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School-Based Anxiety

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Jillian Andresen

on 7 December 2016

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Transcript of School-Based Anxiety

design by Dóri Sirály for Prezi
Resistance/sickness night before
Protests/refusal in AM or on way to school
Repeated visits to nurse or calls home
Repeated requests for parent to pick up from school
Predicted by events at:
School: bullies, tests, speech
Home: separation anxiety, reinforcing "home" environment

What is Anxiety?
National Association of School Psychologists - www.nasponline.org


Rush Neurobehavioral Center- http://rnbc.org

Anxiety and Depression Association of America- www.adaa.org





School Refusal
Separation Anxiety
Sleep difficulties
Depressed mood
Symptoms of School Refusal
School-based Anxiety
: A developmentally inappropriate reaction to the perceived consequences associated with school (failing a class, fears of getting picked on, etc.)

School Refusal
: "Child-motivated refusal to attend school, difficulties remaining in class for the entire day, or both."
NOT a clinically classified DSM Psychological Diagnosis
Must create significant impairment:
Significant number of days missed
Poor school and grade performance
Interpersonal arguments and conflicts
Concrete consequences (detentions, fines, legal action)
Effects 2-5% of school age children
Most common between ages 5-6 and 10-11
Transitional periods-entering middle school and/or high school
Children tend to have average or above-average intelligence
School-Based Anxiety and School Refusal
School-Based Anxiety
Warning Signs at School
Frequent complaints about attending school
Frequent tardiness or unexcused absences
Absences on significant days (tests, speeches, phys. ed.)
Frequent requests to call or go home
Excessive worrying about a parent when in school
Frequent requests to go to the nurse's office
Crying about wanting to go home
Difficulty concentrating
Depressed mood or irritability
Excessive reassurance-seeking behavior
Clinging to an adult
Types of Anxiety Disorders
Generalized Anxiety Disorde
r: occurs in multiple settings and involves excessive apprehension about a number of situations on most days
affects 3-4% of children
persists for at least 6 months

Social Anxiety
: fear of meeting new people or of embarrassing oneself in social situations

Separation Anxiety Disorder
: fear of separating from home or primary caregiver

Panic Disorde
r: unpredictable and repeated panic attacks unrelated to surrounding circumstances

Obsessive-Compulsive Disorder
: uncontrollable, repetitive, thoughts and fears, often accompanied by repetitive behaviors intended to prevent fears from being realized

Selective Mutism
: persistent failure to speak in social situations (despite the physical ability to speak in other situations), most likely due to severe social anxiety

Specific Phobia
: fear of a particular object or situation

Excessive worrying that is irrational or out of proportion to the feared stimulus for an extended period of time
One of the most common mental health conditions in children and adolescents
May results in significant distress within school, peer relationships, home life, and may limit their ability to engage in activities
May develop serious educational or social issues
May withdrawal from social activities or avoid difficult tasks for fear of failing or being embarrassed
May appear forgetful, unmotivated, or inattentive in classroom discussions
Academic performance may start to suffer
Behaviors may be interpreted as defiance, lazy, or disorganized
May isolate themselves to avoid peer interactions
Poor self-concept and believe they lack the skills to initiate and sustain friendships
leads to worries about being rejected by peers
More likely to develop sadness and patterns of anxious thinking
How does anxiety impact our youth?

Establish check-ins on arrival to facilitate transition into school
Accommodate late arrival due to difficulty with transitions
Transitions may be particularly difficult for these children
allow extra time for moving to another activity or location
Refusing to follow directions- may be symptoms of anxiety rather than intentional opposition
Avoiding school- determine the cause of the child's reluctance and address it
Initiate a plan for him or her to return to school as quickly as possible
It may help ease anxiety if the child attends for a shorter school day temporarily.
Identify a "safe" place where the child may go to reduce anxiety during stressful periods
Developing guidelines for appropriate use of the safe place will help both the student and staff

Meetings between parents and school staff- teachers, guidance counselors, or nurses, will allow for collaboration to develop helpful school structure for the child
Flexibility and a supportive environment are essential for a student with generalized anxiety disorder to achieve success in school
School faculty and parents together may be able to identify patterns of difficulty and develop remedies to reduce a child's challenges at these times
May need particular changes (accommodations/modifications) within a classroom

Accommodations, Modifications, and Strategies
Develop relaxation techniques to help reduce anxiety at school
Provide alternative activities to distract the child from physical symptoms
Calming activities may be helpful
Encourage small group interactions to develop increased areas of competency
Provide assistance with peer interactions
An adult's help may be very beneficial for both the child and his or her peers.
Encourage the child to help develop interventions- leads to more successful strategies and fosters the child's ability to problem-solve
Reward a child's efforts - every good effort deserves to be praised

Accommodations, Modifications, and Strategies cont.
Interventions at School

Easily distressed, or agitated when in a stressful situation
Repetitive reassurance questions, "what if" concerns, inconsolable, won't respond to logical arguments
Headaches, stomachaches, regularly too sick to go to school
Anticipatory anxiety, worrying for hours, days, weeks ahead
Disruptions of sleep with difficulty falling asleep, frequent nightmares, difficulty sleeping alone
Perfectionism, self-critical, very high standards that make nothing good enough
Overly-responsible, people pleasing, excessive concern that others are upset with him or her, unnecessary apologizing
Demonstrating excessive avoidance, refuses to participate in expected activities, refusal to attend school
Disruption of child or family functioning, difficulty with going to school, friend's houses, religious activities, family gatherings, errands, vacations
Excessive time spent consoling child about distress with ordinary situations, excessive time coaxing child to do normal activities- homework, hygiene, meals

Warning Signs of Anxiety in Children
Jillian Andresen

Possible reasons:
Stressful life events-Starting/changing schools, moving, death of a loved one, parent divorce, or academic difficulties
Fear of something happening to parent while at school
Fear he/she won't do well in school
Fear of another student
School Refusal
Causes of Anxiety
Brain biochemistry
Overactive fight-flight response
Stressful life circumstances
Learned behavior
**It's common for kids to avoid talking about how they feel
May be worried that others (especially their parents) might not understand
May fear being judged or considered weak, scared, or "babyish"
Girls are more likely to express their anxiety, however boys experience these feelings, too
May find it hard to talk about, which leads many kids to feel alone or misunderstood
Activity 1
Think of 3 things that worry you
Write worries down on separate pieces of paper
Cut 3 pieces of yarn representing how big each worry is
Attach yarn to corresponding pieces of paper
*For younger students- attach each worry to the brain of face shape

Discuss worries
Discuss various solutions and ways to deal with the worries

Activity 2
The Hershey Kiss Exercise
What was it like to eat something mindfully?
Did the Hershey kiss taste any different then it normally does?
What did you notice when you were doing this exercise?
How does this compare to how you normally eat your food?
School Refusal and Cognitive Behavioral Therapy
Symptoms of Anxiety at School
Excessive worry and anxiety about various matters
Repeated seeking of teacher approval
Inability to explain the worries
Inability to stop worrying
Difficulty with transitions from home to school
Refusal/reluctance to attend school
Avoidance of academic and peer activities
Self-criticism and low self-esteem
Difficulty concentrating
Symptoms at School cont.
Other anxiety disorders
Learning disorders
Side effects from medications
Full transcript