Anxiety
It is normal for everyone to feel anxious sometimes, especially around big changes and periods of uncertainty. Some children worry more than others though, and it can get in the way of them functioning well in the classroom. Common worries that children can have relating to school can include doing well on a piece of work, making a fool of themselves in PE and what their classmates think of them. Children can also worry about things that are happening outside of the classroom. For example, they might worry about something bad happening to a parent or the argument they overheard last night.
Signs and symptoms to watch out for
Anxiety can look different for each child. Look out for tears, struggling to separate from parents, seeming more withdrawn from peers, concentration difficulties, fidgeting, changes in appetite, seeming more tired, irritability and angry outbursts, complaining of feeling unwell (e.g. tummy aches), toileting accidents and requesting to go to the toilet more often. You might also notice children expressing more negative thoughts, such as “I’m not good at Maths”, “I miss my Mum” and “No one wants to play with me”. Avoidance is a key sign of anxiety too. Look out for children staying away from feared situations such as working with unknown children, reading or writing in front of others.
Calming Corner
If possible, find a spot in your classroom that children can go to when they start to feel anxious. Make it cosy with blankets, cushions and maybe even fairy lights! Add calming and coping tools (see coping box for ideas). Ensure children know how and when they can use the calming corner. Having a signal or code which they can use to let you know that they need to use the coping corner can be helpful. For example, a ‘time-out’ card that they can give you. For some children, they will need your help to identify when they could use the calming corner.
Coping Box
Create a ‘coping box’ and encourage children to use the box when they start to feel anxious. Coping boxes can work well as part of a calm corner or on their own in classrooms where there is less space. Fill the box with lots of sensory play items. For example, slime, lavender bags, playdough, soft toys, positive statements, stress balls, photographs, fidget toys, colouring pages and pens, bubbles. Encourage children to focus their attention on their senses when using the box, to take their focus away from their worries.
Encourage children to get ‘out of their head’ and ‘into the classroom’ using mindfulness techniques
Children can be encouraged to notice signs of anxiety and intentionally move their attention away and instead engage in new activities. There are lots of helpful mindfulness practice videos on YouTube that you can do as a whole class. For example, belly breathing with Elmo from Sesame Street, safe space imagery with SpongeBob, yoga and sing-alongs with Disney characters.
Reflective listening
Give children the opportunity to speak about their worries when they seem anxious. Let them know of a named adult that they can approach. Practise reflective listening: listen to their concern, tell them that it is normal to worry, show that you have heard them, check your understanding of the concern, and validate their feelings. Help children to listen to each other in this way too.
Modelling calmness
Be aware of how you model your own anxiety when speaking to children in your class. Be sure to only speak to children about their worries when you are calm yourself.
Creating routines
Children experiencing anxiety can commonly feel worried about the future. Maintaining a predictable routine can enhance children’s sense of safety. Let them know what to expect from their day. Offer a visual timetable. Some anxious children will struggle at times in the day where there is more ‘free-time’, usually at break times. It may be helpful to discuss with other members of support staff and make specific plans for activities they can do and children they can play with during these times.
Plan lessons themed on anxiety
Including lessons in the curriculum about anxiety can be helpful for children. There are lots of different topics that could be covered. Even a lesson that explains to children that anxiety is a normal emotion that everyone feels can be useful. Children tend to struggle to identify and express their thoughts (due to their stage of brain development) and so having a planned time to develop these skills is advised. Similarly, exploring with your class how anxiety feels in the body can be helpful, as even physical sensations of anxiety can be anxiety provoking! There are lots of creative ways to have some of these discussions. Children can externalise their worries by drawing them out as their ‘worry monsters’. Then you can also practise ways of answering back to the negative things that the monsters say.
For children who worry about how they are perceived by others, it can be helpful to schedule in a positive affirmations task where children share reflections on what they appreciate about each other.
There are lots of great books available that you could use to help explain anxiety to younger children, such as ‘The Colour Monster’ and ‘The Worrysaurus’.
Monitor and address misinformation
It is possible that children are hearing frightening and inaccurate information from their peers, particularly during break time. Look out for common themes of anxieties in the class (e.g. scary movies, illness and death). Offer opportunities to ask questions about concerns and provide information to the whole class on what is known or not. Be honest. Where children are worried about the unknown, do not pretend to have the answers, building up their tolerance of uncertainty will be helpful to them in the long run.
Modelling making mistakes
Lots of children worry about getting things wrong. One way you can help with this is to help them to learn that making mistakes is normal and something we all experience. For example, intentionally making mistakes when you’re writing on the board. It can also be useful to respond to children’s mistakes in a kind and compassionate manner.
Encouraging self-efficacy and coping (developing a growth mind-set)
Motivate children to make their best efforts to manage their anxiety, by practising their coping skills. Encourage children to practise ‘positive self-talk’ where they say positive statements to themselves, such as ‘I can do it’, ‘This feeling won’t last forever’ and ‘I am good enough’. Break down difficult tasks into smaller, more manageable chunks, to give children a sense of mastery.
Worry Box
When children seem to be mulling over their worries during the school day, they can be encouraged to write their worry down and to put it into a class ‘worry box’ for thinking about at another time. Worries from the worry box can be collected and discussed once a day, at a short and regular specified time (e.g. for 15-30mins). This can help to defer worries until a time when they are more likely to be resolved.
Build a step-by-step plan to overcome avoidance
If there is something specific that a child is anxious about, for example, reading out-loud in class, spend some time with them creating a ‘step-by-step plan’ to gradually work-up to facing their fear. A step by step plan to reading out in front of the whole class might look like this:
Step 1: Read out-loud in front of teacher and/or teaching assistant
Step 2: Read out-loud with a small group of peers (2-3 others)
Step 3: Read out-loud with a medium size group of peers (6-7 others)
And so on, until they can reach the ultimate goal of reading in front of the whole class. Repeat and revise each of the steps as required.
Praise and reward for brave behaviour
Age appropriate rewards can be used to motivate children to approach their fears, rather than to avoid them. The types of rewards that you would use for behaviour management, such as gold stars, class awards and access to a preferred game/toy, can also be used to reward children for brave behaviour. Remember, offering verbal praise for achievements and behaviours that you want to encourage can also be as rewarding. Don’t forget to offer praise and rewards when you see children practising using more appropriate coping strategies too.
Watch out for reassurance seeking and try to limit the reassurance you give
Anxious children will naturally seek reassurance about their concerns. This can mean that they will ask you the same question multiple times. Although giving children reassurance comes naturally, and can relieve their anxiety symptoms in the short-term, in the long-term it can maintain the problem. Limit how much reassurance you are giving children about their concerns. Instead, ask children what they think they can do to feel better, to promote a problem-solving approach to worries, when they are solvable.
Communicating with parents
Find out if children are anxious at home as well as at school. Discuss helpful coping strategies and rewards that parents are using at home so that these can be consistent at school, and vice versa. Let parents know if their child has had a particularly difficult day; they might want to reflect on it when they get home or plan a relaxing activity before bed.
Anti-bullying policy
One of the most common anxieties that young people experience at school involves concerns about what others think of them, often triggered by experiences of teasing and/or bullying. Discuss bullying with your class, how it should be reported to a trusted adult, and consider anti-bullying strategies to have in place such as a buddy system.
Keeping track of anxiety
If you are concerned about a particular child who is anxious frequently, try to find a method to keep track of this and encourage parents to do the same. This should include monitoring whether or not children are eating their snacks and lunches, (as anxiety can lead to a decrease in appetite and an empty stomach can exacerbate negative thinking patterns) and may require liaising with other members of staff too. Keeping track of anxiety could be helpful when thinking about making a referral to children’s mental health services in future.
Further support and information
We recommend getting hold of the book titled ‘Overcoming your child’s fears and worries’ by Cathy Creswell.
See the Anna Freud website to join their Schools in Mind’ network.
For worries and anxiety relating to the COVID-19 pandemic, please refer to the Nip in the Bud Tips for Returning to School video by Dr Jessica Richardson.
Dr Zoë Maiden, Senior Clinical Psychologist and Dr Sarah Miles, Clinical Psychologist
National and Specialist CAMHS Trauma, Anxiety and Depression Clinic