Anxiety in School: How to detect it, and what you can do

Anxiety in school can sometimes be relatively easy to detect. A child is nervous before taking a test or before meeting new people. But every child is different, and her anxiety can take on the look of something that looks like an upset stomach, outbursts or other disruptive behaviors, ADHD, or even sometimes a learning disorder. The problem is that millions of youth who are students in the United States suffer from clinically significant anxiety without it being recognized or treated at all. Left unaddressed, these students can experience considerable disruptions in their academic, social and family functioning. This post is to help you detect it with some ideas about what you can do.

Types of Anxiety Related to School

Prevalence rates for youth who experience anxiety disorders range from 2-27%, depending on the specific disorder, age of the child, method of measurement, and the time period in which the symptoms are measured. Some of the forms of anxiety children can struggle with include: Separation anxiety (worry about being separated from caregivers), social anxiety (difficulty participating in class and socializing with peers due to excessive self-consciousness), selective mutism (difficulty speaking in some settings), generalized anxiety (worry about a wide variety of everyday things; school performance and sometimes perfectionism), Obsessive-compulsive disorder (overloaded by stressful thoughts, kids with OCD try to alleviate anxiety with compulsive rituals), and specific phobias (when kids have an excessive and irrational fear of specific things, like animals or storms). In addition to coexisting impairment, untreated childhood anxiety is also associated with chronic depression, substance use/abuse, and anxiety into adulthood. So, in order to prevent these possible damaging outcomes, it’s imperative that treatment be initiated as soon as possible following the initial presentation of anxiety symptoms.

Recognizing the Signs

Taking all this into account, here are some helpful tips for how to recognize the signs of anxiety in school-aged kids.

Inattention and restlessness

When a student is fidgeting in her seat and not focusing, it tends to look like ADHD, but anxiety could also be the cause. When kids are anxious in the classroom, they might have a hard time paying attention to the lesson content and tuning out the worried thoughts that are overtaking their brains. It looks like inattention, but it’s really initiated by anxiety.

School refusal and clinginess

For kids who experience anxiety from school regularly, refusal to go to school is pretty common. Children with school refusal may complain of physical symptoms shortly before it’s time to leave for school or repeatedly ask to visit the school nurse. If the child is allowed to stay home, the symptoms may quickly disappear, only to reappear the next morning. Starting school, moving, and other stressful life events may trigger the onset of school refusal. Other reasons for school refusal include the child’s fear that something will happen to a parent after she is in school, fear that she won’t do well in school, or fear of another student. Additionally, kids who have trouble separating from their parents and don’t seem to adjust to the separation over a period of time may be struggling with separation anxiety and not just normal amounts of parting angst.

Outbursts and other disruptive behavior

Acting out in class is a behavior not usually associated with anxiety. But when a student is impulsively kicking the chair of the kid in front of him, or throwing a tantrum whenever the normal schedule is ignored or a peer isn’t following the rules, anxiety may be at the root of the behavior. Moreover, kids who are feeling anxious may ask a ton of questions, including repetitive ones, because they want reassurance for their worry. Anxiety can also cause kids to act aggressively. When children are feeling upset or threatened and don’t know how to manage their feelings, their fight or flight response to protect themselves can kick in, and some kids are more likely to fight. This may look like an attack on another child or a teacher, or throwing things, or pushing things over because they feel out of control.

Trying to avoid being called on in class

In some cases, kids will do generally well on homework and tests, but when they’re called on in class, they struggle. When kids are anxious about answering questions in class, they may break eye contact from the teacher, keep their head down and pretend to be working on something else. If they do end up being called on, the anxious child may freeze up so much that she can’t respond, even though she has been paying attention in class and may even know the answer.

Problems with specific subjects

When a child begins to notice a struggle with a specific subject in school, this may be mistaken for a learning disorder, when it’s really anxiety related. When she starts to doubt her abilities in that subject, it can cause anxiety that begins to hinder her learning or displaying what she knows about the subject.

Not turning in homework

When a student doesn’t turn in her homework, it could be mistaken for laziness when it’s really worry and concern that it’s not good enough. This type of anxiety can lead to her second guessing herself, which can cause her to spend so much time on an assignment that it never gets finished. This is otherwise known as perfectionism, and when kids are overly self-critical, it can cause them to sabotage the very thing they are trying their hardest to do, including homework. This type of anxiety might also present like excessive worry before tests, beginning much earlier than their peers, and extensive amounts of dread related to homework assignments and school subjects.

Avoidance of group work or socialization with peers

When kids start refusing to participate in things that make them anxious, including group presentations, gym class, doing group work, or eating lunch in the cafeteria, it may look like they are being defiant or underachieving, but the very opposite might be more accurate. Sometimes kids avoid things because they are afraid of making a mistake or being judged and they elude activities that cause them to feel anxious. Typically, they have a much easier time showing what they know, or giving presentations to the teacher alone in a one-on-one setting.

Accommodations

Learning to detect and identify the symptoms of anxiety early on gives the child an opportunity to have accommodations made at school, with specific interventions to help them function better. Some examples of school accommodations for anxious children include:

• Specific seating within the classroom
• Directions – having the directions on the board or having a signal for when first giving directions
• Class participation – using a signal to let the child know her turn is coming
• Class presentations – allowing the child to present to the teacher one-on-one, or audio/videotape the presentation at home
• Being exempt from answering questions at the board – work up to that with asking the child to write the date on the board and gradually build
• Testing conditions – extended time, alternate/quiet location
• Safe person – having a person at school who understands the child’s anxieties and worries
• Homework expectations – reduction of homework load, extra time.
• Cool down pass – the opportunity to briefly leave the situation to clear their heads with the signal of an orange card or other signal.
• Seating in large groups – allowing them to sit where they feel most comfortable

Each child is different, and accommodations can be tailored to a child’s specific needs. The main concern is to properly address and treat the anxiety and not mistake the symptoms as something else entirely.

Resources:

“Anxiety in the classroom: what it looks like, and why it’s often mistaken for something else.” Child Mind Institute. Retrieved on May 1, 2015 from www.childmind.org

“Sample Accommodations for Anxious Kids.” Worry Wise Kids. Retrieved on May 1, 2015 from www.worrywisekids.org

“School Refusal.” Anxiety and Depression Association of America. Retrieved on May 1, 2015 from http://www.adaa.org/print/living-with-anxiety/children/school-refusal

Sulkowski, M., Joyce, D., & Storch, E. (2012). “Treating Childhood Anxiety in Schools: service delivery in a response to intervention paradigm.” Journal of Child and Family Studies, 21(6), 938-947.