Anxiety


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About anxiety

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

Students with separation anxiety will often hide their anxiety, making it more difficult to identify. They may say they don’t like school or refuse to go to school. Some teens may want to know where a family member is at all times and worry about losing them through death or an accident, and become anxious when they are not with their parent
Students 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.
Students 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 center of attention, such as speaking in front of the class or meeting someone new, 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 They may appear shy/withdrawn, refuse to go to school, and have a limited number of friends.
Students 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.
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, teenagers 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 teenagers may have panic attacks.
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. Teenagers 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 teenagers may develop a fear of being in a crowded place or being away from home.
Some students 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.

Strengths

What might be some strengths?
  • Some students with anxiety may want their work to be perfect and so create high quality work.
  • Teenagers with anxiety may connect with trusted adults or friends for support.
  • Some students who have been through a traumatic event may grow personally as a result. They may feel close to friends and family members, as well as their religion. They might feel they are good at coping with difficult events, be thankful for and value life, and have a clear idea of what is important to them.
  • Teenagers with selective mutism may cooperate well with other students and obey the rules.
    Where might you provide support?
    • Worried and scared students usually try to avoid the thing that stresses them. This could mean that they avoid or don’t join in for some activities.
    • They may look stressed or restless, or they may keep to themselves and avoid some activities or people. A student with anxiety who refuses to participate may be feeling overwhelmed rather than misbehaving or being stubborn.
    • Some students might be very distressed or agitated when feeling anxious. They may even 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.
    • 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 stomachaches and headaches. This might affect their interest in class, or result in frequent sick bay visits. Teenagers with anxiety may find it difficult to concentrate at times or appear restless.
    • Anxiety can reduce a student’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 what they are capable of.

    Evidence-based strategies

    • Some tasks may need to be modified. Allow students to face fears gradually – start at a level they can manage and build from there. Allow them to watch other students perform an activity/behaviour before they try.
    • Allow extra time. If a student 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.
    • Create a predictable environment. If there are going to be changes to the normal routine, tell the student beforehand, and give them a clear idea of what will happen instead.
    • Provide clear rules and expectations. This way students know what is expected from them.
    • Spend a few minutes of each day doing simple relaxation exercises. This can be good for all students – not just those with anxiety. Watch an example of a breathing and relaxation exercise in a primary school setting on our primary 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 time spent with other students and staff can help all students.
    • Talk to parents. Talk to parents to find out the best way to work with their teen. Parents can help you understand a student’s unique strengths and areas they need more help.
    • Consider peer mentoring opportunities. Mentoring programs can provide students with extra support and guidance. Pair younger student mentees with older student mentors who can meet with, listen to, and provide mentees with attention and care.
    • Listen and validate. If a student who has experienced trauma talks to you about their experiences, listen and express empathy. Avoid judgements or predictions (“you will get over this” or “only the strongest survive”). Don’t ask them for more information or detail as this may cause further trauma and distress.
    • 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 students to use to reset and manage their anxiety. Tell them what they need to do when they want to go to that space. Let students sit near their safe space so that they don’t attract attention from others when going there.
    • Create a warm and fun environment. This includes making sure disruptive behaviour is managed well.
    • Don’t draw attention to a student with anxiety. Provide feedback or rewards to students privately.
    • Consider how you discipline. Students 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 students if they are late. This is particularly important if they are anxious about coming to school.
    • Model ‘brave’ behaviours. Watching others model brave behaviours and helpful coping behaviours can help students 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 too much 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.
    • Avoid pointing out mistakes in front of others. Make sure other students cannot see corrections.
    • Help students manage reassurance seeking. Teenagers 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). Provide positive feedback 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. Give positive feedback to 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 do their best.
    • Let students work in small groups. They feel more comfortable talking to a few classmates than talking in front of the whole class.
    • Some students may need a safe place. Provide a safe place for them to reset and manage their anxiety. Let them know what they need to do when they want to go to that space. Let a student sit near the closest exit to their safe space so that they don’t have to walk out with everyone looking at them.
    • Collaborate with health professionals. If a health professional (e.g. psychologist) is working with a student, actively incorporating their suggestions into the program can help provide opportunities for a student 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 students set goals. Give them opportunities to make choices or be part of making decisions.
    • Make sure students and staff do not use stereotypes and biases. This includes ‘jokes’ that could upset students who have experienced trauma linked to gender, race or other cultural factors.
    • Be aware of how you feel. Supporting a student 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 student.
    • 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 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

    • Consider and avoid any known trauma triggers when choosing books for students who have been through a traumatic event.
    • Some students may need support with tasks like oral reports/presentations. Offer other options, such as presenting to a small group of friends, making a PowerPoint presentation, or providing a private video of their presentation.
    • Give extra information or support to students if there are out-of-routine activities, rotations or excursions.
    • If known, consider a student’s triggers or trauma history when selecting topics that could be related.
    • Give extra information or support to students if there are out-of-routine activities.
    • Students with selective mutism or anxiety may find being tested out loud too difficult, so consider giving them a written or visual test.
    • Maths can make some students anxious.
    • Avoid tests or exercises where students are timed, as a student with anxiety may feel too stressed to do their best.
    • Help a student 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.
    • Some of the teaching tips from above that may be relevant in this setting include normalise mistakes, and allow time to calm down.
    • Give extra information or support to students if there are out-of-routine activities, rotations or excursions.
    • Give extra information or support to students if there are out-of-routine activities, rotations or excursions.
    • Some students may experience cyberbullying and be anxious about using technology. See the AllPlay Learn story about cyberbullying under relevant resources below.

    Other considerations

    • Assemblies or other large gatherings may worry some students.
    • Let a student with anxiety sit where they feel safe (e.g. near the back or side) and 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 student can cope with and build slowly from there.
    • Changes in routine can be upsetting for many teenagers with anxiety, and strangers leading a classroom may be particularly upsetting.
    • If possible let a teenager with anxiety (or their caregiver) know of an absence in advance.
    • Support the relief teacher and student by informing them that the student may feel anxious and provide strategies to best help the student.
    • Teenagers with anxiety can become anxious with changes in routine.
    • Provide clear information about what will take place and consider pairing them with a close friend or person they feel safe with.
    • Unexpected safety drills may upset some students with anxiety. This can be made worse if there are lots of other crowds of students.
    • Consider letting the student know beforehand that there will be a drill and pairing them with a close friend or person they feel safe with.
    • Some students may refuse to attend school.
    • Provide warm and calm support to the student and acknowledge how they are feeling.
    • If a student is too upset to join the class immediately, provide them with a safe space to start with instead, such as the school library.
    • As a student feels more comfortable being present at school, they can gradually re-join the class. For some students, this may take time.
    • Additional help from health professionals working with the student, their family and the school may be needed to put a plan in place to support a young person to return to school.
    • Watch a masterclass on supporting students with school refusal in AllPlay Learn's Inclusive Foundations for Children with Disabilities for secondary teachers - Anxiety lesson
    • Some students might show challenging behaviours. It’s important to remember children are most likely trying to communicate a need or want that is not being met.
    • Consider specific phobias or trauma history in planning discipline. This may mean not isolating a student who has experienced trauma.
    • Refer to the ABC approach for more information on how to reduce challenging behaviour by supporting the young person and promoting more helpful behaviour, and our emotions page for more information about supporting a young person with managing their emotions.
    • Some students with anxiety may also have signs of depression, which may reduce their interest in school, and their motivation and mood.
    • Provide warm and consistent support. Break assignment and school work down into smaller tasks.
    • Students with anxiety and depression may need some changes to homework and classwork expectations.
    • Consider referral to the school welfare team for the student to get help.
    • Some students with anxiety may turn to alcohol or drugs to reduce their anxiety. These students may benefit from referral to support agencies, such as the school welfare team or HeadSpace.
    • Some students with anxiety may find navigating high school friendships difficult as they may take other student’s behaviours personally. See AllPlay Learn’s bullying, cyberbullying and Monday freak out stories.
    • For more information about supporting students with disabilities when transitioning across education settings, access AllPlay Learn's transition page.
    • Post-school transition to adult life should begin as early as possible in school.
    • Aim to increase independence by working on organisational, social and problem-solving skills, and time- and self- management skills. Provide plenty of opportunities to practise them across a range of contexts.
    • It may be helpful to identify skill gaps and develop a support plan to help them be successful (e.g. social skills, academic and/or employment skills).

    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 student’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 students with disabilities and developmental challenges. Some particularly relevant resources for students with anxiety include our secondary student resources for seeking help, and:

    Strengths and abilities communication checklist
    Story - Monday freak out
    Story - What is cyberbullying
    Story - What is bullying and what to do about it

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