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Help Kids Manage School Anxiety

by Michele Ranard, M.Ed.
735 words

“Anxiety becomes a problem when it causes emotional pain and suffering and disrupts your child’s ability to function well at school and in daily life.” (Diane Peters Mayer)

All children occasionally feel butterflies during the school day. Nervousness may spring up while waiting to be called upon to give a speech on Rosa Parks. And if dancing is not their forte, that hip hop unit in P.E. class just may trigger a stomach ache.

When Is Worry Excessive?

A measure of anxiety is normal. But some children experience persistent and excessive worry at school or while thinking about school at home. They may experience anxiety attacks and feel ill. School anxiety can interfere with academic work, behavior at home, emotional health, and socializing.

Psychologist and educator Marie Hartwell Walker likens school anxiety to a phobia of dogs. She writes “For some kids going to school is like confronting a vicious dog everyday. For them school is a place where they can’t succeed, where they feel bad about themselves, where they constantly fall short.”

What’s So Scary About School?

Social worker and author of Overcoming School Anxiety (2008), Diane Peters Mayer writes that over 6 million school children have school anxiety—a mind-body reaction ranging from butterflies to blanking out or having a panic attack.

Kids may report feeling sick because their emotional and physical symptoms confuse them. Symptoms of school anxiety can include: a pounding heartbeat, diarrhea, nausea, headache, tense muscles, shortness of breath, and dizziness. Kids may feel overwhelmed, out of control, helpless, or embarrassed. Parents sometimes mistake a child’s suffering for manipulation.

Mayer describes various reasons for school anxiety:

1. Feeling overwhelmed by demands. Standards within the school curriculum are higher than ever. Kids who aren’t great test takers may feel the pressure of high stakes assessment and competition. Sometimes heavy homework loads and falling behind will create the anxiety.

2. Genetics and modeling. Many anxious children have anxious parents or may be sensitive to their parent’s fear and anxiety. When a parent projects excessive worry onto the child, anxiety may be exacerbated.

3. Household stress. The burdened economy is but one factor increasing the stress within families. Due to unemployment and financial hardship, many kids may be struggling along with their caregivers. Other children may be over-scheduled and lacking sufficient time for free play.

4. Social issues. Kids who have trouble fitting in at school are at risk for school anxiety. Mayer says tweens are especially vulnerable. Bullying at school may also be a contributing factor.

5. Lack of support at school. Not all schools have programs in place to help kids with anxiety. This makes treatment and success there more difficult.

How Parents and Loved Ones Can Help

Mayer’s book touches on the following tips for overcoming school anxiety.

1. Hear them and exude confidence. Mayer says listen to your child describe the anxiety. “Reassure your child that together you are going to solve the problem and make things better.” Since your child may be feeling out of control, it is important for you to keep your own worry and anxiety in check. To make things better for her, stay calm in spite of what she may say or do.

2. Partner with school. Brainstorm with your child’s teachers and counselors on behalf of your child. Sometimes it is necessary to see a child therapist or a doctor outside of school. Emphasize with your child that this help is HONORABLE and not a sign of weakness or failure.

3. Relaxation techniques. Various deep breathing, meditation, and relaxation exercises can help. A pediatrician, school counselor, or psychologist can be a helpful resource for suggestions.

4. Reduce stress at home. This is a tough one! It’s extremely important to become a role model of good coping skills when it comes to stress and managing problems. Take good care of yourself and watch others around you benefit.

5. Don’t be afraid to hope. “I believe in you” are powerful words for your child to hear from you. Talk about how you are confident she will overcome this rough patch and emerge stronger. Discuss how learning something new is never a waste of time and a critical part of development.

More Help for Anxiety

The Anxiety Disorders Association of America (www.adaa.org) provides information and checklists for parents to find professional help for their children or to find a therapist who treats anxiety disorders in your area.

Michele Ranard helps children deal with school anxiety as an academic tutor. She has two children, a master’s in counseling, and blogs at hellolovelychild.blogspot.com and hellolovelyinc.blogspot.com.


Resources:

Anxiety Disorders Association of America (ADAA) www.adaa.org
Peters, Diane. 2008. Overcoming School Anxiety. AMACOM.
Walker, Marie Hartwell. “School Phobia: I’m Not Stupid, I’m Scared.” www.psychcentral.com

10 Ways Parents Can Help
by Michele Ranard, M.Ed.
850 words

"I JUST KNOW I'M NOT GONNA DO WELL!"  You have probably heard this a few times around the house from a fretful child. But if your child seems to worry excessively, there are proactive ways to help which may not have occurred to you.

Although less serious than anxiety disorders, excessive worry is one of the most frequent problems children face. Author of The Worried Child (2004), Paul Foxman indicates children with “beyond normal but less than severe anxiety” may be shy, withdrawn, and inhibited. Sometimes anxiety is mistaken for depression, hyperactivity, or physical illness.

Common Worries

For infants and todders, common fears include loud noises, large looming objects, strangers, separation, and changes in the house. Preschoolers often fear the dark, noises at night, masks, monsters, and animals such as dogs. Typical worries for school-age children include snakes, spiders, storms, being home alone, angry teachers, failure, rejection, scary TV shows, injury, illness, doctors, shots, and death (WebMd, 2007).

Worry is often an irrational focus on unlikely events. “There is usually a discrepancy between reality and what children worry about. For example, car and bicycle injuries are more likely to occur than any other events in childhood, yet children seldom worry about having those types of injuries" Foxman explains.

Addressing Their Worry


1. Don't try to talk them out of it. No matter what your child age, author of Freeing Your Child From Anxiety (2004) Tamar Chansky suggests discussing their fears with respect. You probably already realize this if you've ever tried to reason with a young child that there is absolutely not a ghost in their closet. She advises parents to speak calmly and confidently. While complete avoidance of the fears is not the answer, neither should they be forced to do more than what feels comfortable.

2. Explain what worry is plainly. Foxman says explain anxiety by asking them to imagine they are a small animal (such as a rabbit) living in nature among predators. “When a vulnerable animal is threatened, it senses danger and hides until it is safe again. When it is safe, the rabbit relaxes and resumes normal activities.”

3. Separate anxiety from the child. Psychologist Dawn Huebner suggests teaching children to externalize worry in order to set the stage for taking control in What to Do When You Worry Too Much (2005). “Think of anxiety with a capital A, as if it were a separate entity with its own name rather than an integral part of your child.” (Bonus: the principles in her book are relevant to anxious parents as well.)

4. Introduce age-appropriate books. For emerging readers, consider sharing stories about overcoming fear. When My Worries Get to Big (2006) is a relaxation guide to recognize feelings of anxiety and teach practical strategies to control those feelings. Is A Worry Worrying You? (2007) addresses typical and not so typical childhood worries in a humorous way (worried an eagle will build a nest in your hair?). Perfectionist tweens may benefit from What to Do When Good Enough Isn’t Good Enough (2007) by psychologist Thomas Greenspoon about the harmful effects of obsessing over perfection.

Worry Management Strategies

Keep these excellent techniques from Foxman, Huebner, and Chansky in mind to help your worrying child learn to effectively manage anxieties.

5. Discuss perfectionism. Your child needs to learn to be selective and make wise choices based on urgency and importance so Foxman recommends he learn “to set reasonable limits and pace his energy.” Help your child understand the difference between excellence (putting your best effort forward based on available resources) and perfection.

6. Think distraction. Even if nothing in your child’s feared situation changes, Huebner suggests playing outside and bike riding can keep your child absorbed so “there is less room for The Worry to creep back in.”

7. Frame worry as a negative habit. Help your child see worry as a negative habit, not a reasonable way to think or prepare for upcoming events. Teach them to say “so what” and get away from all or nothing thinking. Explain “Life is complex and things do not always fit neatly into categories.”

4. Teach them about second reactions. As Chansky puts it, “Managing worry means challenging the credibility of those automatic thoughts and cultivating a strong second reaction—speed dialing that voice of reason, connecting to some truth circuits, and in so doing, bringing that magnified risk down to a manageable size.”

5. Encourage assertiveness. Chansky says kids can “boss back” the worry rather than being held hostage to it.

6. Ditch feelings for facts. Replace dwelling on how awful something could be with how unlikely it would be. “When estimating the risk, go with the facts, not your feelings” advises Chansky. You can ask these two questions: How much of you feels scared something bad will happen? How much of you really believes it will happen?”

Huebner reminds parents of worried kids to stay positive and project confidence: “You are moving toward the day where you will be able to say that your child used to worry too much, but not any more.”

Michele Ranard has experience teaching children strategies to cope with anxiety. She has a husband, two sons, and a master’s in counseling. Visit her at hellolovelychild.blogspot.com.


Resources:

Buron, Kari Dunn. When My Worries Get Too Big! A Relaxation Book for Children Who Live With Anxiety. Autism Asperger Publishing Company, 2006.

Chansky, Tamar E. Freeing Your Child From Anxiety: Powerful, Practical Solutions to Overcome Your Child’s Fears, Worries, and Phobias. Three Rivers Press, 2004.

Foxman, Paul. The Worried Child: Recognizing Anxiety in Children and Helping Them Heal. Hunter House, 2004.

Greenspoon, Thomas S. What to Do When Good Enough Isn’t Good Enough: The Real Deal on Perfectionism: A Guide for Kids. Free Spirit Publishing, 2007.

Huebner, Dawn. What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety. Magination, 2005.

Stuart, Annie. “Childhood Fears and Anxieties: Experts Describe How Parents Can Help When Their Child is Afraid.” WebMD. http://children.webmd.com/features/childhood-fears-anxieties. April 2007.

Wolff, Ferida. Is a Worry Worrying You? Tanglewood Press, 2007.

5 Ways to Ease Their Anxiety.
Michele Ranard, M.Ed.
560 wds

If your child will be visiting the hospital for a procedure, they may feel fretful about what to expect and any pain they may experience. These expert tips will help guide you in calming their nerves.

Why They Worry About Hospital Stays

According to Dr. Judith A. Jones of Kidshealth.org, many children are fearful of needles and whether they will feel pain. Depending on the procedure, Dr. Jones suggests it may be possible for them to get medicine to feel more relaxed. Young children may struggle with separation anxiety and will likely feel more at ease if they are held by their parents while falling asleep before surgery. Older children may experience “exposure of body parts during surgery, cutting and scarring of the body, waking up during surgery, loss of control, pain after surgery, and even death.”

5 Tips to Ease Worry

Many children will benefit from a calm conversation before their hospital stay about what to expect. Kidshealth.org suggests the following tips for such a talk with your child:

1. Let your child know where you'll be during the whole experience. Kids will feel better knowing you won’t be far and will be there when they wake up. “You may also be able to sit with your child until he or she falls asleep before the surgery. Discuss this with your anesthesiologist. And explain that (in many outpatient procedures), your child can come home soon after the surgery is done. In cases that require hospitalization, most hospitals avoid separation anxiety by permitting at least one parent to stay with the child day and night.”

2. Give your child age-appropriate and developmental stage-appropriate info. Less information is usually more appropriate for younger children. “That doesn't mean lying — it just means giving the most appropriate information for your child's age and developmental stage.” Too many details may increase your child’s anxiety so take their age and personality into account. Tweens and teens may worry they will wake up during the procedure, so they should be reassured they will not.

3. Be sensitive about how you say it. You will want to avoid using the term “nap” so they don’t become anxious about naps in the future. Also avoid “cut,” “stuck with a needle,” or “put to sleep.”

4. Reassure them it is normal to feel “funny” after surgery. “Explain that there may be some pain and discomfort after the surgery, but that the doctor can give medicine to help. It's important for kids to understand that they don't have to try to be brave or ‘put on a happy face’ after surgery.” Help your child understand they may feel groggy, scared, or sad after the anesthesia, but everything will be fine because you’ll be there with them, and it won’t last long.

5. Be calm for your child. If you stay relaxed (breathe!), your child is less likely to feel nervous about the hospital. “If you need to vent your emotions, try to take a few minutes to step out of the room where your child can't see or hear you.”

The experts at kidshealth.org remind parents that keeping their own anxiety in check will ease a child’s pre-op worries and positively influence their post-op recovery. As Dr. Jones suggests, “Remember to use nonverbal cues to communicate assurance: your tone of voice, facial expressions, gestures, and body language convey powerful messages.”

Michele Ranard is a professional counselor, tutor, and freelancer. Visit her at hellolovelychild.blogspot.com.

Resources:

Kidshealth.org
http://kidshealth.org/parent/system/surgery/anesthesia_prepare.html#
reviewer: Judith A. Jones, M.D.

Why They Feel Overwhelmed & How to Help
690 wds
by Michele Ranard, M.Ed.

As a mother and former preschool teacher, I understand stress. Every parent does. But it can be a real issue for kids too. It turns out the hormone our bodies release to deal with stressors—cortisol—is one way to measure and explore stress in children.

Adults cope with stress by learning to calm themselves, and three to six-year-olds need to learn coping too. Understanding some of the underlying structures of stress may help us better guide them.

Cortisol Levels at Home & Away
Why does cortisol matter? Cortisol controls our responses to stress and aids in digestion, the immune system, and energy usage. When we face challenges, cortisol levels spike and provide us with energy. It can suppress immunity when stress is chronic so we need stable levels to remain healthy.

Sarah Watamura of the Child Health & Development Lab at the University of Denver looked at cortisol and stress in toddlers and preschoolers. She found young kids were aware of stress within the family even if parents tried to hide it. Paying attention to a preschooler’s stress signals (crying after separation, exhaustion after day care, trouble sleeping, frequent illness) and reacting with support helps.

What stresses them out? Watamura discovered that even more than separation anxiety, it was their interaction with peers. Levels of cortisol often increased as they attempted to play with lots of other kids.

“At home, preschool-age children typically show a decreasing pattern of cortisol production across the day,” Watamura says. “At child care, many children show a rising pattern,” probably since they are more challenged there.

Nurturance At Home to Combat Stress

Science shows nurturance matters. The amount of nurturing rat pups receive from their mothers (licking and grooming in infancy) has lasting effects on the stress response over the life cycle. Laurie Miller Brotman and researchers at the NYU School of Medicine found in studies of parenting and children’s stress response that in fact, there is a cause-effect relationship.

They aimed to see whether intervention for preschoolers at risk for antisocial behavior could alter the kids’ biological response to a stressful social situation (playing with a group of unfamiliar peers). After the intervention, cortisol levels of preschoolers who were taught coping skills were found to be lower than for those without instruction.

Brotman says “The results provide further evidence that early intervention can have a profound effect on children.”

Stress at Home

Preschoolers are affected by the stress of family members. A new study published in the Journal of Child Psychology and Psychiatry found that almost 15 percent of preschoolers have atypically high levels of depression and anxiety. This five-year exploration of Sylvana M. Cote and fellow international researchers in Canada and France found that children with atypical levels were more likely to have mothers with a history of depression.

“We found that lifetime maternal depression was the second most important predictor of atypically high depressive and anxiety problems during preschool years,” says Cote. The researchers stress preventive interventions are needed to see a long-term impact on the well-being of kids at risk.

Tips to Help Stressed Out Preschoolers Cope

*Assure your child. If the stressor for your child is at home, Watamura says talk to your child about how you will be able to figure it out and that there’s no need for worry.

*Assess the connection. If your stressed child goes to day care or preschool, investigate to make sure your child’s teacher is bonding with her. Science shows that cortisol levels are more stable when there is a secure attachment.

*Ask around. Watamura suggests asking your care provider: “Does my child play well when she wants to play? How does she do when I leave? When are the roughest times of day?”

*Choices. Give your child appropriate ones i.e. let her pick a friend for a playdate.

*Offer a heads up. To prevent a meltdown, make sure she knows what to expect—she’ll be better able to adjust to circumstances which could trigger stress.

*Forget about creating CONSTANT nirvana. Watamura reminds that “Like adults, kids don’t always have to be happy” so you shouldn’t automatically try to “fix” things.

Michele Ranard has two children, a master's in counseling, and a blog at hellolovelychild.blogspot.com.

Resources:
Cote, Sylvana M. Journal of Child Psychology and Psychiatry. Feb 2009.

Watamura, Sarah, Ph.D. Director of the Child Health & Development Lab at the University of Denver. http://www.du.edu/psychology/child_health_and_development/

Laurie Miller Brotman, Ph.D. “Effects of a Psychosocial Family-Based Preventive Intervention on Cortisol Response to a Social Challenge in Preschoolers at High Risk for Antisocial Behavior.” Archives of General Psychiatry. Oct 2007.