According to the Child Mind Institute, approximately 23% of children have or have had a psychiatric disorder, and half of all psychiatric illness occurs before the age of 14. Despite those numbers, understanding if your child is experiencing anxiety can be challenging: The signs associated with anxiety can be easily explained away by other external issues, or as “a phase.” The classic, oft-referenced sign of anxiety in children is a complaint of a stomach ache—however, there are many other telling behaviors and comments to be on the lookout for.

Please note that this article is not a substitute for professional medical advice, diagnosis or treatment, so please don’t hesitate to reach out to a professional for diagnosis and treatment.

1. Often seeking reassurance and approval

Children who suffer from anxiety often seek reassurance in a manner that seems excessive. Most children enjoy praise from the adults in their lives, but children facing anxiety might appear to seek approval almost constantly. Parents might notice this approval-seeking in relation to academics (for example during homework time) or sports. Children seeking frequent approval are looking to be reassured that things in their lives are going well.

2. Rigidity and control-seeking

Anxious children are often aware of everything in their environment that they do not control, and therefore often look to assert control as often as they can. This might look like a desire to strictly adhere to a routine, or even a preference for toys or other items to be arranged in a particular way. They may display challenging behaviors when these routines are disrupted.

3. Perfectionism

Children struggling with anxiety might do a task over and over until it seems “just so” or until they are given reassurance or approval. This can often be seen during art activities, homework time or sports activities. Doing something repeatedly, in the hopes of making it perfect, can be a way for children to seek control and can reflect a strong desire for approval from others.

4. Preoccupation with disasters or conflict

Some anxious children demonstrate an intense interest in or preoccupation with disasters or conflict, such as war or other types of unrest. This might be in part due to fear of losing access to caregivers or other important people in their lives.

5. Tantrums and other challenging behavior after school

Some children will attempt to “hold it together” or manage their anxiety at school, to follow the rules and behave well. This can result in challenging behavior after school because children are exhausted from the energy it takes to manage their behavior for a full school day. This sometimes manifests in tantrums or “meltdowns” after school that do not have an obvious cause. In these instances, parents can plan a relaxing transition period for children after school and before homework time.

6. High activity level

Active, high energy children are sometimes anxious children. This high activity level is the result of the physical arousal that comes with anxiety. Parents might notice this high level of energy throughout the day but particularly before worry-provoking situations.

So what can you do?

Talk and listen

Parents can also help children identify the signs of anxiety and how they might be experiencing it by discussing the signs with their child and pointing out what they notice in the moment. A parent might say, “I notice your heart is beating fast and you’re sweaty.” Once children can identify when their anxiety levels are particularly high, children can notice when they need to do something to help them calm themselves.

Support and reassure

Parents can support children who are experiencing anxiety by providing regular reassurance, and also by teaching children strategies—such as deep breathing or progressive muscle relaxation, like these.

Seek help

Parents who worry that their child suffers from anxiety are encouraged to pursue the assistance of a mental health professional. A mental health professional can assess to determine whether your child’s behaviors are related to an anxiety disorder, another type of disorder that produces similar behaviors, or if your child’s behaviors are within the range of what is typical for his or her age.