Coping with Childhood Anxiety in the Classroom

Slide1CHILDHOOD  A NXIETY   IN   THE  C LASSROOM Strategies for identifying and managing anxiety disorders in children and adolescents Jennifer Welbel, LPC Clinical Program Fellow Anxiety and CBT The Family Institute at Northwestern University February 22 nd , 2014

Slide2OVERVIEW  Prevalence of anxiety disorders in children and adolescents  Who is the anxious child  Developmental factors to consider  Overview of common childhood anxiety disorders  The impact of anxiety in the classroom  How to talk to parents about it  Classroom support strategies

Slide3DEVELOPMENTALLY   APPROPRIATE A NXIETY  What is anxiety?  Normal response to perceived danger, like a warning signal.  Experienced as a general feeling of discomfort, distress, or a sense of danger  Normal part of childhood development – as many as 70% of children worry about a number of things  Typically occurs when children confront novel experiences and situations that they have not yet mastered

Slide4NORMAL  D EVELOPMENTAL  F EARS • Stranger anxiety • Loud noises • Unexpected objects or people Infancy (birth-8 months) • Separation anxiety • Fears of thunder, lightening, fire, water, darkness, and nightmares Toddlerhood (1 – 3) • Separation anxiety • Fear of death or dead people • Fears of ghosts, spiders, the dark, storms, monsters) Early Childhood (4-5) • Fear of natural disasters • Fears of serious illness • Fear of specific objects Elementary School (5-7) • Performance fears • Peer rejection and exclusion • Concerns about academic performance Middle and High School (12-18)

Slide5PREVALENCE   OF  A NXIETY  D ISORDERS IN  C HILDREN  & A DOLESCENTS 20%  have an anxiety disorder by the time they turn 18 75% have onset before 21 Average age of onset: 11

Slide6PREVALENCE   OF  A NXIETY  D ISORDERS IN  C HILDREN  & A DOLESCENTS Insert graph with prevalance of chidlhood anxiety disorders

Slide7THE   IMPACT   OF   ANXIETY   IN   THE CLASSROOM  Social  Social isolation  Fewer friends  May be the target of peer ridicule  Less friends  Academic Performance  Decrease in classroom participation  May result in school refusal and/or school absences  Difficulty concentrating  May avoid writing on the board or asking questions in class  Lower grades

Slide8WHO   IS   THE   ANXIOUS   CHILD ? Transitory anxiety becomes problematic anxiety when…  It is excessive and out of proportion to the situation  It begins to interfere in the child’s social, family, and academic functioning

Slide9WHO   IS   THE   ANXIOUS   CHILD ? Thoughts Feelings Behaviors Physical Symptoms

Slide10WHO   IS   THE   ANXIOUS   CHILD ? Thoughts • Overestimate danger • Underestimate ability to cope • Misinterpretation of cues • Future-oriented

Slide11WHO   IS   THE   ANXIOUS   CHILD ? Feelings • Fear • Anger • Anxiety • Irritability

Slide12WHO   IS   THE   ANXIOUS   CHILD ? Behaviors • Avoidance • Reassurance seeking • Need for control • Decrease in risk taking

Slide13WHO   IS   THE   ANXIOUS   CHILD ? Physical Symptoms • Stomachache • Headache • Muscle tension • Loss of sleep • Perspiration • Dizziness

Slide14COMMON   CHILDHOOD   ANXIETY DISORDERS Social Anxiety Disorder Excessive fear of one or more social or performance situations, in which the child fears being judged or embarrassed

Slide15COMMON   CHILDHOOD   ANXIETY DISORDERS  Unrealistic and excessive anxiety upon separation from major attachment figures  Excessive worry about potential harm to oneself and/or major attachment figures  Common worries: Getting kidnapped, death, becoming ill Separation Anxiety Disorder

Slide16COMMON   CHILDHOOD   ANXIETY DISORDERS Selective Mutism

Slide17COMMON   CHILDHOOD   ANXIETY DISORDERS  Excessive, unrealistic, and uncontrollable worries about day to day activities  “What if” concerns that span far into the future  Child needs to know the details about every situation  Believes that worry prevents bad things from happening Generalized Anxiety Disorder

Slide18COMMON   CHILDHOOD   ANXIETY DISORDERS Obsessive Compulsive Disorder Common Obsessions • Contamination or germs • Symmetry or order • Good, bad, and magical numbers • “Just right” feeling • Fear that harm, illness, or death will befall oneself or others Common Compulsions • Repeatedly washing • Avoiding touching “dirty” objects • Counting behavior • Rearranging items to be in a certain order • Erasing words and rewriting • Checking behavior