Download Childhood Anxiety in the Classroom

CHILDHOOD ANXIETY IN THE CLASSROOM
Strategies for identifying and managing anxiety disorders in
children and adolescents
February 22nd, 2014
Jennifer Welbel, LPC
Clinical Program Fellow
Anxiety and CBT
The Family Institute at
Northwestern University
OVERVIEW
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

DEVELOPMENTALLY APPROPRIATE
ANXIETY
 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
NORMAL DEVELOPMENTAL FEARS
Infancy (birth-8
months)
•Stranger anxiety
•Loud noises
•Unexpected objects or people
Toddlerhood (1 –
3)
•Separation anxiety
•Fears of thunder, lightening, fire, water, darkness, and
nightmares
Early Childhood
(4-5)
•Separation anxiety
•Fear of death or dead people
•Fears of ghosts, spiders, the dark, storms, monsters)
Elementary
School (5-7)
Middle and High
School (12-18)
•Fear of natural disasters
•Fears of serious illness
•Fear of specific objects
•Performance fears
•Peer rejection and exclusion
•Concerns about academic performance
PREVALENCE OF ANXIETY DISORDERS
IN CHILDREN & ADOLESCENTS
20% have an anxiety disorder
by the time they turn 18
75% have onset before 21
Average age of onset: 11
PREVALENCE OF ANXIETY DISORDERS
IN CHILDREN & ADOLESCENTS
Insert graph with prevalance of chidlhood anxiety
disorders
THE IMPACT OF ANXIETY IN THE
CLASSROOM

Social
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Social isolation
Fewer friends
May be the target of peer ridicule
Less friends
Academic Performance

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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
WHO 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
WHO IS THE ANXIOUS CHILD?
Thoughts
Physical
Symptoms
Feelings
Behaviors
WHO IS THE ANXIOUS CHILD?
Thoughts
•Overestimate danger
•Underestimate ability to
cope
•Misinterpretation of cues
•Future-oriented
WHO IS THE ANXIOUS CHILD?
Feelings
•Fear
•Anger
•Anxiety
•Irritability
WHO IS THE ANXIOUS CHILD?
Behaviors
•Avoidance
•Reassurance seeking
•Need for control
•Decrease in risk taking
WHO IS THE ANXIOUS CHILD?
Physical Symptoms
•Stomachache
•Headache
•Muscle tension
•Loss of sleep
•Perspiration
•Dizziness
COMMON 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
COMMON CHILDHOOD ANXIETY
DISORDERS
Separation Anxiety Disorder


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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
COMMON CHILDHOOD ANXIETY
DISORDERS
Selective Mutism
COMMON CHILDHOOD ANXIETY
DISORDERS
Generalized Anxiety Disorder

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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
COMMON CHILDHOOD ANXIETY
DISORDERS
Obsessive Compulsive Disorder
Common Obsessions
Common
Compulsions
• 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
• Repeatedly washing
• Avoiding touching
“dirty” objects
• Counting behavior
• Rearranging items
to be in a certain
order
• Erasing words and
rewriting
• Checking behavior