Post on 22-Aug-2020
Anxietyin Primary School aged children
Liz Anderson - Director
Psychological Solutions & The Health Hub
liz@thehealthhub.org.au
Kelly Wozencroft- Associate Director
Psychological Solutions & The Health Hub
kelly@thehealthhub.org.au
About UsEducational and Developmental Psychologist
- Have worked at Redlands College for past 6 years
- Specialise in children and young people 0-18years
- Specialise in school related issues (Learning Disorders assessment / diagnosis and Verifications, differentiating/ adaptations to the classroom)
- Strong interest in a bottom up approach to working with kids – not all behaviour is a choice -There are many behaviours that are the result of the Central Nervous System (i.e. fidgeting) not the frontal lobe / pre frontal cortex.
My job is to answer the ? – what is going on for this child (Psych, Speech, OT, Diet, Sleep, Medication etc) and provide solutions
When kids feel right, they’ll behave right
Consider the following when looking at what is causing a behaviour:
Sleep
Cognitive Ability
Diet
Exercise / Lifestyle
Trauma
Mental health – Anxiety,
Depression
CAPDSpeech Language
Parenting Style
Medication
Vision
Hearing
Attachment Style
Sensory Processing / Praxis / Low Tone
What is Anxiety?1 in 7 school-age children has a mental health problem (anxiety / depression,
behavioural problems)
BUT 1 in 4 gets help the help they need
Nearly ½ of all mental health problems begin before the age of 14
Comorbid with ADHD, ASD, CAPD, Abuse
Class of 25 Students
ADHD – 1:10
ASD– 1:100 (68)
Anxiety / Depression–1:4-7
Abuse– 1:3 GIRLS
- 1:5 BOYS
What is Anxiety? (kids language) Anxiety is a bucket of lots of feelings
Circle of Thoughts
Feelings
Behaviours
Teenager / Adult Language
When can it occur?Any time
❖Exams / test
❖Social settings
❖Panic attacks
❖Separation
❖Phobias – dogs, storms etc.
❖Obsessive Compulsive Disorder
❖Post Traumatic Stress Disorder
❖Adjustment Disorder
Symptoms (Body Clues)
Assessment for Anxiety (see The Health Hub Website for a copy of these)
Kids- Paediatric Symptoms Checklist
- Spence Children’s Anxiety Scale
Teenagers / Adults
- Kessler Psychological Distress Scale (K10)
- Depression Anxiety Stress Scales (DASS – 21/42)
- Strengths and Difficulties Questionnaires (SDQ)
www.thehealthhub.org.au
What is normal vs anxiety
What is normal vs anxiety
What is normal vs anxiety
Internaliser verses Externaliser
- Anger / Defiance - Class clown- Irritating (MBA / low level)- Increased RTC referrals - Attention and concentration issues /
Hyperactivity- Zone out- Increased sensory seeking behaviours
- Quiet - Looks like they are coping - Become more quiet- Pick nails, twist pair, pick hair- Withdrawal from friends- Parents report more problems at home- Zone out- Hyperfocus (I must…)
School refusal –look for patterns
(i.e. Monday double HPE)
Remember: Other
diagnoses
Common situation that
trigger
stress and anxiety for young children
When feeling anxious about separation, young children display many different behaviors, including:
❖Crying or whining
❖Clinginess (holding hand or leg, wanting to be held, hiding behind parent)
❖Shyness
❖Silence (instead of constant talking or babbling)
❖Unwillingness to interact with others, even if they are familiar people
❖Time frames – 1st 2 weeks normal separation, should separate easier each time (should see progress) – what is the parents response to leaving child……
Some children experience a continuation or reoccurrence of separation anxiety into their elementary school years.
Most children outgrow separation anxiety by about age 5.
About 1 in 25 children experience Separation Anxiety Disorder (SAD)
Triggers:❖New class or teacher
❖New brother or sister
❖Moving to a new home
❖Tension at home (such as a divorce, death, or serious illness)
❖A parents service in the military
❖An extremely scary event that a child experiences personally (such as a nightmare or a bad storm)
❖A child who is naturally ‘shy’ may experience anxiety more than other children
What to look for (8-10 year olds)
➢Social
➢ Limited number of friends
➢ Not initiating play
➢ Excuses– I can’t go and play because I have to help the teacher…
➢Worrying
➢ Excessive worry about the future
➢Sleep
➢ Refusing sleep overs / sleep issues
➢ Reassurance seeking / won’t sleep in own bed or alone
➢Psychosomatic complaints
➢ sore tummy, headache)
➢ Frequent flyer at sick bay
➢Quiet / withdrawn / sadness
➢Toileting issues
➢Repetitive touching (e.g. turning on and off lights, touching object a certain number
of times)
➢Difficulty concentrating
➢Avoiding eye contact
➢Getting in trouble at school
➢Poor concentration
➢Shaking / crying / muscle tension
➢Panics if parent or other family member is late for pick-ups-needs frequent reassurance
of pick-up plan
• Over studying (e.g. sacrificing sleep)
• Psychosomatic complaints
• Avoidance (including school avoidance)
• Fearing something will happen to a loved one
• Self-esteem issues
• Withdrawn / sitting alone
• Feel scared to ask or answer questions in class
• Panic attacks / shaking / muscle tension
• Weight gain or loss
• Difficulty concentrating
• Avoiding eye contact
• Moodiness, short temper, clinginess
• Getting in trouble at school
• Eating disturbances
• Perfectionism
• Repetitive touching
SIGNS OF ANXIETY IN 12 – 14 YEAR OLDS
How to help!Awareness & Tracking ◦ Talk to the student about what changes you are seeing… “I
have noticed that…”
◦ Encourage / set up meeting with parents / school counsellors / Head of Year
◦ Advise the student “they are not in trouble”◦ Help is getting extra tools to help manage a challenging situation
Its not attention
seeking, its connection
seeking! They need
help!
Differentiation / Special Considerations
◦ Sit in a different quiet area for assessment◦ Orals: may require the child to film
themselves doing oral (at school or home / small groups off friends
◦ In class – may need breaks◦ Personal check in’s are VERY helpful “How
are you doing”, “Is there anything I can do to help make school easier for you” (shows the student you are human and that you care)
◦ Homework club
Learning difficulties
Hardest things are:
• Getting everything done
• Trying to please teachers
• I am actually sensitive (when teachers get mad at
me, it really upsets me)
• I want to do my best, I plan to do my best, but my
brain does not always have the same agenda as
me at the same time!
Hard to focus on getting an assignment done when you don’t care (hopelessness / lack of motivation)
Teachers write things on board – cannot keep up when copying / miss things / get afraid because missed the info / teachers moved on and therefore cannot ask them (would be better if they slowed down)
My thoughts can catastrophize situations – e.g. if someone talks during my oral – my mind keeps saying to me they are paying me out or laughing at me. It’s really hard to focus on the oral when I’m just trying to stop my thoughts getting out of control
Children with anxiety difficulties are often quiet and obedient. This can lead to their difficulties being overlooked. It is important to take note of children’s worries so that their difficulties can be addressed sooner rather than later.
General principles for assisting children with anxiety disorders
Increase children’s helpful coping skillsAnxious feelings are fed by anxious thinking. It is important not to dismiss children’s anxious feelings, but to help children see that the situations they are worried about may not be as bad as they think.
Teach by exampleShowing children how you cope positively with feeling anxious or stressed and remaining calm and positive when they are feeling anxious can help them to feel more confident.
Avoid taking overChildren with anxiety are usually very happy for someone else to do things for them. However, if adults take over, it stops children from learning how to cope themselves.
Encourage children to ‘have a go’Having a go helps to show children that they can cope. Praise or reward them for every step they manage to take.
Establish a Plan for Separation and Reunion
➢Whenever possible, schedule separations after naps or feedings.
➢Develop a “goodbye” ritual
➢Establish consistency
➢Be calm, and when you say you’re leaving, go
➢Make new surroundings as familiar as possible
Breathing – Calm the brain and the body
Other strategies❖Crack to Egg
❖Go Noodle
❖Apps - Breathing
Thinking, Feeling and DoingEducate kids that the way they think, affects how they feel, and what they do
❖Thought Detective
What evidence is
there that this is true?
How is this making me
feel? How is this making me
feel? If we asked 5
trusted people, what would they
say?
Catch it Trap it Change it
Steps for learning how to cope with anxiety about speaking in front of others
The child helps to construct the steps from easiest to hardest then practises using coping skills to
try the first step. When the child is able to cope without anxiety he/she moves up a step to the
next level. Efforts should be acknowledged at each step using praise, rewards and positive self-
talk.
1. Discussing a school project with a small group of other children
2. Starting off the group discussion
3. Presenting your part of the project to your group
4. Presenting your project to the class as part of your group
5. Presenting by yourself a project you have prepared with your group
6. Giving a two minute talk to class that you have prepared yourself
7. Presenting with your group at school assembly
8. Giving a report on your own at school assembly