How to tell when school stress is a sign of an anxiety disorder, ADHD, or something else

Writer: Juliann Garey

Clinical Expert: Ken Schuster, PsyD

Key Takeaways

- Everyone feels stress about school sometimes, but the feeling should fade once the test or project is over. If it lingers, it may be signs of an anxiety disorder.

- Academic anxiety can show up as stomachaches, meltdowns, or perfectionism — spending excessive hours on assignments or redoing work.

- Because academic anxiety often overlaps with conditions like ADHD and learning disorders, it can be hard to know what’s really going on. Understanding the root of the issue helps figure to how to help.

- What is academic anxiety?

- Symptoms to watch for

- Diagnosis: Untangling anxiety from other issues

- Consequences of untreated academic anxiety

- Treatment options

- How parents can help

- The role of teachers and schools

For many children, school comes with a dose of everyday stress: a tough test, a presentation in front of the class, or the pressure to finish a big assignment. That kind of stress is normal. But for some kids, school-related stress can turn into something more consuming and disruptive. Left untreated, it can take a serious toll on children’s well-being and performance.

Ken Schuster, PsyD, a neuropsychologist at the Child Mind Institute, has seen firsthand how school stressors can lead to serious anxiety. Because school is where kids spend most of their time, it’s not surprising that it’s the focus of their attention and worries. “Academic anxiety isn’t a clinical diagnosis in itself,” he explains. “It’s really anxiety that’s triggered by school demands. And for some kids, that trigger is so powerful it disrupts their ability to learn and thrive.”

What is academic anxiety?

“Everyone feels stress sometimes,” says Dr. Schuster. “It’s part of life. The key difference is whether it fades once the stressful event is over.” Kids get nervous about a test, but once the test is done, the anxiety should drop. “If it doesn’t — if a child is losing sleep, avoiding school, melting down over homework, or can’t enjoy being with friends — that’s when we start thinking about an anxiety disorder,” he says.

Because school stress can trigger different kinds of anxiety, clinicians look at which specific anxiety disorder best matches a child’s symptoms. Constant, free-floating worry might be diagnosed as generalized anxiety disorder. Extreme perfectionism — like erasing so many times the paper has a hole in it — can be evidence of OCD. If the fear centers on performance situations — like reading aloud or speaking in class — social anxiety disorder might be the best fit. Kids who have racing hearts, trouble breathing, or feel like they might pass out before a test may meet criteria for panic disorder. The goal is to figure out how the anxiety shows up and whether it’s getting in the way of everyday life.

Is school stress getting worse and more pervasive? Dr. Schuster says kids have always worried about school, but today’s kids face some extra challenges. More students are competing for spots at selective schools — both private and public and certainly colleges — and the pressure to take advanced classes starts earlier. Then there’s social media, which amplifies the feeling that everyone else is doing better. “When I was looking at colleges in the 1990s, it was a personal process with my family and counselor,” Dr. Schuster says. “Now kids scroll TikTok and see other students comparing test scores and acceptance rates. That magnifying glass can make the pressure feel a lot more intense.”

Symptoms to watch for

School stress doesn’t look the same in every child, but there are some common patterns parents and teachers can spot:

- Physical complaints: Headaches, stomachaches, or nausea before school or exams

- Avoidance: Refusing to go to school, cutting class, or procrastinating on assignments

- Clinginess or meltdowns: Younger kids may cling to their parents at drop-off or melt down at homework time

- Obsessive studying or perfectionism: Spending excessive hours on assignments, rewriting or over-preparing

- Difficulty concentrating: Trouble staying focused in class or on homework because of racing thoughts

- Sleep and appetite changes: Sleeping poorly, overeating for comfort, or losing appetite altogether

Dr. Schuster notes that symptoms can occur in other contexts besides school. “The stomachaches, the meltdowns, the obsessive behavior — those aren’t unique to school stress. What makes the difference is the trigger. If schoolwork is what sets them off, that’s what we’re dealing with.”

Diagnosis: Untangling anxiety from other issues

Because academic anxiety often overlaps with other conditions, it can be hard to know what’s really going on. ADHD and learning disorders frequently coexist with anxiety, and one can mask the other. “A child may look anxious, but sometimes that anxiety comes from struggling with reading or math,” Dr. Schuster explains. “Or vice versa: The anxiety itself can interfere with focus.” Getting clarity usually requires a full evaluation. That might involve conversations with parents, teachers, and the child, along with questionnaires and sometimes formal academic testing. The goal, Dr. Schuster says, is always the same. “We want to answer the ‘why’ question. Is this anxiety rooted in a learning disorder? Is it part of a broader anxiety issue? Or is it performance-related? Knowing that tells us how to help.” He emphasizes that these evaluations aren’t about labeling kids, but about opening doors to the right support. “The earlier we understand what’s going on, the sooner we can target the help a child really needs.”

Consequences of untreated academic anxiety

When academic anxiety isn’t addressed, it tends to grow. In the short term, kids may resist going to school, shut down in class, or disengage from learning altogether. “They might come to believe they’re incapable or not intelligent,” Dr. Schuster says. Over time, constant anxiety can chip away at sleep, concentration, appetite, and self-esteem. “Imagine feeling stressed eight hours a day, five days a week, nine months out of the year,” he says. “It’s exhausting. And it can spill into other forms of anxiety and depression.”

Untreated academic anxiety can also erode a child’s relationship with school itself. “If every day feels like a battle, kids stop connecting with learning. That loss of confidence can follow them for years,” Dr. Schuster warns. That’s why early intervention matters. Recognizing the problem and getting help can prevent a downward spiral that affects both academic success and emotional health.

Treatment options

The good news is that academic anxiety is highly treatable. The most effective approaches are rooted in therapy, but they can also include skill-building and, in some cases, medication.

- Cognitive behavioral therapy (CBT): Teaches kids to recognize anxious thoughts and replace them with more realistic ones. “‘If I don’t get an A, something terrible will happen,’ might become, ‘One grade doesn’t define me.’” Dr. Schuster explains.

- Exposure therapy: A step-by-step way to face fears until they feel less scary. It might start with simply talking about an anxiety-provoking situation in a safe setting, then role-playing it, and eventually practicing in real life (for example, having a child purposely give a wrong answer in front of peers in a group therapy setting) until it feels manageable.

- Study strategies: “Sometimes the fix is more practical,” Dr. Schuster says. “If the way you’re studying isn’t effective, of course you’ll feel anxious walking into a test. Changing the approach can reduce a lot of stress.” 

- Medication: Used carefully and usually alongside therapy if anxiety is severe and persistent.

“There’s no one-size-fits-all fix,” Dr. Schuster says. “We figure out what’s driving the anxiety and then use the right mix of tools.”

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How parents can help

Parents are on the front lines, and their response can make a big difference. The most important step is simply talking about it. “Don’t brush it under the rug and hope it goes away,” Dr. Schuster advises. “Validate what your child is experiencing and let them know it’s real.”

- Don’t reinforce avoidance: Letting kids skip school makes anxiety worse.

- Break tasks into smaller steps: Help them tackle projects bit by bit.

- Focus on effort, not perfection: Praise persistence, not just grades.

- Stay in touch with teachers: Keep track of how anxiety shows up at school.

- Get help if needed: A counselor or clinician can provide extra support.

“One common mistake is thinking, ‘If my child is so distressed, maybe I’ll just let them stay home,’” Dr. Schuster says “That only makes things worse. Avoidance strengthens the anxiety.”

The role of teachers and schools

Teachers and schools can be powerful allies in helping kids manage academic anxiety. Even small changes in the classroom can lighten the load:

- Giving clear and repeated instructions

- Creating safe opportunities for kids to ask questions

- Building predictable routines that reduce uncertainty

Sometimes kids need more formal support. Section 504 plans and Individualized Education Programs (IEPs) are legal documents that make sure kids with significant anxiety or learning challenges get what they need. A 504 plan usually requires a diagnosis and covers accommodations like extended time or a quieter room for tests. An IEP is more comprehensive and can include services like weekly counseling or small-group instruction. Both require an evaluation, though some schools offer short-term supports before formal plans are finalized.

Academic anxiety can be overwhelming for children and families alike. But it’s also highly treatable with the right recognition and support. “The most important thing,” Dr. Schuster emphasizes, “is not to dismiss what kids are going through. Their feelings are real. When we acknowledge them, validate them, and give them tools to cope, we set them up not just to succeed in school, but to thrive in life.”

Frequently Asked Questions

What is academic anxiety?

Academic anxiety is a form of anxiety triggered specifically by school demands, such as tests, presentations, or assignments. Unlike everyday stress, it can interfere with a child’s ability to learn and thrive.

How is academic anxiety different from normal school stress?

What happens if academic anxiety is left untreated? https://standingabovethecrowd.com/?p=16302

James Donaldson on Mental Health - Academic Anxiety: When School Stress Becomes Too Much

How to tell when school stress is a sign of an anxiety disorder, ADHD, or something else

Writer: Juliann Garey

Clinical Expert: Ken Schuster, PsyD

Key Takeaways

- Everyone feels stress about school sometimes, but the feeling should fade once the test or project is over. If it lingers, it may be signs of an anxiety disorder.
- Academic anxiety can show up as stomachaches, meltdowns, or perfectionism — spending excessive hours on assignments or redoing work.
- Because academic anxiety often overlaps with conditions like ADHD and learning disorders, it can be hard to know what’s really going on. Understanding the root of the issue helps figure to how to help.
- What is academic anxiety?
- Symptoms to watch for
- Diagnosis: Untangling anxiety from other issues
- Consequences of untreated academic anxiety
- Treatment options
- How parents can help
- The role of teachers and schools

For many children, school comes with a dose of everyday stress: a tough test, a presentation in front of the class, or the pressure to finish a big assignment. That kind of stress is normal. But for some kids, school-related stress can turn into something more consuming and disruptive. Left untreated, it can take a serious toll on children’s well-being and performance.

Ken Schuster, PsyD, a neuropsychologist at the Child Mind Institute, has seen firsthand how school stressors can lead to serious anxiety. Because school is where kids spend most of their time, it’s not surprising that it’s the focus of their attention and worries. “Academic anxiety isn’t a clinical diagnosis in itself,” he explains. “It’s really anxiety that’s triggered by school demands. And for some kids, that trigger is so powerful it disrupts their ability to learn and thrive.”

What is academic anxiety?

“Everyone feels stress sometimes,” says Dr. Schuster. “It’s part of life. The key difference is whether it fades once the stressful event is over.” Kids get nervous about a test, but once the test is done, the anxiety should drop. “If it doesn’t — if a child is losing sleep, avoiding school, melting down over homework, or can’t enjoy being with friends — that’s when we start thinking about an anxiety disorder,” he says.

Because school stress can trigger different kinds of anxiety, clinicians look at which specific anxiety disorder best matches a child’s symptoms. Constant, free-floating worry might be diagnosed as generalized anxiety disorder. Extreme perfectionism — like erasing so many times the paper has a hole in it — can be evidence of OCD. If the fear centers on performance situations — like reading aloud or speaking in class — social anxiety disorder might be the best fit. Kids who have racing hearts, trouble breathing, or feel like they might pass out before a test may meet criteria for panic disorder. The goal is to figure out how the anxiety shows up and whether it’s getting in the way of everyday life.

Is school stress getting worse and more pervasive? Dr. Schuster says kids have always worried about school, but today’s kids face some extra challenges. More students are competing for spots at selective schools — both private and public and certainly colleges — and the pressure to take advanced classes starts earlier. Then there’s social media, which amplifies the feeling that everyone else is doing better. “When I was looking at colleges in the 1990s, it was a personal process with my family and counselor,” Dr. Schuster says. “Now kids scroll TikTok and see other students comparing test scores and acceptance rates. That magnifying glass can make the pressure feel a lot more intense.”

Symptoms to watch for

School stress doesn’t look the same in every child, but there are some common patterns parents and teachers can spot:

- Physical complaints: Headaches, stomachaches, or nausea before school or exams
- Avoidance: Refusing to go to school, cutting class, or procrastinating on assignments
- Clinginess or meltdowns: Younger kids may cling to their parents at drop-off or melt down at homework time
- Obsessive studying or perfectionism: Spending excessive hours on assignments, rewriting or over-preparing
- Difficulty concentrating: Trouble staying focused in class or on homework because of racing thoughts
- Sleep and appetite changes: Sleeping poorly, overeating for comfort, or losing appetite altogether

Dr. Schuster notes that symptoms can occur in other contexts besides school. “The stomachaches, the meltdowns, the obsessive behavior — those aren’t unique to school stress. What makes the difference is the trigger. If schoolwork is what sets them off, that’s what we’re dealing with.”

Diagnosis: Untangling anxiety from other issues

Because academic anxiety often overlaps with other conditions, it can be hard to know what’s really going on. ADHD and learning disorders frequently coexist with anxiety, and one can mask the other. “A child may look anxious, but sometimes that anxiety comes from struggling with reading or math,” Dr. Schuster explains. “Or vice versa: The anxiety itself can interfere with focus.” Getting clarity usually requires a full evaluation. That might involve conversations with parents, teachers, and the child, along with questionnaires and sometimes formal academic testing. The goal, Dr. Schuster says, is always the same. “We want to answer the ‘why’ question. Is this anxiety rooted in a learning disorder? Is it part of a broader anxiety issue? Or is it performance-related? Knowing that tells us how to help.” He emphasizes that these evaluations aren’t about labeling kids, but about opening doors to the right support. “The earlier we understand what’s going on, the sooner we can target the help a child really needs.”

Consequences of untreated academic anxiety

When academic anxiety isn’t addressed, it tends to grow. In the short term, kids may resist going to school, shut down in class, or disengage from learning altogether. “They might come to believe they’re incapable or not intelligent,” Dr. Schuster says. Over time, constant anxiety can chip away at sleep, concentration, appetite, and self-esteem. “Imagine feeling stressed eight hours a day, five days a week, nine months out of the year,” he says. “It’s exhausting. And it can spill into other forms of anxiety and depression.”

Untreated academic anxiety can also erode a child’s relationship with school itself. “If every day feels like a battle, kids stop connecting with learning. That loss of confidence can follow them for years,” Dr. Schuster warns. That’s why early intervention matters. Recognizing the problem and getting help can prevent a downward spiral that affects both academic success and emotional health.

Treatment options

The good news is that academic anxiety is highly treatable. The most effective approaches are rooted in therapy, but they can also include skill-building and, in some cases, medication.

- Cognitive behavioral therapy (CBT): Teaches kids to recognize anxious thoughts and replace them with more realistic ones. “‘If I don’t get an A, something terrible will happen,’ might become, ‘One grade doesn’t define me.’” Dr. Schuster explains.
- Exposure therapy: A step-by-step way to face fears until they feel less scary. It might start with simply talking about an anxiety-provoking situation in a safe setting, then role-playing it, and eventually practicing in real life (for example, having a child purposely give a wrong answer in front of peers in a group therapy setting) until it feels manageable.
- Study strategies: “Sometimes the fix is more practical,” Dr. Schuster says. “If the way you’re studying isn’t effective, of course you’ll feel anxious walking into a test. Changing the approach can reduce a lot of stress.” 
- Medication: Used carefully and usually alongside therapy if anxiety is severe and persistent.

“There’s no one-size-fits-all fix,” Dr. Schuster says. “We figure out what’s driving the anxiety and then use the right mix of tools.”

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How parents can help

Parents are on the front lines, and their response can make a big difference. The most important step is simply talking about it. “Don’t brush it under the rug and hope it goes away,” Dr. Schuster advises. “Validate what your child is experiencing and let them know it’s real.”

- Don’t reinforce avoidance: Letting kids skip school makes anxiety worse.
- Break tasks into smaller steps: Help them tackle projects bit by bit.
- Focus on effort, not perfection: Praise persistence, not just grades.
- Stay in touch with teachers: Keep track of how anxiety shows up at school.
- Get help if needed: A counselor or clinician can provide extra support.

“One common mistake is thinking, ‘If my child is so distressed, maybe I’ll just let them stay home,’” Dr. Schuster says “That only makes things worse. Avoidance strengthens the anxiety.”

The role of teachers and schools

Teachers and schools can be powerful allies in helping kids manage academic anxiety. Even small changes in the classroom can lighten the load:

- Giving clear and repeated instructions
- Creating safe opportunities for kids to ask questions
- Building predictable routines that reduce uncertainty

Sometimes kids need more formal support. Section 504 plans and Individualized Education Programs (IEPs) are legal documents that make sure kids with significant anxiety or learning challenges get what they need. A 504 plan usually requires a diagnosis and covers accommodations like extended time or a quieter room for tests. An IEP is more comprehensive and can include services like weekly counseling or small-group instruction. Both require an evaluation, though some schools offer short-term supports before formal plans are finalized.

Academic anxiety can be overwhelming for children and families alike. But it’s also highly treatable with the right recognition and support. “The most important thing,” Dr. Schuster emphasizes, “is not to dismiss what kids are going through. Their feelings are real. When we acknowledge them, validate them, and give them tools to cope, we set them up not just to succeed in school, but to thrive in life.”

Frequently Asked Questions

What is academic anxiety?

Academic anxiety is a form of anxiety triggered specifically by school demands, such as tests, presentations, or assignments. Unlike everyday stress, it can interfere with a child’s ability to learn and thrive.

How is academic anxiety different from normal school stress?

What happens if academic anxiety is left untreated?

https://standingabovethecrowd.com/james-donaldson-on-mental-health-academic-anxiety-when-school-stress-becomes-too-much-2/

Kids who seem oppositional are often severely anxious

Writer: Caroline Miller

Clinical Experts: Jerry Bubrick, PhD , Rachel Busman, PsyD, ABPP , Nancy Rappaport, MD

What You'll Learn

- Why do kids with anxiety sometimes act out?

- What are the signs that a disruptive child might be anxious?

- What happens when anxiety is mistaken for bad behavior?

- What kinds of help are available for anxious kids who act out?

- Quick Read

- Full Article

- Unrecognized anxiety

- A great masquerader

- Problems at school

- Giving kids tools to handle anxiety

- Anxiety confused with ADHD

- How to identify anxiety

The symptoms of anxiety that most of us think of are clinging to parents, avoiding things or being very shy. But problem behavior can also be a symptom of anxiety. That’s because some anxious children feel an overwhelming need to get out of the situation that’s making them uncomfortable. That behavior may look like anger or defiance. 

Signs that a child who is acting out might be anxious include lashing out, throwing tantrums, seeming distracted, moving around a lot (like leaving their seat or even running out of the room), arguing with others, and asking lots of questions. 

Adults may mistakenly think that children who are acting out are being difficult on purpose. Parents don’t feel respected and may be frustrated or exhausted. At school, when kids disrupt class or don’t follow instructions, they offend teachers. Instead of learning to manage their anxiety, they end up in the principal’s office.  

Anxious kids who act out may be mistakenly diagnosed with ADHD or a behavior disorder. That’s why it’s important to have a careful evaluation by a mental health professional, like a psychologist, psychiatrist or social worker, to find out what’s causing the behavior. Anxiety can be treated very successfully with cognitive behavior therapy, or CBT. Kids learn techniques to calm themselves down when they are anxious, and the anxiety fades over time. Medication is sometimes recommended, too.  

A10-year-old boy named James has an outburst in school. Upset by something a classmate says to him, he pushes the other boy, and a shoving-match ensues. When the teacher steps in to break it up, James goes ballistic, throwing papers and books around the classroom and bolting out of the room. He is finally contained in the vice principal’s office, where staff members try to calm him down. Instead, he kicks the vice principal in a frenzied effort to escape. The staff calls 911, and James ends up in the emergency room.

To the uninitiated, James looks like a boy with serious anger issues. It’s not the first time he’s flown out of control. The school insists that his parents pick him up and take him home for lunch every day because he’s been banned from the cafeteria.

Unrecognized anxiety

But what’s really going on? “It turns out, after an evaluation, that he is off the charts for social anxiety,” reports Jerry Bubrick, PhD, a clinical psychologist who treated many children with anxiety and OCD at the Child Mind Institute. “He can’t tolerate any — even constructive — criticism. James is terrified of being embarrassed, so when a boy says something that makes him uncomfortable, he has no skills to deal with it, and he freaks out. Flight or fight.”

James’s story illustrates something that parents and teachers may not realize — that disruptive behavior is often generated by unrecognized anxiety. A child who appears to beoppositional or aggressive may be reacting to anxiety — anxiety they may, depending on their age, not be able to articulate effectively, or not even fully recognize.

“Especially in younger kids with anxiety you might see freezing and clinging kind of behavior,” says Rachel Busman, PsyD, a clinical psychologist, “but you can also see tantrums and complete meltdowns.”

A great masquerader

Anxiety manifests in a surprising variety of ways in part because it is based on a physiological response to a threat in the environment, a response that maximizes the body’s ability to either face danger or escape danger. So while some children exhibit anxiety by shrinking from situations or objects that trigger fears, some react with overwhelming need to break out of an uncomfortable situation. That behavior, which can be unmanageable, is often misread as anger or opposition.

“Anxiety is one of those diagnoses that is a great masquerader,” explains Laura Prager, MD, director of the Child Psychiatry Emergency Service at Massachusetts General Hospital. “It can look like a lot of things. Particularly with kids who may not have words to express their feelings, or because no one is listening to them, they might manifest their anxiety with behavioral dysregulation.”

The more commonly recognized symptoms of anxiety in a child are things like trouble sleeping in their own room or separating from their parents, avoidance of certain activities. “Anyone would recognize those symptoms,” notes Dr. Prager, co-author of Suicide by Security Blanket, and Other Stories from the Child Psychiatry Emergency Service. But in other cases the anxiety can be hidden.

“When the chief complaint is temper tantrums, or disruption in school, or throwing themselves on the floor while shopping at the mall, it’s hard to know what it means,” she explains. “But it’s not uncommon, when kids like that come in to the ER, for thediagnosis to end up being a pretty profound anxiety disorder.”

Problems at school

It’s not uncommon for children with serious undiagnosed anxiety to be disruptive at school, where demands and expectations put pressure on them that they can’t handle. And it can be very confusing to teachers and other staff members to “read” that behavior, which can seem to come out of nowhere.

Nancy Rappaport, MD, a Harvard Medical School professor who specializes in mental health care in school settings, sees anxiety as one of the causes of disruptive behavior that makes classroom teaching so challenging. “The trouble is that when kids who are anxious become disruptive they push away the very adults who they need to help them feel secure,” notes Dr. Rappaport. “And instead of learning to manage their anxiety, they end up spending half the day in the principal’s office.”

Dr. Rappaport sees a lot of acting out in school as the result of trauma at home. “Kids who are struggling, not feeling safe at home,” she notes, “can act like terrorists at school, with fairly intimidating kinds of behavior.” Most at risk, she says, are kids with ADHD who’ve also experienced trauma. “They’re hyper-vigilant, they have no executive functioning, they misread cues and go into combat.”

Giving kids tools to handle anxiety

When a teacher is able to build a relationship with a child, to find out what’s really going on with them, what’s provoking the behavior, she can often give them tools to handle anxiety and prevent meltdowns. In her book, The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students, Dr. Rappaport offers strategies kids can be taught to use to calm themselves down, from breathing exercises to techniques for distracting themselves.

“When a teacher understands the anxiety underlying the opposition, rather than making the assumption that the child is actively trying to make them miserable, it changes their approach,” says Dr. Rappaport, “The teacher is able to join forces with the child himself and the school counselor, to come up with strategies for preventing these situations.”

If it sounds labor-intensive for the teacher, it is, she notes, but so is dealing with the aftermath of the same child having a meltdown.

Anxiety confused with ADHD

Anxiety also drives a lot of symptoms in a school setting that are easily misconstrued as ADHD or defiant behavior.

“I’ll see a child who’s having difficulty in school: not paying attention, getting up out of their seat all the time, asking a lot of questions, going to the bathroom a lot, getting in other kids’ spaces,” explains Dr. Busman. “The behavior is disrupting other kids, and is frustrating to the teacher, who’s wondering why they ask so many questions, and why they’re so wrapped up in what other kids are doing, whether they’re following the rules.”

People tend to assume what’s happening with this child is ADHD inattentive type, but it’s commonly anxiety. Kids with OCD, mislabeled as inattentive, are actually not asking all those questions because they’re not listening, but rather because they need a lot of reassurance.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How to identify anxiety

“It probably occurs more than we think, either anxiety that looks disruptive or anxiety coexisting with disruptive behaviors,” Dr. Busman adds. “It all goes back to the fact that kids are complicated and symptoms can overlap diagnostic categories, which is why we need to have really comprehensive and good diagnostic assessment.”

First of all, good assessment needs to gather data from multiple sources, not just parents. “We want to talk to teachers and other people involved with the kid’s life,” she adds, “because sometimes kids that we see are exactly the same at home and at school, sometimes they are like two different children.”

And it needs to use rating scales on a full spectrum of behaviors, not just the area that looks the most obvious, to avoid missing things.

Dr. Busman also notes that a child with severe anxiety who’s struggling in school might also have attention or learning issues, but they might need to be treated for the anxiety before they can really be evaluated for those. She uses the example of a teenager with OCD who is doing terribly in school. “They’re ritualizing three to four hours a day, and having constant intrusive thoughts — so we need to treat that, to get the anxiety under control before we ask, how are they learning?”

Frequently Asked Questions

Can acting out be a symptom of anxiety in a child?

Are anxious kids misdiagnosed because they act out?

Anxious kids who act out may be misdiagnosed with ADHD or a behavior disorder. That’s why it’s important to have a careful evaluation by a mental health professional, like a psychologist, psychiatrist, or social worker, to find out what’s causing the behavior.

How are anxious kids treated? https://standingabovethecrowd.com/?p=16300

James Donaldson on Mental Health - How Anxiety Leads to Problem Behavior

Kids who seem oppositional are often severely anxious

Writer: Caroline Miller

Clinical Experts: Jerry Bubrick, PhD , Rachel Busman, PsyD, ABPP , Nancy Rappaport, MD

What You'll Learn

- Why do kids with anxiety sometimes act out?
- What are the signs that a disruptive child might be anxious?
- What happens when anxiety is mistaken for bad behavior?
- What kinds of help are available for anxious kids who act out?
- Quick Read
- Full Article
- Unrecognized anxiety
- A great masquerader
- Problems at school
- Giving kids tools to handle anxiety
- Anxiety confused with ADHD
- How to identify anxiety

The symptoms of anxiety that most of us think of are clinging to parents, avoiding things or being very shy. But problem behavior can also be a symptom of anxiety. That’s because some anxious children feel an overwhelming need to get out of the situation that’s making them uncomfortable. That behavior may look like anger or defiance. 

Signs that a child who is acting out might be anxious include lashing out, throwing tantrums, seeming distracted, moving around a lot (like leaving their seat or even running out of the room), arguing with others, and asking lots of questions. 

Adults may mistakenly think that children who are acting out are being difficult on purpose. Parents don’t feel respected and may be frustrated or exhausted. At school, when kids disrupt class or don’t follow instructions, they offend teachers. Instead of learning to manage their anxiety, they end up in the principal’s office.  

Anxious kids who act out may be mistakenly diagnosed with ADHD or a behavior disorder. That’s why it’s important to have a careful evaluation by a mental health professional, like a psychologist, psychiatrist or social worker, to find out what’s causing the behavior. Anxiety can be treated very successfully with cognitive behavior therapy, or CBT. Kids learn techniques to calm themselves down when they are anxious, and the anxiety fades over time. Medication is sometimes recommended, too.  

A10-year-old boy named James has an outburst in school. Upset by something a classmate says to him, he pushes the other boy, and a shoving-match ensues. When the teacher steps in to break it up, James goes ballistic, throwing papers and books around the classroom and bolting out of the room. He is finally contained in the vice principal’s office, where staff members try to calm him down. Instead, he kicks the vice principal in a frenzied effort to escape. The staff calls 911, and James ends up in the emergency room.

To the uninitiated, James looks like a boy with serious anger issues. It’s not the first time he’s flown out of control. The school insists that his parents pick him up and take him home for lunch every day because he’s been banned from the cafeteria.

Unrecognized anxiety

But what’s really going on? “It turns out, after an evaluation, that he is off the charts for social anxiety,” reports Jerry Bubrick, PhD, a clinical psychologist who treated many children with anxiety and OCD at the Child Mind Institute. “He can’t tolerate any — even constructive — criticism. James is terrified of being embarrassed, so when a boy says something that makes him uncomfortable, he has no skills to deal with it, and he freaks out. Flight or fight.”

James’s story illustrates something that parents and teachers may not realize — that disruptive behavior is often generated by unrecognized anxiety. A child who appears to beoppositional or aggressive may be reacting to anxiety — anxiety they may, depending on their age, not be able to articulate effectively, or not even fully recognize.

“Especially in younger kids with anxiety you might see freezing and clinging kind of behavior,” says Rachel Busman, PsyD, a clinical psychologist, “but you can also see tantrums and complete meltdowns.”

A great masquerader

Anxiety manifests in a surprising variety of ways in part because it is based on a physiological response to a threat in the environment, a response that maximizes the body’s ability to either face danger or escape danger. So while some children exhibit anxiety by shrinking from situations or objects that trigger fears, some react with overwhelming need to break out of an uncomfortable situation. That behavior, which can be unmanageable, is often misread as anger or opposition.

“Anxiety is one of those diagnoses that is a great masquerader,” explains Laura Prager, MD, director of the Child Psychiatry Emergency Service at Massachusetts General Hospital. “It can look like a lot of things. Particularly with kids who may not have words to express their feelings, or because no one is listening to them, they might manifest their anxiety with behavioral dysregulation.”

The more commonly recognized symptoms of anxiety in a child are things like trouble sleeping in their own room or separating from their parents, avoidance of certain activities. “Anyone would recognize those symptoms,” notes Dr. Prager, co-author of Suicide by Security Blanket, and Other Stories from the Child Psychiatry Emergency Service. But in other cases the anxiety can be hidden.

“When the chief complaint is temper tantrums, or disruption in school, or throwing themselves on the floor while shopping at the mall, it’s hard to know what it means,” she explains. “But it’s not uncommon, when kids like that come in to the ER, for thediagnosis to end up being a pretty profound anxiety disorder.”

Problems at school

It’s not uncommon for children with serious undiagnosed anxiety to be disruptive at school, where demands and expectations put pressure on them that they can’t handle. And it can be very confusing to teachers and other staff members to “read” that behavior, which can seem to come out of nowhere.

Nancy Rappaport, MD, a Harvard Medical School professor who specializes in mental health care in school settings, sees anxiety as one of the causes of disruptive behavior that makes classroom teaching so challenging. “The trouble is that when kids who are anxious become disruptive they push away the very adults who they need to help them feel secure,” notes Dr. Rappaport. “And instead of learning to manage their anxiety, they end up spending half the day in the principal’s office.”

Dr. Rappaport sees a lot of acting out in school as the result of trauma at home. “Kids who are struggling, not feeling safe at home,” she notes, “can act like terrorists at school, with fairly intimidating kinds of behavior.” Most at risk, she says, are kids with ADHD who’ve also experienced trauma. “They’re hyper-vigilant, they have no executive functioning, they misread cues and go into combat.”

Giving kids tools to handle anxiety

When a teacher is able to build a relationship with a child, to find out what’s really going on with them, what’s provoking the behavior, she can often give them tools to handle anxiety and prevent meltdowns. In her book, The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students, Dr. Rappaport offers strategies kids can be taught to use to calm themselves down, from breathing exercises to techniques for distracting themselves.

“When a teacher understands the anxiety underlying the opposition, rather than making the assumption that the child is actively trying to make them miserable, it changes their approach,” says Dr. Rappaport, “The teacher is able to join forces with the child himself and the school counselor, to come up with strategies for preventing these situations.”

If it sounds labor-intensive for the teacher, it is, she notes, but so is dealing with the aftermath of the same child having a meltdown.

Anxiety confused with ADHD

Anxiety also drives a lot of symptoms in a school setting that are easily misconstrued as ADHD or defiant behavior.

“I’ll see a child who’s having difficulty in school: not paying attention, getting up out of their seat all the time, asking a lot of questions, going to the bathroom a lot, getting in other kids’ spaces,” explains Dr. Busman. “The behavior is disrupting other kids, and is frustrating to the teacher, who’s wondering why they ask so many questions, and why they’re so wrapped up in what other kids are doing, whether they’re following the rules.”

People tend to assume what’s happening with this child is ADHD inattentive type, but it’s commonly anxiety. Kids with OCD, mislabeled as inattentive, are actually not asking all those questions because they’re not listening, but rather because they need a lot of reassurance.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

How to identify anxiety

“It probably occurs more than we think, either anxiety that looks disruptive or anxiety coexisting with disruptive behaviors,” Dr. Busman adds. “It all goes back to the fact that kids are complicated and symptoms can overlap diagnostic categories, which is why we need to have really comprehensive and good diagnostic assessment.”

First of all, good assessment needs to gather data from multiple sources, not just parents. “We want to talk to teachers and other people involved with the kid’s life,” she adds, “because sometimes kids that we see are exactly the same at home and at school, sometimes they are like two different children.”

And it needs to use rating scales on a full spectrum of behaviors, not just the area that looks the most obvious, to avoid missing things.

Dr. Busman also notes that a child with severe anxiety who’s struggling in school might also have attention or learning issues, but they might need to be treated for the anxiety before they can really be evaluated for those. She uses the example of a teenager with OCD who is doing terribly in school. “They’re ritualizing three to four hours a day, and having constant intrusive thoughts — so we need to treat that, to get the anxiety under control before we ask, how are they learning?”

Frequently Asked Questions

Can acting out be a symptom of anxiety in a child?

Are anxious kids misdiagnosed because they act out?

Anxious kids who act out may be misdiagnosed with ADHD or a behavior disorder. That’s why it’s important to have a careful evaluation by a mental health professional, like a psychologist, psychiatrist, or social worker, to find out what’s causing the behavior.

How are anxious kids treated?

https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-anxiety-leads-to-problem-behavior-3/

James Donaldson on Mental Health - More Americans Plan Mental Health Resolutions Heading Into 2026

Washington, D.C. — Heading into 2026, more than one in three Americans (38%) say they plan to make a mental health-related New Year’s resolution, according to new findings from the American Psychiatric Association’s Healthy Minds Poll. This is up 5% from last year. Younger adults are leading this trend, with those ages 18–34 (58%) significantly more likely to report planning a mental health resolution compared with older adults (32% of 45-64-year-olds; 11% of those 65 and over).

A strong majority (82%) of Americans say they plan to make at least one New Year’s resolution for 2026. Physical fitness (44%) and financial goals (42%) remain the top areas of focus, followed closely by mental health (38%), which continues to rise in priority. Other common goals include diet (29%), social or relationship resolutions (29%), and spiritual goals (28%).

“It is encouraging to see more individuals planning to prioritize their mental health in 2026, particularly younger adults,” said APA President Theresa Miskimen Rivera, M.D. “The strategies people are embracing — such as regular physical activity, mindfulness practices, adequate sleep, time in nature and engaging in therapy — reflect a growing recognition that mental health is deeply connected to daily habits. Even small, intentional changes can have a meaningful and lasting impact on overall well-being.”

Looking back on 2025, 63% of Americans rated their mental health as excellent or good, while 28% said it was fair and 8% said it was poor.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Anxiety Heading into the New Year

Heading into 2026, anxiety remains common. Americans report feeling anxious about personal finances (59%), uncertainty about the next year (53%), and current events (49%), with concerns about physical and mental health close behind.

Issues Americans are Anxious About

IssuePercent anxious
(somewhat or very)Personal finances59%Uncertainty of the next year53%Current events49%Physical health46%Mental health42%Job security33%Relationships with friends and family32%Keeping New Year’s resolutions30%Romantic relationships29%

“A new year can bring change, possibility, and uncertainty,” said APA CEO and Medical Director Marketa M. Wills, M.D., M.B.A. “Feelings of anxiousness underscore the importance of paying attention to how we’re doing and taking practical steps, large or small, to support our mental health.”

These results are from the APA’s Healthy Minds Poll, conducted by Morning Consult, Dec. 2–3, 2025, among 2,208 adults. For a copy of the survey results, contact press@psych.org. See past Healthy Minds Polls.

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 39,200 physician members specializing in the diagnosis, treatment, prevention, and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-more-americans-plan-mental-health-resolutions-heading-into-2026/

Washington, D.C. — Heading into 2026, more than one in three Americans (38%) say they plan to make a mental health-related New Year’s resolution, according to new findings from the American Psychiatric Association’s Healthy Minds Poll. This is up 5% from last year. Younger adults are leading this trend, with those ages 18–34 (58%) significantly more likely to report planning a mental health resolution compared with older adults (32% of 45-64-year-olds; 11% of those 65 and over).

A strong majority (82%) of Americans say they plan to make at least one New Year’s resolution for 2026. Physical fitness (44%) and financial goals (42%) remain the top areas of focus, followed closely by mental health (38%), which continues to rise in priority. Other common goals include diet (29%), social or relationship resolutions (29%), and spiritual goals (28%).

“It is encouraging to see more individuals planning to prioritize their mental health in 2026, particularly younger adults,” said APA President Theresa Miskimen Rivera, M.D. “The strategies people are embracing — such as regular physical activity, mindfulness practices, adequate sleep, time in nature and engaging in therapy — reflect a growing recognition that mental health is deeply connected to daily habits. Even small, intentional changes can have a meaningful and lasting impact on overall well-being.”

Looking back on 2025, 63% of Americans rated their mental health as excellent or good, while 28% said it was fair and 8% said it was poor.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Anxiety Heading into the New Year

Heading into 2026, anxiety remains common. Americans report feeling anxious about personal finances (59%), uncertainty about the next year (53%), and current events (49%), with concerns about physical and mental health close behind.

Issues Americans are Anxious About

IssuePercent anxious(somewhat or very)Personal finances59%Uncertainty of the next year53%Current events49%Physical health46%Mental health42%Job security33%Relationships with friends and family32%Keeping New Year’s resolutions30%Romantic relationships29%

“A new year can bring change, possibility, and uncertainty,” said APA CEO and Medical Director Marketa M. Wills, M.D., M.B.A. “Feelings of anxiousness underscore the importance of paying attention to how we’re doing and taking practical steps, large or small, to support our mental health.”

These results are from the APA’s Healthy Minds Poll, conducted by Morning Consult, Dec. 2–3, 2025, among 2,208 adults. For a copy of the survey results, contact press@psych.org. See past Healthy Minds Polls.

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 39,200 physician members specializing in the diagnosis, treatment, prevention, and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org. https://standingabovethecrowd.com/?p=16298

Knowing what makes kids act out is the first step to finding solutions

Photo by Pixabay on Pexels.com

Writer: Caroline Miller

- Anxiety

- ADHD

- Learning Disorders

- Sensory Processing Problems

- Depression

- Autism

- Trauma

Downloadable Resources

- Learning Disabilities and Behavior Problems

When children act out more than occasionally — with frequent tantrums, outbursts or defiance — the first step to dealing with the problem behavior is finding out what’s behind it. And the cause may not be obvious.

Especially when children are young, they may not be able to tell you what they’re feeling. And in fact they may not even know what’s bothering them.

Tantrums and outbursts are usually signs that kids are struggling with feelings they don’t have the skills to manage. They may be overwhelmed by their frustration or anger and not know how to express themselves more effectively, or calm themselves down. They may need help developing skills to control their behavior.

(For more information see How Can We Help Kids With Self-Regulation.)

But if it’s happening a lot, it could be caused by a number of underlying issues.

Anxiety

We tend to think of anxious kids as shy, clingy, or timid, but anxiety can also cause kids to act out. When anxious children are put into situations that trigger their anxiety, they may lash out or have a tantrum in an effort to escape that situation.

It’s not uncommon for it to happen at school, where demands and expectations may put pressure on them that they can’t handle. For instance, if a child who has social anxiety feels criticized, they might throw books and papers on the floor or punch the person making them uncomfortable. And that behavior can be very confusing to teachers and other staff, since it seems to come out of nowhere.

(For more information see How Anxiety Leads to Disruptive Behavior.)

ADHD

ADHD is usually diagnosed when kids are having trouble paying attention. But for many children with the disorder — and their parents — behavior is a big problem, too. They may ignore instructions. And they may lash out, throw a tantrum, or be defiant when they are asked to do things they don’t want to do.

This behavior is often a result of ADHD symptoms. They may not do what they’re told because they are distracted or because it’s unusually hard for them to tolerate tasks that are difficult or boring. They’re especially likely to misbehave if they’re asked to stop doing something they enjoy, like playing a video game. So things like homework, going to bed, getting dressed, and coming to dinner can become battlegrounds.

Children with ADHD are also more impulsive than other kids. They may be overwhelmed with frustration or other powerful feelings, and might impulsively throw a shoe or push someone or yell “shut up!”

(For more information see ADHD and Behavior Problems.)

Learning Disorders

If a child acts out repeatedly in school or during homework time it could be the result of alearning disorder. If, for instance, they have trouble with math problems or a writing assignment, rather than ask for help, they might rip up the paper or start something with another child to create a diversion.

Kids who find learning harder than other kids do can be very frustrated and lose their temper frequently. And if they don’t know they have a learning disorder, they can worry that they’re stupid. So they often tend to hide their struggles. Getting into trouble might be less painful than letting people know that something is wrong with them. Paying attention to when the problem behavior happens can lead to exposing a learning issue and getting a child help.

(For more information see Supporting the Emotional Needs of Kids With Learning Disorders.)

Sensory Processing Problems

Children who have trouble processing sensory information can have extreme and confusing behavior when their senses are overwhelmed. They might do things like scream if their faces get wet or have a meltdown if they’re in a situation that’s too bright, noisy, or crowded. They might refuse to wear clothes that they find uncomfortable or eat food that feels wrong in their mouths.

Kids with sensory problems can also be rigid about routines and get upset or resist changes that seem insignificant to other people. They are also at risk for running away when an environment feels too overwhelming for them. The “fight or flight” response can kick in when kids are feeling overloaded with sensory input, and their panicked reactions can put them in real danger.

(For more information see Sensory Processing Issues Explained.)

Depression

Some children who have frequent temper tantrums have a disorder called disruptive mood dysregulation disorder, or DMDD. These kids have severe tantrums with chronic irritability in between outbursts. They tend to view things negatively and are quick to explode over issues that seem minor to other people.

(For more information see DMDD: Extreme Tantrums and Irritability.)

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Autism

Children on the autism spectrum are often prone to dramatic meltdowns. These children tend to be rigid — dependent on consistent routines for their emotional comfort — and any unexpected change can set them off. And they may lack the language and communication skills to express what they want or need.

Some behavior problems in kids with autism can be caused by medical issues that have gone unrecognized, especially in kids who are nonverbal. These include things like acid reflux, constipation, allergies, menstrual cramps, ear infections, and even bone fractures. All kids exhibit more negative behaviors when they don’t feel well, and kids on the spectrum may explode out of frustration that they are in pain and don’t know how to communicate it, or make it stop.

(For more information see Autism Behaviors: Do They Reflect Medical Issues?)

Trauma

Children who have been subjected to trauma or abuse often have trouble managing strong emotions. As babies and toddlers, children learn from adults how to calm and soothe themselves by being calmed and soothed by adults. If they haven’t had that experience, because of neglect, they can be quick to act out when they get upset and have trouble calming down. They need coaching and practice at de-escalating when they feel overwhelmed.

Kids who have experienced trauma also tend to interpret other people as hostile to them, so they may act out irritably in response. They may develop the belief that they’re bad and what’s happened to them is their fault. This leads to the expectation that people are not going to like them or treat them well, so there’s no point in trying to behave.

Photo by Pixabay on Pexels.com https://standingabovethecrowd.com/?p=16296