1. Anxiety in the Classroom Information taken from Book 8 Teaching Students with Emotional Disorders and/or Mental Illnesses from Alberta Education 1

2. Anxiety Disorders 2

3. Most Common Types of Anxiety Separation Anxiety Disorder – Excessive anxiety in relation to leaving home or caregiver that causes significant distress or impairment Selective Mutism - A consistent failure to speak in specific social situations despite speaking in other situations. Specific Phobia – Fearful or anxious about or avoidant of specific objects or situations with the fear being out of proportion. Social Anxiety Disorder (Social Phobia) - Fear or anxiety about social situations where one is exposed to possible scrutiny by others. 3

4. Most Common Types of Anxiety (con’t) Panic Disorder – Recurrent unexpected panic attacks which is an abrupt surge of intense fear or discomfort. Agorphobia – Fear and anxiety about situations because of thoughts that escape might be difficult or help not available. Generalized Anxiety Disorder – persistent and excessive anxiety and worry that cause significant distress or impairment. Substance/Medication Induced Anxiety Disorder 4

5. New Home in DSM-5 Post-traumatic Stress Disorder (PTSD) is now housed in the Trauma and Stressor-Related Disorder category. Obsessive Compulsive Disorder is now housed in the Obsessive-Compulsive and Related Disorders category. 5

6. Considerations 6

7. Physiological Considerations Often in children problematic anxiety consists of a physiological side, involving activity in various systems:  Breathing (shallow, rapid)  Heart (pounding, skipped beats)  Vascular (blushing, fainting, dizziness)  Musculoskeletal (trembling, feelings of weakness in the limbs, aches, stiffness)  Dermatological (increased sweating, clammy skin)  Digestive (stomach ache, nausea, vomiting, diarrhea). 7

8. Psychological Considerations Additionally, psychological factors must also be considered:  Apprehensive self-absorption interfering with effective problem solving  High levels of negative feelings  Excessive worry about possible danger or threat  A sense of being unable to control the threat if it occurs 8

9. Behavior/Social Considerations Behavioral cues to excessive anxiety include: Refusing tasks Exam-performance anxiety Reactions to certain school-based sights, sounds and smells Complaints of freezing Frequent trips to the washroom Attendance problems Repetitive perfection-seeking behaviors Clinging to parents or teacher 9

10. Medications Common side-effects of medication prescribed for anxiety includes: Drowsiness lack of energy Clumsiness, slow reflexes Slurred speech Confusion and disorientation Depression Dizziness, lightheadedness Impaired thinking and judgment Memory loss, forgetfulness Nausea, stomach upset Blurred or double vision 10

11. Other Considerations Level of cognitive functioning (e.g., Mild Developmental Delay) will affect the effectiveness of some strategies. Another diagnoses (e.g., Autism Spectrum Disorder) 11

12. Treatment Options - Medications - Cognitive - Behaviour -Therapy - Family Therapy - Group Therapy - Psychodynamic Therapy 12

13. Strategies 13

14. Strategies Communicate Develop trust Identifying what can be done to help Developing realistic goals and chart progress Normalize regression. 14

15. Strategies Teach positive self talk Communicate by using pre-determined signals Identify the level of distress at specific times Routine, predictable environment Opportunities to leave/get support when needed 15

16. Strategies Creating distractions Using visualization Conduct reality checks to avoid unrealistic expectations Using peer group 16

17. Strategies Special accommodations. Given extra time. Allow movement breaks. Allow sensory tools. 17

18. Strategies to Support Behaviours Acknowledge that behaviors are a result of an Anxiety Disorder. Track the behaviors. Determine triggers and setting events. Develop a plan that focuses on PROACTIVE strategies. Implement proactive strategies (e.g., different location, relaxation exercise, sensory tool, etc.) 18