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There are seven types of anxiety that may impact students in the educational setting.
- Generalized Anxiety Disorder - chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it
- Obsessive-Compulsive Disorder (OCD) - recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as hand washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety.
- Panic Disorder - unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.
- Post-Traumatic Stress Disorder (PTSD) - an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.
- Social Phobia (or Social Anxiety Disorder) - overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation - such as a fear of speaking in formal or informal situations, or eating or drinking in front of others - or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.
- Separation Anxiety - the fear or distress that can happen to both children and adults when they think about separating from home or from the people they've become attached to.
- Selective Mutism is a complex childhood anxiety disorder characterized by a child's inability to speak and communicate effectively in select social settings, such as school. These children are able to speak and communicate in settings where they are comfortable, secure, and relaxed.
It may be challenging to recognize anxiety in students, which is why it is very important for teachers and other School District personnel to be educated in the many ways that anxiety can manifest in school. First, anxiety in students may manifest socially, i.e., students who have anxiety may try to avoid tasks or environments that make them feel anxious. It is important for teachers and School District personnel to consider that a student may be suffering from anxiety if they see such indicators as avoiding socializing with peers, avoiding or not completing class presentations, avoiding group work in the classroom, avoiding the cafeteria during lunch, and avoiding gym class.
Anxiety can and typically does manifest in students emotionally as well. Indeed, students with anxiety may have a difficult time understanding and appropriately expressing their emotions. Teachers and School District personnel should be cognizant of such manifestations as flat affect, irritability, sadness, and anger, which can be signs of anxiety in students.
Another way that anxiety in students may manifest is behaviorally. More specifically, students with anxiety may demonstrate behavioral difficulties that may be related to their feelings of anxiety. For instance, a student's behavior of compulsively kicking classmate's chair may be related to the student's Obsessive Compulsive Disorder. Students that have anxiety may have a tantrum when there are unexpected changes. A student may be asking a lot of questions, even repetitive ones, because they are feeling anxious and need reassurance. A student with anxiety may not understand what they are feeling and a natural "fight or flight" response may become activated. The "fight" response to anxiety could be aggressive behaviors and the "flight" response could be eloping (i.e., running away) behaviors.
Anxiety often manifests in students physically. District teachers and personnel should monitor and consider that a student may have anxiety if the student has frequent complaints of headaches, stomachaches, and other physical ailments, frequent visits to the nurse, or signs of a panic attacks, such as fast, heavy breathing, sweaty palms and fast heart rate.
Students with anxiety may have difficulty even attending school at all. School Districts should consider the possibility of anxiety when a student demonstrates frequent absences, frequent lateness to school, or frequently avoiding class by, for instance, repetitively s going to the bathroom.
Students with anxiety may require an Individualized Education Program (IEP) if they require Specially Designed Instruction and/or Related Services to address the anxiety. If a student's needs can be met with only accommodations, a Section 504 Agreement can be implemented. However, it is highly unlikely that a student's anxiety can be adequately addressed without the need for one or more of the following Specially Designed Instruction and Related Services: 1) Counseling services to teach how to recognize anxiety and appropriate coping skills; 2) Social Skills instruction to help students learn ways to appropriately interact with peers; and 3) Behavioral services to help students learn appropriate ways to cope with their anxiety.
It may be necessary to implement accommodations as well, but it is important that students are not provided with only accommodations that could possibly reinforce social isolation. Specifically, it may be necessary to implement such accommodations as: permitting the student to present to teacher instead of class; permitting the student to work alone instead of groups; allowing the student to come in late; permitting the student to leave class early; permitting the student to eat lunch in an environment other than the lunchroom; and permitting the student to obtain Physical Education requirements outside of the school setting. However, it is important to understand that these are accommodations that should be provided when students are learning how to recognize their anxiety, and obtain appropriate coping skills, appropriate social skills, and appropriate behaviors, but should not be provided in lieu of teaching these skills. Indeed, it is in most cases essential that the necessary Specially Designed Instruction and Related Services are provided to improve students' abilities to function appropriately and make meaningful educational progress, and to avoid the possibility of reinforcing social isolation through accommodations.
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