Change can be stressful for families and that can trickle down and lead to child anxiety. Milestones like moves, deaths and even the start of school can cause kids to demonstrate reluctance, fear and/or anxiety. It may be tougher, though, for young kids to put word to those feelings.

Clear and compassionate communication can help. Parents can start by expressing their own feelings as an invitation for their child to express theirs. “You’ve seen me crying because I feel sad that Grandpa is in the hospital. How do you feel about it?”

If it’s difficult to pinpoint the child’s behavior to a specific event, it can help to share an observation about changes in their behavior. “I’ve noticed that you’ve been quiet lately. In the past, you’ve told me that happens when you feel upset. Do you want to tell me about something that happened?”

A common transition that can be tough on kids is the start of school. Children may be anxious about how to face friends, teachers and classes again. “It’s understandable that children have fears about what school will be like when they go back, and those can persist for some time,” says Vera Feuer, MD, director of pediatric emergency psychiatric care at Cohen Children’s Medical Center (CCMC) and head of Northwell Health’s school-based mental health program.

Look to validate feelings

Dr. Feuer encourages parents to take seriously their child’s resistance to return to school and activities — not every child can do that seamlessly. Some children will not respond well to hyper-positive responses, such as, “You love school! It’s fun! Everything will be fine!”

Dr. Feuer points out that it can be helpful to validate a child’s feelings: “Many kids have a hard time with this,” or “I understand that this can be difficult.” Parents also can ask clarifying questions and listen closely to the answers, explain what returning to school will look like, and perhaps connect with other understanding parents, coaches, teachers or school administrators to give them a subtle heads-up about the child’s concerns.

“Play is the work of childhood,” is a quote — and method — that may help parents of children who are too young to express anxiety verbally. Parents can engage through play and setting scenes, suggests Kristina Howard, a certified child life specialist at Cohen Children’s Medical Center.

“Children tend to express internal feelings through play,” Howard says, citing an example of children who can’t eat before surgery playing with food toys to express their hunger.

It may help other children to slow down, she adds. It can help for parents and child to breathe together. They can blow bubbles, or alternately smell a flower and then blow out a candle, which gets children to breathe in through the nose and out through the mouth.

Parents can head off difficulties by establishing an open and strong line of communication with teachers and activity leaders. That can include scheduling regular check-ins, progress reports or writing notes. It’s also important to reassure children that everyone encounters struggles from time to time—they’re not alone and have their parents’ support when difficulties come.

Some children respond well to parents communicating openly and supportively understanding their concerns. Some may not. They may need a hand from a professional.

During the school year, that can give families access to more recourses to help with child anxiety. It can mean more access to counselors, social workers and psychologists.

“The federal government has released more funds to improve access to pediatric mental health care services, including more convenient teletherapy sessions,” Dr. Feuer explains. “This should make it easier for children to get the therapy they need.”

Anxiety in children doesn’t always manifest this seriously. Parents can watch for changes in their child’s behavior and communication and share their observations with professionals if they’re not sure whether help — like that of a social worker, therapist, psychologist or psychiatrist — would be useful.