Addressing Barriers to Learning: Helping Students Cope with Disruptive Behaviors Anxiety Disorder Mental Health in the Schools Series Suzanne Rilling Mili Lal Susan Cole

OBJECTIVES  Overview of Anxiety Disorder  Signs and Symptoms  Strategies/Interventions  Classroom Accommodations  Developing a Plan  Case Study

ANXIETY  A generalized response to people or events that pose no immediate threat although to the individual they seem threatening.

Types of Anxiety Disorders:  Separation Anxiety Disorder  Generalized Anxiety Disorder  Panic Disorder  Obsessive Compulsive Disorder  Post-Traumatic Stress Disorder  Phobias (social, objects, animals)

ANXIETY DISORDERS  General Information: Effects approx % of school aged children Most prevalent psychiatric diagnosis in those 16 yrs. & younger Associated with negative impact in multiple domains High rate of comorbidity

Diagnostic Criteria  Symptoms are at an inappropriate severity level for age and developmental stage.  Must cause SIGNIFICANT functional impairment to be considered a disorder.

Signs and Symptoms of Anxiety: COGNITIVE  Fearful  Nervous  Stressed  Self-defeating  Inattentive  Indecisive

Signs and Symptoms of Anxiety: BEHAVIORAL  Restless  Clingy  Dependent  Shy  Withdrawn  Avoidant

Signs and Symptoms of Anxiety: PHYSICAL  Increased heart rate  Shortness of breath  Skin Irritation  Sweating  Gastro-Intestinal  Dizziness  Dry Mouth  Stuttering  Sleep Disturbance  Muscle tension

ACTIVITY  WHAT MIGHT ANXIETY LOOK LIKE IN YOUR CLASSROOM/SCHOOL ENVIRONMENT?

Observable/Measurable Behaviors of Anxiety in the Classroom  Clingy  Refusal  Withdrawn  Leaving the room  Frequent visits to the nurse  Shut down  Cries easily  Negative self-talk  Nail biting  Hair Twirling

Types of Treatment  Psychotherapeutic Treatments Cognitive Behavioral Therapy Family Therapy Other Therapies  Medication Treatments  Other Services

Anxiety and Development  Childhood Fear of animals, the dark, imaginary creatures  Middle Childhood School Performance  Adolescence Social and Interpersonal

STRATEGY INFORMATION SHARE  WHAT WORKS?  WHAT DOESN’T?

Helpful Accommodations  Back and Forth Notebook between home and school  Extended time for tests/assignments  Late start to school day or shortened day  Unlimited access to bathroom/water  Extra set of books at home  Tool kit to manage emotions  Calculator for math  Break long tasks into smaller segments  Permission to have snacks  Alternative/Modified assignments  Books on tape  Natural Light  Hard copy of notes

Developing A Good Intervention Plan STEP 1: Establish a team STEP 2: Get Student Input STEP 3: Teach Self-Monitoring Techniques STEP 4: Design Classroom Exit Strategy for the student

CASE STUDY MATTHEW-6 th Grade

AVAILABLE SCHOOL-BASED SUPPORT SERVICES