Could my nine year old son have problems with anxiety rather than hyperactivity?

This column allows people to ask questions about anxiety and anxiety disorders.  The names of those asking questions have been deleted to ensure their privacy.

Question 1.  Dear Doctor, My nine year old son's teacher has suggested to me that he might have problems with hyperactivity, and thinks I should have him tested.  In school and at home he has difficulty sitting and paying attention.  He can also be loud and aggressive.  Could he have problems with anxiety rather than hyperactivity?

Answer.  Dear parent, it is very unlikely your son has an anxiety problem rather than a problem with hyperactivity.  Anxious children usually are very quiet and do not wish to draw attention to themselves.  Usually an anxious child will only act out when faced with a situation provoking his/her anxiety.  For example, a child who becomes very fearful when separated from his/her parents may act out when he/she believes separation, such as being sent off to school, will occur.  Many children with hyperactivity problems do get anxious when being chastised for their hyperactive behaviours, but this is very normal.  We all get anxious when we fear we will be punished.