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Anxiety in Children and Adolescents

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Christine Judd

on 6 November 2013

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Transcript of Anxiety in Children and Adolescents

Impacts on learning
Anxiety in Children and Adolescents
* attendance
* impaired attention
* impaired memory
* impaired higher order reasoning
* effects on sleeping
* involvement in behaviour disorders
The Way out
What is anxiety?
* types of anxiety
* protective factors
How you can help
Survey Monkey results
Your three most requested topics were:
* role of anxiety in behaviours such as school refusal or behavioural disorders
* how anxiety may effect learning and memory
*causes of, and factors which protect against, anxiety.
Also questions about:
* parental involvement/influence
* contribution which inexplicit or unsystematic teaching may make to development of anxiety
* how should teachers respond? When should student be pushed a bit harder?
Why would you want to know more about anxiety in children?
* Anxiety is one of the most common disorders
* Anxiety often plays a role in learning and behaviour difficulties
* Anxiety has one of the best responses to treatment
* The sooner it is treated the less likelihood of reoccurence and the less severe reoccurance is likely to be
* Anxiety can rob people of friendships, achievements, self esteem, life enhancing experiences .

What is happening neurologically during anxiety?
Limbic system is in overdrive hindering higher order thinking.
What happens neurologically during anxiety?
The amygdala and hippocampus are particularly involved

What happens neurologically during anxiety?
Due to flooding with hormones such as cortisol neural branches (dendrites) may be effected. Over time some neurons may have their myelin damaged. Some areas (the hippocampus is particularly vulnerable) may reduce in size.
So what does that mean for learning?
Learning may be affected at any or all stages:
* attention
* reasoning
* memory

Focussing attention, maintaining attention and shifting attention are primarily "executive functions" and therefore rely heavily on the neo-cortex. While anxious, a student will likely have less access to the neo-cortex. They may also be pre-occupied with anxious thoughts or feelings.
Delayed access to neo-cortex will also impede reasoning such as:
* integrating new learning with existing learning
* evaluation
* critical thinking
Laying down of new memories may be impeded due to attention issues and/or reasoning issues. (Think children who know every dinosaur name but no times tables. Or young people who score well on an IQ test but remember nothing from yesterday's science lesson).
Access to existing memories may be blocked:

* temporarily - cortisol may temporarily shrink dendrites. (Think children who"know it one day and not the next" or the classic memory block during tests.)

* permanently - dendrites may be destroyed, myelin destroyed. In long term cases MRI will show decreased size in hippocampus
Some specific examples of impacts on learning
". . there is a significant negative correlation between social anxiety and reading comprehension but no significant correlation between social anxiety and reading fluency." Tysinger, Tysinger and Diamanduros

[ie because comprehension relies more heavily on working memory than does fluency]
impacts on learning
Complex - may depend to some degree on type of anxiety eg
Sharma and Rao (1984) found academic performance was negatively effected by test anxiety but not necessarily by general anxiety.
Sud and Sujata (2006) found that anxiety, perfectionism, procrastination, worry and emotionality were all negatively related to academic performance
Remembering that anxiety is about an overwhelming sense of apprehension that something beyond the person's capacity to cope is going to occur, it is understandable that an anxious person will try to avoid the source of that "something".
For children and young people "extreme danger" may be represented by any or many things.
While wanting to avoid fearful feelings is natural, doing so generally makes things worse as the proof that they"can't cope" seems to mount with every passing day. Plus friendships break down, work falls further behind (so it's harder to pick up) and daily routines crumble.
school avoidance
And the longer this goes on the more the brain becomes "wired" for anxious and avoidant thought patterns.
Of course, not all students who don't come to school are avoiding it due to anxiety
Some just have a better offer. But it's not always easy to tell which is which.
There are 3 instinctive reactions to anxiety:
Examples of "fleeing" include:
school avoidance
"fussing about" to avoid starting or finishing
"I didn't know about it"
Distracting you or others with chit chat or stories
trips to the toilet
Unexplained illness
Excessive immersion in fantasy or books
Excessive immersion in computer games
Deny, deny,deny
Examples of "freezing" include:
can't remember
seems not to hear or remember what has just been said.
poor problem solving or reasoning (even though that school counsellor swears they have an "average" IQ)
seems passive, unemotional or doesn't seem to react much to bullying or nastiness
Slow worker
easy to forget
Examples of "fight" mode
oppositional with authority
reacts to comments with excessive aggression
highly defensive ("Why doesn't SHE have to do it?" "So did he . . . why pick on me")
May seem to destroy potential relationships before they get properly off the ground (eg criticism, disloyalty, irritability)
Might appear not to care about much
[Ben's story]
Ensuring work is challenging - but not too challenging.
Discussions about "how can we solve this?" that build a culture of problem solving rather than "avoidance".
Helping children and young people to calm down before they try to understand what's happened or deal with it. (ie help them get to a point where their neo cortex will be ready to engage)
Helping children to keep perspective by picking them up when they use absolutes like "always", "never", "don't ever" etc.
Language that focusses on the positive and coping (4 to 1: What are 4 things you did right, "what might you improve next time?" "who stuck by you?"
Your good teaching practices help
Be on the look out for signs of anxiety and discuss the possibility with parents and your school counsellor.
offer the student a "check in" time with you.
"time out" or a safe place can be helpful but needs frequent review with student so that is a transition strategy not a reinforcer for avoidance.
model relaxation techniques
modify stressful situations
avoid singling the student out
reward effort and build a culture of personal best.
Some more ideas:
* Teaching practices
* Open a dialogue
* Look for the signs

Some more ideas
Open a dialogue. If a child seems worried about a task:

1. Ask them "how comfortable do you feel about this?" (maybe let them show you on a thermometer or scale).
2. Acknowledge their feelings and normalise them ("Other children feel like this too")
3. Help them break down the task into manageable chunks and offer encouragement.
4. Praise their efforts
Try to reward non-anxious behaviour
eg. Quietly praise the child for speaking up in class or starting on time.
Try to re-direct anxious behaviour
eg give them a job to do.
Avoid excessive reassurance (only answer once)
eg If a student is in the habit of asking repeatedly "Am I doing it right?" ask them what they think and why they think that.

eg If a student asks the same question more than once you can say (not unkindly) "You know the answer to that" or "You've asked me that before - is there another way you can find out?"
Encourage risk taking in small steps and as part of a plan.
eg speaking in front of class, sitting with a new person, going on an excursion, attempting a new task etc. Knowing what you can push - and how far - depends on your knowing the child - and them knowing that you know them.
Graduate challenges (to improve chances of success) BUT also explain, model and help children accept that everyone has times when they get it wrong. It is normal and OK.
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