Anxiety - General

General Information

All children feel anxious at times. Many children, for example, show great distress when separated from their parents or when they have to deal with situations that are new to them. For 10 to15% of children, anxiety can be severe enough to interfere with their daily activities. Anxiety problems can lead to isolation, lost opportunities to learn and play, and low self-esteem.

Although by the teen years more girls than boys are diagnosed with anxiety disorders, both boys and girls develop anxiety problems. New information shows that many boys who present with conduct problems have underlying anxiety problems. Children dealing with anxiety often have parents who are similarly affected, suggesting that biology has a role to play in whether someone is anxiety-prone. But the good news is that with the right supports, treatment, and environment, children with anxiety are very successful in learning to overcome its impact.

General Characteristics To Look For

  • frequent absences
  • avoidance of class or social activities
  • isolating behaviour
  • frequent physical complaints
  • excessive worry about homework or grades
  • fear of new situations
  • falling grades or underachievement
  • frequent bouts of tears
  • frustration
  • drug or alcohol abuse

Generalized anxiety: Children experience persistent, extreme, unrealistic worry unrelated to actual events. They are often self-conscious and tense and have a chronic need for reassurance. They may suffer from aches and pains that appear to have no physical basis.

Selective mutism: Children become non-verbal in school settings, with adults, and/or with peers. They may be unable to answer questions, take part in group discussion, or give oral reports.

Phobias: Children suffer unrealistic and excessive fears that may centre on a particular object (e.g., spiders) or situation (e.g., being in an enclosed space). Social phobias may centre on a fear of being watched, criticized, or judged harshly by others.

Panic attacks: Children may experience periods of intense fear accompanied by physical symptoms such as a pounding heartbeat, sweating, dizziness, nausea, or a feeling of imminent death. Students with panic attacks will go to great lengths to avoid them. This may mean refusal to attend school, leaving the school grounds, or refusal to be separated from parents.

Obsessive-compulsive problems: Children become trapped in a pattern of repetitive thoughts and behaviours. These may include repeated handwashing, counting, or arranging and rearranging objects. (See “Special Focus on Children Dealing with Obsessive-Compulsive Difficulties” for more information.)

Post-traumatic stress (PTS): Children suffering from PTS may be overwhelmed, startled, or upset easily. They may be vigilant about potential harm, overly vulnerable to being harmed by others.

Impact On Student Success

  • Signs of anxiety can easily be missed. Students may have been affected long before adults notice.
  • Students may take longer to finish work because they worry about getting it right.
  • Students may refuse to begin, out of fear that they will not be able to do anything right.
  • When pressed, they may respond with inappropriate and uncharacteristic forcefulness.
  • Getting behind in their work because of numerous absences from school often creates a cycle of fear of failure, increased anxiety, and avoidance, which in turn leads to more absences.
  • Take an empathetic but confident approach—emphasize that the child can successfully get through his/her anxious feelings.
  • Help children see how worries can be tamed—talk out loud as you address your own fears and worries.
  • Notice and reward the small steps a child takes.
  • Encourage and normalize mistakes by demonstrating your own and how they can be overcome.
  • Make sure children are not carrying worries that are not theirs to manage—keep adult worries among the adults in the family.
  • Modify or adapt tasks to better suit the student’s learning style and allow work load adjustment.
  • Post the daily schedule where it can easily be seen so that students know what to expect.
  • Encourage follow-through on assignments or tasks, yet be flexible on deadlines.
  • Allow the use of technology—for example, video presentations vs. a speech in front of the class.
  • Consider the location and timing of case conferences—on or off site, before or after school, to help anxious students participate.
  • If necessary, in consultation with the Superintendent of Education, modify the student’s class schedule or reduce or modify time spent at school.
  • Anticipate and plan for a successful return to normal school routines and activities.
  • Work as a team with the school to reinforce and encourage school attendance.
  • Share strategies that work at home that can be adapted to the classroom or vice versa. This helps create a seamless world for the child. Consult with the family doctor or child mental health services about assessment and treatment needs.
  • Provide predictability and consistency to help manage anxiety
  • Child mental health services can provide: psycho-educational consultation, treatment, skills coaching for families and children and consultation with school teams for student success.
  • Family doctors or specialists can make decisions about whether medication can play a helpful role.
  • With child/family consent, describe treatment approaches and expected outcomes to other partners in the support team to improve everyone’s understanding of the child’s situation.
  • Help promote seamlessness between school and home strategies; be available to both parents and educators to help with this process.
  • Engage recreation and cultural services to help build in positive experiences for the child.
  • Engage in ongoing joint training initiatives.
  • Focus on “UPSTREAM” prevention initiatives