Anxiety


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About anxiety

We all worry or feel scared at times, but some children may worry so much that they avoid participating in activities, being with others, or going places. Children with disabilities and developmental challenges often experience higher rates of anxiety than their peers. Anxiety can take different forms, and some children can show symptoms of a number of types of anxiety. You can learn about the different forms of anxiety below.

Separation anxiety in very young children is normal, however, should lessen from the age of two. For some children, separation anxiety continues into primary school. Children with separation anxiety persistently become excessively upset when separated from family members. They may find separation at the beginning of the day difficult, or they may even refuse to attend school.
Children with selective mutism can become anxious about speaking in social situations. They may speak confidently and comfortably at home, yet not talk at all at school or in other specific situations. This behaviour lasts for at least a month, and beyond the first month of school. Some students may not speak or communicate with others at all in a specific setting, some may speak to select people in a setting, and others may whisper or use gestures. They may also find eye contact difficult. Selective mutism is not the same as traumatic mutism, in which a student may cease speaking in any setting after a traumatic event.
Children with social anxiety usually fear and avoid places and situations where they may need to interact with others. They can be self-conscious, and find situations where they are the centre of attention, such as speaking in front of a group of others or meeting someone new, very challenging. They experience significant distress in social situations, and may cry, freeze/shrink, or fail to speak. They may appear shy/withdrawn, refuse to go to school, and have a limited number of friends.
A specific phobia is an intense and unreasonable fear of a situation or object. Some phobias that may be seen at school are fear of being away from home or in crowded places, exam/test anxiety, or maths or science phobia. While many students experience some anxiety about tests or specific subjects, students with a specific phobia may have so much anxiety that they don’t do well in the test or subject. They may have physical symptoms such as light-headedness and feeling sick, and some students may have panic attacks.
Children with generalised anxiety tend to have a wide range of unreasonable, excessive and uncontrollable worries, including worries about the past, the future, and their current popularity or performance. They tend to experience anxiety in a range of settings, which can disrupt their ability to relax or enjoy activities. They may be restless or irritable and have trouble paying attention when worrying. They may also lack confidence.
Some children who have experienced trauma may develop symptoms of Post-Traumatic Stress Disorder (PTSD). Students with PTSD may be irritable, have difficulty concentrating, or experience flashbacks or intrusive memories/dreams of the traumatic event. Students with PTSD may experience significant physical and psychological distress when exposed to reminders of the events (triggers), and may avoid situations in which they could be exposed to these triggers. They may have persistent and exaggerated negative beliefs about themselves or others, experience ongoing disruptions to their mood or emotions, and feel detached or estranged from others. Disruptions to behaviour can also occur, such as reckless or self-destructive behaviour, outbursts, or aggression.
Panic disorder involves repeated and unpredictable panic attacks. Panic attacks are short periods of fear or panic with significant physical symptoms, such as chest pain, difficulty breathing, dizziness, feeling sick and a sense of detachment from one’s self. Children with a panic disorder may spend a lot of time worrying about having another panic attack and might avoid situations that could make them anxious. In some cases children may develop a fear of being in a crowded place or being away from home.

Strengths

What might be some strengths?
  • Some children with anxiety want their work to be perfect, and so their work may be high quality.
  • Children with selective mutism may cooperate well with other children and obey the rules.
  • Children with anxiety may connect with trusted adults or friends for support.
Where might you provide support?
  • Worried and scared children usually try to avoid the thing that scares them. This could mean that they avoid or don’t join in some activities.
  • They may look nervous or restless, or they may keep to themselves and avoid some activities or people. A child with anxiety who refuses to participate may be feeling overwhelmed rather than misbehaving or being stubborn.
  • Some children who are really scared might cry and become very upset.
  • Some students may refuse to attend school.
  • They may seek lots of reassurance from staff and they may be upset if their work is not perfect. They might refuse to try something if they don’t feel they can do it well (particularly if others are watching), or throw their work away to start again.
  • Some children may become very upset when separating from their family. Events that are out of routine, such as excursions, sports events, or camps may be very challenging.
  • Anxiety can cause physical symptoms such as frequent stomach aches and headaches. This might affect their interest in class, or result in frequent sick bay visits.
  • Children with anxiety may find it difficult to concentrate at times or appear restless.
  • Anxiety can reduce a child’s ability to do well in a task, especially when they’re working in test-like conditions. This means that sometimes their results might not reflect their true capability.

Evidence-based strategies

  • Sit beside a child when talking/working with them. Work together on a specific activity rather than focus on the child.
  • If a child doesn’t want to speak, you can think aloud. Give some time for the child to answer, and continue to talk with the child even if they do not speak.
  • Some tasks may need to be modified. Allow children to face fears gradually – start at a level they can manage and build from there. Allow them to watch other children perform an activity/behaviour before they try.
  • Allow extra time. If a child is anxious about sitting tests, give them extra time to complete the test. Also allow time to calm down before the test using strategies such as slow breathing. Remind them to pay close attention to the instructions. Give them time to feel comfortable with the place the test will be held and any examiners who will be there.
  • Encourage and acknowledge effort. Children with severe anxiety may accept negative consequences for not doing what they are told rather than facing their fear. Encouraging a child for finishing or trying to do a task that makes them anxious can help to motivate them.
  • Neutral responses for selective mutism. When a child has selective mutism it may be important to give a neutral response if they speak and not bring them unwanted attention. Ask the child’s parents how you should respond when their child speaks.
  • Create a predictable environment. If there are going to be changes to the normal routine, tell the child beforehand, and give them a clear idea of what will happen instead.
  • Provide clear rules and expectations. This way children know what is expected from them.
  • See AllPlay Learn’s class schedule in the relevant resources below
  • Spend a few minutes of each day doing simple relaxation exercises. This can be helpful for all children. Watch an example of a breathing and relaxation activity on the teacher resource page.
  • Incorporate mindfulness practices. This can include educating students about emotions and mindfulness, as well as specific mindfulness exercises. For example, use tools such as emotion metres to help students recognise what emotions they are feeling.
  • Provide time for positive interactions. Positive interactions with other children and staff can help all children.
  • Talk to parents. Talk to parents to find out the best way to work with their child. Parents can help you understand a child’s unique strengths and areas they need support.
  • Support students on arrival. Have a clear routine for the start of each day. If needed, have a teacher there who can help students say goodbye to their family and get organised for the school day.
  • Consider peer mentoring opportunities. Mentoring programs can provide students with extra support and guidance. Pair younger students with older student mentors who can meet with, listen to, and provide mentees with attention and support.
  • Support students with developing the skills and abilities to manage daily life demands. This can include activities which support self-awareness, coping with emotions, problem-solving and interpersonal relationships.
  • Create a safe space. Create a space for children to use to reset and manage their anxiety. Tell them what they need to do when they want to go to that space. Let a child sit near their safe space so that they don’t attract attention from others when going there.
  • Create a warm and fun environment. Be outwardly positive towards students and make sure disruptive behaviour is managed well.
  • Don’t draw attention to a child with anxiety. Provide feedback or encouragement to children privately.
  • Consider how you discipline. Children with anxiety might think whole class discipline is aimed at them personally, or they might be scared of any type of discipline that makes others notice them. Avoid whole class discipline or harsh or embarrassing discipline.
  • Don’t punish if they are late. This is particularly important if they are anxious about coming to school.
  • Acknowledge a child’s emotions. Provide warm and calm support to a child when they are distressed or anxious, and acknowledge how they are feeling.
  • Model ‘brave’ behaviours. Watching others model brave behaviours and helpful coping behaviours can help children learn how to overcome their own fears.
View an example demonstrating how a teacher can use a strengths-based approach to apply evidence-based strategies to support a student with anxiety.

Best practice tips

  • Teach students that making mistakes is normal. Some students may worry about making mistakes in their work. Tell the class regularly that mistakes are normal and they help us learn.
  • Talk to students about tests. Before tests prepare students and normalise that some questions may be difficult while others will be simpler.
  • Help students manage work output. For students who worry about having perfect work avoid giving them an extension, as they may then spend even longer worrying about making it perfect. If they are slow at finishing work you may need to praise them for how much they complete instead of praising or assessing the quality of their work within a set time.
  • Be tolerant and patient with mistakes. Avoid pointing out mistakes in front of others. Make sure other students cannot see corrections.
  • Help students manage reassurance seeking. Children with anxiety may check instructions often because they are worried about making a mistake. Give a calm and simple explanation, and ask them to write down their worries or save their questions for later (rather than repeatedly asking you questions). Encourage them when they work well by themselves. Write instructions on the board.
  • Break large tasks or assignments down into smaller tasks. Large tasks may worry some students. Encourage students when they complete or attempt to complete smaller tasks.
  • Try not to give tasks where students are timed. They may feel too stressed to work well.
  • Let students work in small groups. They feel more comfortable talking to a few classmates than talking in front of the whole class.
  • Create a safe space. Create a space for children to use to reset and manage their anxiety. Tell them what they need to do when they want to go to that space. Let a child sit near their safe space so that they don’t attract attention from others when going there.
  • Collaborate with health professionals. If a health professional (e.g. psychologist) is working with a child, actively incorporating their suggestions at school can help provide opportunities for a child to manage their anxiety.
  • For selective mutism, it can be helpful to have a child become comfortable speaking in one context before generalising to other contexts. Provide encouragement privately.
  • For selective mutism, provide opportunities where appropriate for students to communicate non-verbally.
  • Let children set goals. Give them opportunities to make choices or be part of making decisions.
  • Make sure children and staff do not use stereotypes and biases. This includes ‘jokes’ that could upset children who have experienced trauma linked to gender, race or other cultural factors.
  • Be informed about anxiety and the diverse ways it may present in school settings. For example, experiencing anxiety, including selective mutism, can be a distressing experience for children, and is not something a child chooses.
  • Be aware of how you feel. Supporting a child with anxiety can at times be difficult, and you may feel frustrated. Being aware of your feelings and thoughts is important for a calm and supportive relationship with a child.
  • Create a school culture around acceptance, inclusion and belonging. Promote a positive school culture by encouraging supportive relationships between peers and teachers, and student participation and engagement in school activities and learning. Visit AllPlay Learn's Inclusive Communities for Schools page to access a suite of resources to support you in building an inclusive school culture.
  • Address bullying. Anti-bullying programs, which may include encouraging prosocial skills and bystander behaviour, can also promote a positive school climate that supports students experiencing anxiety.
  • Create a trauma-informed environment. View AllPlay Learn's resources and strategies on creating trauma-sensitive school environments here.
  • Promote self-determination. Empower and teach children to make simple choices, set goals, be independent, and develop problem-solving abilities. Use technology as needed. For example, technology can be used by students who communicate non-verbally to indicate preference.

Curriculum considerations

  • Additional support or alternative approaches such as small groups may support students who are anxious about performing in front of others.
  • Teaching tips that may be relevant include modifying tasks, predictability, clear rules and expectations, normalising mistakes, small group work and providing a supportive and structured classroom environment.
  • Consider our AllPlay Dance resources when engaging children who experience anxiety in dance and movement activities.
  • Consider and avoid any known trauma triggers when choosing books for children who have been through a traumatic event.
  • Offer choices. Tasks like oral reports/presentations may make some children very anxious. Offer other options, such as presenting to a small group of friends, or making a PowerPoint presentation.
  • Physical Education can be very different from week to week. Support may be needed for children who can become anxious with changes.
  • Additional support or alternative approaches such as working in pairs or small groups may support students who are anxious about performing in front of others.
  • Some parts of Physical Education may be extra worrying to a child with anxiety, such as swimming lessons, sports competitions or changing their uniform with other students there.
  • Teaching tips that may be relevant include a modifying tasks, predictability, clear rules and expectations, normalising mistakes, small group work and providing a supportive and structured classroom environment.
  • Consider some of our AllPlay Footy resources when involving children with anxiety in group and individual sports activities.
  • Give extra information or support to students if there are out-of-routine activities, rotations or excursions. For example, if there is an open morning to let parents see students’ projects, make sure a child has a buddy with them or a safe space they can go to if feeling anxious.
  • Give extra information or support to students if there are out-of-routine activities.
  • Children with selective mutism or anxiety may find being tested out loud too difficult. Consider giving them a written or visual test.
  • Maths can make some students anxious.
  • If possible, avoid tests or exercises where children are timed, as a child with anxiety may feel too stressed to do their best.
  • Help a child feel confident by making sure they are given tasks they can do well. This might mean giving lots of questions/activities that a student can already do, with a few questions/activities that they are still learning.
  • Teaching tips that may be relevant include normalising mistakes and allow time to calm down.
  • Give extra information or support to students if there are out-of-routine activities, rotations or excursions. For example, if there is an open morning to let parents see students’ projects, make sure a child has a buddy with them or a safe space they can go to if feeling too anxious.
  • Give extra information or support to students if there are out-of-routine activities.

    • Other considerations

    • Assemblies or other large gatherings may worry some students.
    • Let children sit where they feel safe - perhaps near their teacher. As they feel less anxious, encourage them to sit closer to their classmates.
    • Performing in front of others or receiving awards may cause anxiety. Start with what a child can do and build slowly from there.
    • Changes in routine can be upsetting for many children with anxiety, and strangers leading a session may be particularly upsetting.
    • If possible, tell parents of an absence in advance so they can prepare their child for the change.
    • Support the relief teacher and child by informing them that the child may feel anxious and about strategies to best help the child.
    • See AllPlay Learn’s story When my teacher is away under relevant resources below .
    • Provide clear information about what will take place and consider pairing them with a buddy or safe person.
    • Unexpected safety drills may upset some children with anxiety.
    • Consider letting the child know beforehand that there will be a drill, and pairing them with a buddy or person they feel safe with.
    • Some students might also show challenging behaviours. It’s important to remember children are most likely trying to communicate a need or want that is not being met.
    • Refer to the ABC approach for more information on how to reduce challenging behaviour by supporting the child and promoting more helpful behaviour, and our emotions page for more information about supporting a child with managing their emotions.
    • Some children may be upset when separating from their family in the morning.
    • Provide warm and calm support to the child, and acknowledge how they are feeling.
    • Provide a child with a safe space to start with if they are too upset to join the class immediately.
    • Some children may separate more easily if they can start in the classroom before other children arrive, or if they can choose where their parent will say goodbye.
    • If a child is becoming very upset at separation, and you have tried other strategies, it may help if a parent sits outside the classroom or comes in as a parent helper. This extra support can be gradually reduced as a child feels more confident.
    • Some children with anxiety may need support when preparing for a move across education settings.
    • Make clear links to what will be similar. Tell students what will be the same so that they know they already have some of the skills they will need.
    • See some of the simpler year 7 school work. This helps students feel that they can manage high school work. It is important that the work is not more difficult than a student can already do.
    • For more information about supporting students with disabilities when transitioning to a primary or secondary school setting access AllPlay Learn's transition page.

    Featured resource

    AllPlay Learn’s Recognising and supporting student anxiety forms help teachers and students to reflect on:

    • a student’s early signs that they are feeling anxious
    • later signs that their anxiety is escalating
    • triggers or contributors to the student’s anxiety
    • strategies that may be effective at specific timepoints

    Talking with families about their observations will help you develop a shared and richer understanding about the student’s anxiety. Involving students in recognising and responding to signs of anxiety can increase their autonomy and confidence. Some students may complete these forms independently, while others may find working with a trusted teacher, family member or health professional (e.g. their psychologist) helpful.

    These forms can be used to support collaboration and communication across teaching staff, which can help create consistent supportive environments that foster a child’s sense of security and capability in managing their anxiety. You may also like to consider including these forms within an existing Individual Learning Plan to support the student throughout the year.

    Recognising and supporting child/student anxiety forms

    Relevant resources

    Visit our resources page for a range of resources that can help to create inclusive education environments for children with disabilities and developmental challenges. Some particularly relevant resources for children with anxiety include:

    Strengths and abilities communication checklist
    Class schedule
    Emotion cards (A4)
    Story - When my teacher is away

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