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invisible anxiety1 in 8 children are diagnosed with an Anxiety Disorder.

Separation Anxiety Disorder, Specific Phobia, and Obsessive Compulsive Disorder (OCD) are common in younger children, ages 6-9.  Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), and Panic Disorder are more prevalent between 8 and 12 years.  All of these disorders may continue through adolescence. These anxious children, who spend up to eight hours a day in school, are frequently overlooked and denied educational support and accommodations because their anxiety is invisible.  Discover how to identify invisible anxiety in the classroom.

Why Invisible Anxiety?  Four Common Reasons

1. Children’s anxiety symptoms are not always overtly apparent to teachers.

“Mrs. Smith, there is no problem…your child is quiet, well-behaved, and an excellent student.”

 2. Anxiety symptoms are confused with defiant or oppositional behaviors.

“Mr. Brown, your son cries, whines, refuses to read aloud, or raise his hand.”

 3. It’s often difficult to determine how anxiety symptoms interfere with learning.

“Your child worries, but so does every student in this academically rigorous school.”

4. Schools often have few resources and may deem a child’s anxiety to be a private matter.

“We see your child’s anxiety, but what can we do? This is emotional and should be dealt with at home, or by your doctor.”

Recognizable Effects of Invisible Anxiety on Behavior

Without obvious physical signs like sweating, tremors, or blushing, anxiety can be missed.  More subtle signs include inflexibility, over-reactivity, intense emotion, and impulsivity.

Anxiety is not always distinctive – sometimes, the only difference between oppositional and anxiety-related behavior is the underlying cause. One of the most identified school fears is separation from parents. Other frequently reported worries include riding the bus, eating in the cafeteria, public restrooms, being called on in class, changing for gym and being bullied.

Furthermore, these invisible anxiety symptoms can greatly affect academic performance. Anxiety impacts working memory and processing speed, making it difficult to learn, retain, and recall information.  Teachers must be educated on the behavioral manifestations of anxiety in the classroom in order to make this invisible disability easier to detect and understand.

Be On the Look Out for Invisible Anxiety Related Behaviors

Avoidance of interactions with classmates and teachers

Speaking at low volume or only to select individuals

Frequent requests to leave the classroom, to use the bathroom, see the nurse, or call a parent

Complaints of feeling hot/cold; trouble breathing; aches, pains, itchiness

Social isolation, no participation in at recess or in afterschool groups

Awkwardness in appearance and conversation with peers

Task avoidance and defiance

Sudden change in actions such as writing very small, excessive focus on certain ideas, need for order, repetitive behavior

Supporting the Child with Invisible Anxiety

When anxiety interferes with learning, it is considered a functionally impairing disability. Under the Americans with Disabilities Act and the IDEA Laws, students with disabilities are entitled to classroom accommodations and supports under section 504 and through Individualized Education Plans (IEP).

For many children, anxiety disorders fall under the classification of Other Health Impaired (OHI). If students with anxiety are to succeed in school, they need a behavioral intervention plan that addresses anxiety and teaches more appropriate responses. Parents can make this happen.

Share evaluations and clinical information that explain your child’s anxiety in school.

Have the treatment provider present information about the disorder, your child, what educators might expect and suggested school recommendations.

Design supports to help lessen anxiety while encouraging normal routine; least restrictive supports should be considered first.

Encourage your child to share what is going on in school, as well as, his or her reactions to the school’s response.

Schools: Accommodate the Child with Invisible Anxiety

Every child is unique, thus each support plan is individualized. The main goal of accommodations must be to lower the child’s anxiety while increasing self-esteem and encouraging independence, self-advocacy and developing new skills.  The following are some of the 504 and IEP interventions that may help to your child:

Remain in School

Always keep the child in school. Do not reinforce or increase anxiety symptoms by sending a child home unless absolutely necessary.

Provide Positive Reinforcement

Provide positive reinforcement, like stickers, extended computer time or a special activity when a child tolerates a feared situation.

Encourage Verbally

Present verbal encouragement and prompts in subtle, non-punitive ways.

Prepare in Advance

Offer advance preparation for upcoming changes to routine or daily schedule, including field trips or fire drills and supervision during transitions between classes and activities.

Be Consistent

Provide a consistent, predictable schedule; post in a visible place for the child’s reference.

Provide Breaks

Allow breaks as necessary and provide opportunities for action. For instance, pacing without disturbing others, running an errand, handing out papers, or using a soft squeeze ball.

Prompt in Advance

Prompt in advance before calling on him to answer a question.

Avoid Humiliation

Avoid using jokes, sarcasm and bringing unwanted attention to student.

Modify Assignments

Modify assignments; have the child complete only odd numbered problems, allow him the use of a word processor, or give an oral exam instead of high pressure written exam.

Allow Extra Time

Allow extra time on quizzes, exams, and in-class assignments.

Designate a Coordinator

Designate one teacher as the coordinator of this plan, to aid with implementation and review, as necessary.

Summary on Invisible Anxiety

Anxiety is the leading mental health disorder in children; thus, it is inevitable that educators will encounter students experiencing disabling symptoms in the classroom. It is imperative that teachers are educated about subtle, often invisible signs of anxiety among their students.  Teachers must engage in supportive collaboration with parents and faculty to help generate an effective action plan. Children with anxiety are entitled to specific support and accommodations, with a positive goal of enhancing learning potential and promoting positive behaviors.

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Dr. Kimberly Williams is a clinical psychologist and neuropsychologist who specializes in the assessment and treatment of children and adults with psychological disorders including anxiety, depression, and disruptive behaviors, as well as learning disorders, developmental delays, executive functioning issues and social deficits. When Dr. Williams isn’t in her Great Neck and Brooklyn, NY offices helping kids get ahead in their academic and social development, she is consulting and providing workshops and training in issues related to Autism, Asperger’s Disorder, Nonverbal Learning Disability, Special Education and Parent Advocacy. Visit her site at Dr. Kimberly Williams.