here is what you need to know.

The short answer

Anxiety disorders can begin in early childhood, though distinguishing clinical anxiety from normal fears and temperamental caution can be tricky in young children. About 7% of children ages 3-17 have a diagnosed anxiety disorder. Early signs include persistent worry, avoidance of age-appropriate activities, physical complaints with no medical cause, difficulty separating, and sleep problems. Early intervention is highly effective.

Key takeaways

  • Anxiety disorders can begin in early childhood, though distinguishing clinical anxiety from normal fears and temperamental caution can be tricky in young children. About 7% of children ages 3-17 have a diagnosed anxiety disorder. Early signs include persistent worry, avoidance of age-appropriate activities, physical complaints with no medical cause, difficulty separating, and sleep problems. Early intervention is highly effective.
  • Usually normal when: Some fear and worry is normal and healthy
  • Call your doctor if: Your child is unable to attend school or care due to anxiety
  • Varies by age — see the age-by-age breakdown below

Parents everywhere have the same worry. You are doing the right thing by looking into it.

What Parents Should Know

According to AAP, CDC, NIH guidelines, anxiety disorders can begin in early childhood, though distinguishing clinical anxiety from normal fears and temperamental caution can be tricky in young children. About 7% of children ages 3-17 have a diagnosed anxiety disorder. Early signs include persistent worry, avoidance of age-appropriate activities, physical complaints with no medical cause, difficulty separating, and sleep problems. Early intervention is highly effective. At 12-24 months, true anxiety disorders are very difficult to diagnose at this age because intense fears and separation distress are developmentally normal. Watch for: extreme and persistent distress in any new situation, inability to be comforted, and complete avoidance of things most children this age tolerate. It is generally considered normal when some fear and worry is normal and healthy. However, you should contact your pediatrician promptly if your child is unable to attend school or care due to anxiety.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Some fear and worry is normal and healthy
Your child is unable to attend school or care due to anxiety
Your child worries about specific things but can be reassured
Anxiety causes panic attacks with difficulty breathing or feeling of dying
Fears are age-appropriate and do not prevent most activities
Your child expresses hopelessness or desire to not exist
Your child has periods of worry but also periods of happy, carefree play
Worry or fear is persistent and present most days

By Age

What to expect by age

12-24 months

True anxiety disorders are very difficult to diagnose at this age because intense fears and separation distress are developmentally normal. Watch for: extreme and persistent distress in any new situation, inability to be comforted, and complete avoidance of things most children this age tolerate.

2-3 years

Potential early signs: your child is fearful of many situations most peers handle, has frequent stomachaches or headaches with no medical cause, cannot tolerate any change in routine, asks excessive "what if" questions, or needs constant reassurance about safety.

3-4 years

Anxiety becomes more recognizable: persistent worry about specific things, difficulty falling asleep due to worry, avoidance of activities they used to enjoy, frequent crying or distress in anticipation of events, or physical tension like nail biting or hair twisting.

4-5 years

At this age, children can sometimes verbalize their worries. Signs to watch: "What if" thinking, catastrophizing ("What if the house catches fire?"), perfectionism, difficulty making decisions due to fear of wrong choices, and resistance to trying new things due to worry about failure.

What to Tell Your Pediatrician

  • Describe when you first noticed early signs of anxiety in toddlers and preschoolers and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if worry or fear is persistent and present most days.
  • Mention if your child avoids age-appropriate activities due to anxiety.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Some fear and worry is normal and healthy
  • Your child worries about specific things but can be reassured
  • Fears are age-appropriate and do not prevent most activities
  • Your child has periods of worry but also periods of happy, carefree play
Mention at your next visit when...
  • Worry or fear is persistent and present most days
  • Your child avoids age-appropriate activities due to anxiety
  • Physical symptoms like stomachaches or headaches have no medical explanation
  • Your child's quality of life is affected by worry
Act now when...
  • Your child is unable to attend school or care due to anxiety
  • Anxiety causes panic attacks with difficulty breathing or feeling of dying
  • Your child expresses hopelessness or desire to not exist

What You Can Do at Home

  • Keep track of when you notice early signs of anxiety in toddlers and preschoolers — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that some fear and worry is normal and healthy — this is generally within the range of normal.
  • At 12-24 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Respond consistently and calmly to your baby's behavior. Maintain predictable daily routines.
  • While monitoring at home, seek immediate care if your child is unable to attend school or care due to anxiety.

Toddler or Preschooler Worries Excessively

Some worry is healthy and normal, but excessive worry that persists most days and interferes with your child's enjoyment of life may be a sign of generalized anxiety. Young children who worry excessively often ask repetitive "what if" questions, seek constant reassurance, anticipate worst-case scenarios, and have difficulty enjoying activities because they are worried about what might go wrong.

Normal Fears at Different Ages

Fears are a normal part of cognitive development. As your child's brain matures, they become able to imagine dangers they could not comprehend before. This means new fears often appear alongside cognitive growth - it is a sign that your child's thinking is becoming more sophisticated. Most childhood fears are temporary and resolve on their own with gentle support.

Phobia vs Normal Fear in Children

The difference between a normal fear and a phobia is intensity, duration, and impact on functioning. Normal fears are common, proportional to the trigger, and fade with time and gentle exposure. A phobia is an extreme, persistent fear that is out of proportion to the actual threat and causes avoidance that interferes with daily life. About 5-10% of children develop a specific phobia. Most respond well to gentle, gradual exposure with professional support.

Shyness vs Social Anxiety in Toddlers

Shyness is a temperament trait found in about 15-20% of children. It means your child is slow to warm up to new people and situations. Social anxiety is different - it involves intense fear and distress around social situations that interferes with functioning. Many shy children are perfectly happy once they warm up; anxious children remain distressed. Shyness is not a problem to fix, but social anxiety may need support.

Milestone

Month-by-Month Development

Detailed monthly development guides from birth through 24 months.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is early signs of anxiety in toddlers and preschoolers normal?
Anxiety disorders can begin in early childhood, though distinguishing clinical anxiety from normal fears and temperamental caution can be tricky in young children. About 7% of children ages 3-17 have a diagnosed anxiety disorder. Early signs include persistent worry, avoidance of age-appropriate activities, physical complaints with no medical cause, difficulty separating, and sleep problems. Early intervention is highly effective.
When should I call the doctor about early signs of anxiety in toddlers and preschoolers?
Your child is unable to attend school or care due to anxiety Anxiety causes panic attacks with difficulty breathing or feeling of dying Your child expresses hopelessness or desire to not exist
When is early signs of anxiety in toddlers and preschoolers normal?
Some fear and worry is normal and healthy Your child worries about specific things but can be reassured Fears are age-appropriate and do not prevent most activities
What causes early signs of anxiety in toddlers and preschoolers?
Anxiety disorders can begin in early childhood, though distinguishing clinical anxiety from normal fears and temperamental caution can be tricky in young children. About 7% of children ages 3-17 have a diagnosed anxiety disorder. Early signs include persistent worry, avoidance of age-appropriate activities, physical complaints with no medical cause, difficulty separating, and sleep problems. Early intervention is highly effective. Common explanations include: Some fear and worry is normal and healthy. Your child worries about specific things but can be reassured.
What should I mention to my pediatrician about early signs of anxiety in toddlers and preschoolers?
You should mention early signs of anxiety in toddlers and preschoolers at your next visit if: Worry or fear is persistent and present most days. Your child avoids age-appropriate activities due to anxiety. Physical symptoms like stomachaches or headaches have no medical explanation.
Is early signs of anxiety in toddlers and preschoolers normal at 12-24 months?
True anxiety disorders are very difficult to diagnose at this age because intense fears and separation distress are developmentally normal. Watch for: extreme and persistent distress in any new situation, inability to be comforted, and complete avoidance of things most children this age tolerate.
Is early signs of anxiety in toddlers and preschoolers normal at 2-3 years?
Potential early signs: your child is fearful of many situations most peers handle, has frequent stomachaches or headaches with no medical cause, cannot tolerate any change in routine, asks excessive "what if" questions, or needs constant reassurance about safety.
Should I go to the ER for early signs of anxiety in toddlers and preschoolers?
Seek emergency care if your child is unable to attend school or care due to anxiety, or if anxiety causes panic attacks with difficulty breathing or feeling of dying. When in doubt, call your pediatrician's after-hours line for guidance.
Does early signs of anxiety in toddlers and preschoolers go away on its own?
In many cases, early signs of anxiety in toddlers and preschoolers resolves on its own, especially when some fear and worry is normal and healthy. By 4-5 years, at this age, children can sometimes verbalize their worries. Signs to watch: "What if" thinking, catastrophizing ("What if the house catches fire?"), perfectionism, difficulty making decisions due to fear of wrong choices, and resistance to trying new things due to worry about failure.
AAPCDCNIH

References

  1. [1]American Academy of Pediatrics. Anxiety Disorders in Children. HealthyChildren.org. AAP
  2. [2]Centers for Disease Control and Prevention. Anxiety and Depression in Children. CDC
  3. [3]Bufferd SJ et al. A large-scale study of temperament and anxiety disorders in early childhood. J Am Acad Child Adolesc Psychiatry. 2014;53(1):97-107. NIH

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Early Signs of Anxiety in Toddlers and Preschoolers.

Things to mention

  • Describe when you first noticed early signs of anxiety in toddlers and preschoolers and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if worry or fear is persistent and present most days.
  • Mention if your child avoids age-appropriate activities due to anxiety.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Worry or fear is persistent and present most days
  • Your child avoids age-appropriate activities due to anxiety
  • Physical symptoms like stomachaches or headaches have no medical explanation

Urgent signs to report immediately

  • Your child is unable to attend school or care due to anxiety
  • Anxiety causes panic attacks with difficulty breathing or feeling of dying
  • Your child expresses hopelessness or desire to not exist

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

Related Resources

Ear Infection TriageEarly Intervention DirectoryBaby Sign Language GuideEmergency ContactsBaby Tracker

Bottom line

Most cases of early signs of anxiety in toddlers and preschoolers are normal. Talk to your pediatrician if your child is unable to attend school or care due to anxiety.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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Toddler or Preschooler Worries Excessively

Some worry is healthy and normal, but excessive worry that persists most days and interferes with your child's enjoyment of life may be a sign of generalized anxiety. Young children who worry excessively often ask repetitive "what if" questions, seek constant reassurance, anticipate worst-case scenarios, and have difficulty enjoying activities because they are worried about what might go wrong.

Normal Fears at Different Ages

Fears are a normal part of cognitive development. As your child's brain matures, they become able to imagine dangers they could not comprehend before. This means new fears often appear alongside cognitive growth - it is a sign that your child's thinking is becoming more sophisticated. Most childhood fears are temporary and resolve on their own with gentle support.

Phobia vs Normal Fear in Children

The difference between a normal fear and a phobia is intensity, duration, and impact on functioning. Normal fears are common, proportional to the trigger, and fade with time and gentle exposure. A phobia is an extreme, persistent fear that is out of proportion to the actual threat and causes avoidance that interferes with daily life. About 5-10% of children develop a specific phobia. Most respond well to gentle, gradual exposure with professional support.

Shyness vs Social Anxiety in Toddlers

Shyness is a temperament trait found in about 15-20% of children. It means your child is slow to warm up to new people and situations. Social anxiety is different - it involves intense fear and distress around social situations that interferes with functioning. Many shy children are perfectly happy once they warm up; anxious children remain distressed. Shyness is not a problem to fix, but social anxiety may need support.

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