Anxiety & Worry

• A child who will not start, particularly when the task is open-ended or the answer might be wrong.
• Frequent trips to the toilet or the medical room, often clustered before the same lesson.
• Repeated checking questions: "Is this right?", "What do I do now?", after the answer has been given.
• Reluctance to speak in front of the class, or to read aloud, that does not match their ability.
• Difficulty at arrival, changes of adult, wet play, assembly, the hall, PE changing.
• Withdrawal from a group, or hovering at the edge of a game.
• Work that is heavily rubbed out, restarted, or never finished because it is not good enough.
• Irritability, refusal or leaving the room — anxiety does not always look anxious.

Pattern matters more than incident. The same difficulty in every lesson and the same difficulty only in writing, or only after lunch, are different pieces of information.

Anxiety is frequently read as low ability, lack of effort, poor behaviour or attention difficulty. A child who cannot start looks unmotivated; a child who leaves the room looks defiant; a child who cannot hold information while worried looks as though they were not listening.

It runs the other way too, and this matters just as much. Not every reluctance is anxiety. Work pitched too high, instructions too long to hold, an unfamiliar word, a hearing difficulty, a friendship falling out or simple boundary-testing all produce similar surfaces. Checking task demand and language load first is not a detour; it is often the answer.

Worry occupies the same limited attention and working memory that the task needs. A child spending a lesson managing a feeling has less capacity for the content, which is why work sometimes falls far below what you know they can do — and why they can appear to have forgotten something they knew yesterday.

Assessment is particularly affected. Timed work, being called on, reading aloud and anything with a public outcome will underestimate an anxious child. If you want to know what they know, ask in a low-stakes way.

• Short, calm, quiet, and out of earshot of the class.
• Ask what would make the next ten minutes manageable, not what is wrong with them.
• Offer two acceptable options rather than an open question.
• Do not require eye contact or an explanation on the spot.
• Say what will happen next, so the immediate future is known.
• Follow up briefly later — that is what makes it a relationship rather than an incident.

• Public discussion of a child's worry, or of an adjustment being made for them.
• Insisting on participation in the moment as a matter of principle.
• Long reasoning while the child is overwhelmed.
• Removing the child from the parts of the day they enjoy as a consequence.
• Treating a persistent pattern as something to manage alone — loop in the SENDCO or pastoral lead.
• Assuming a quiet, compliant, high-achieving child is fine.

Parents often see a very different child at 4pm than you see at 11am. If a family reports difficult mornings or distressing evenings and you see nothing, both accounts are usually accurate — it means school is costing more than it appears.

Involve the SENDCO or pastoral lead when a pattern persists across contexts despite adjustments, when attendance or participation is being affected, when a child is very distressed, or when you are unsure. Bring examples: date, lesson, what preceded it, what helped.

1. NHSProfessional guidance
   Anxiety in children — advice for parents

   The plainest UK statement of the distinction this guide rests on: all children feel worried sometimes, and anxiety becomes a concern when it is out of proportion, persistent, and getting in the way of ordinary life.

2. NHSProfessional guidance
   Anxiety disorders in children

   Describes recognised anxiety difficulties and the routes to help — GP first, then local children and young people's mental health services. Diagnosis sits here, not with schools.

3. NHSProfessional guidance
   Children and young people's mental health — advice for parents

   The parent-facing hub, including what to do first and where support exists locally.

4. National Institute for Health and Care ExcellenceProfessional guidance
   Social, emotional and mental wellbeing in primary and secondary education (NG223) (2022)

   Recommends a whole-school approach: supportive climate, trusted relationships, universal curriculum content, targeted support for those who need more, and staff training to deliver it.

5. National Institute for Health and Care ExcellenceProfessional guidance
   Social anxiety disorder: recognition, assessment and treatment (CG159) (2013)

   Clinical guidance covering children and young people. Referenced here only to be clear where the clinical threshold and treatment decisions sit — with health services.

6. Department for EducationProfessional guidance
   Mental health and behaviour in schools (2018)

   Non-statutory advice on the line between what a school can reasonably provide and what needs a clinical service — the question most often at issue with anxiety.

7. Department for EducationProfessional guidance
   Mental health issues affecting a pupil's attendance: guidance for schools (2023)

   Directly addresses anxiety-related absence: attendance is usually improved by support and adjustment alongside expectation, rather than enforcement alone.

8. Department for EducationStatutory guidance
   Working together to improve school attendance (2022, statutory from 2024)

   Sets out the 'support first' expectation and the duties schools and local authorities hold where attendance is affected by health or SEND.

9. Department for EducationStatutory guidance
   SEND Code of Practice: 0 to 25 years (2015)

   Names anxiety as an example of a social, emotional and mental health need, and sets out the graduated approach — assess, plan, do, review.

10. Department for Education (research by University College London)Research evidence
    Identifying and supporting children and young people with social, emotional and mental health needs: a rapid evidence review (2025)

    Part of the DfE's SEND evidence programme. Published as research; the DfE states it does not endorse the approaches described.

11. Education Endowment FoundationResearch summary
    Improving Social and Emotional Learning in Primary Schools — guidance report (2019, updated 2021)

    Recommends teaching social and emotional skills explicitly and using them across the day. Rated by the EEF as moderate impact for very low cost, on moderate evidence.

12. Public Health England / Department for EducationProfessional guidance
    Promoting children and young people's mental health and wellbeing: a whole-school and whole-college approach (2021)

    The eight-principle framework most UK schools audit their wellbeing provision against.

13. Anna FreudProfessional guidance
    Mentally Healthy Schools

    Quality-assured UK resource bank for primary schools — useful when choosing classroom materials that are not simply commercial products.