Mental Health Wellness Toolkit Project: Part 2- Anxiety

Susanna Gomes, Meghan Mulhearn, Cassandra Giesbrecht, Rayna Dokken, Nicole Smirnos-

North

Faculty of Education, University of Winnipeg

EDUC 5431-771 Mental Health Promotion in Schools

Instructor: Amy Rasmussen Waluk

October 25, 2022

 Introduction

Anxiety is a common mental health concern facing students across all grade levels and

demographics. This case study has previously introduced Anna, a Grade 2 girl who has been

presenting anxious behaviors since the beginning of the school year. Her teachers are working on

creating a safe space for Anna at school, where her learning needs will be supported and her

anxiety will be met with compassion and understanding. The following paper will explore best

practice for teachers attending to anxiety, adaptations to support students, and who should be

involved in planning. It will also include an example lesson plan with adaptations in mind for

students who experience anxiety at school like Anna. 

Attending to Anxiety in the School Setting

There are several ways in which anxiety impacts student learning in the classroom, and it

is very important for teachers to consider this when planning for student success. Attending to

anxiety may be challenging for teachers, as there are a range of presenting behaviors. According

to the Child Mind Institute, “sometimes anxiety is easy to identify — like when a child is feeling

nervous before a test at school. Other times, anxiety in the classroom can look like something

else entirely…which is one of the reasons it can be hard to detect in the classroom,” (Ehmke,

2022). In order for teachers to attend appropriately to the needs of children with anxiety, they

should take the time to understand the child and where their behavior may be stemming from, in

order to establish that anxiety is the cause. According to a study conducted by Bridgewater State

University, teachers estimated that 40-60 percent of students in their classrooms have anxiety,

(Kane, 2021).  While this number seems high, it is interesting to note that this study concluded

that “only about half of the anxious students have a diagnosis of an anxiety disorder. The other

half simply just display signs of being anxious or give a self or parent report of anxiety,” (Kane,
2021). With these statistics in mind, it becomes very clear that anxiety is a common challenge

facing students and teachers must attend to this concern in the best possible way in order to

ensure success for students. 

Teachers should first reflect on how their daily routines and practices may be impacting

anxious students in a negative way. As many teachers have likely observed, students with

anxiety may not always feel comfortable advocating for themselves, so it is important to be

aware of situations that we may be unintentionally placing students where anxiety levels may be

increased. The Child Mind Institute outlines several areas where students' success in school may

be limited as a result of anxiety, and teachers should familiarize themselves with how these may

be present in their classrooms. These areas include inattention, attendance issues, disruptive

behavior, avoidance, lack of socialization, and perfectionism (Ehmke, 2022). When observing

students who exhibit these behaviors, other indications may point to anxiety as a cause. Teachers

who observe students engaging in physical behaviors such as  “shaking the leg, clicking a pen, or

playing with an object or their clothing…or crying and having panic attacks” (Kane, 2022)

should be on alert that their student is experiencing anxiety and needs to be attended to. 

Accommodating Anxiety in the School Setting

There are a variety of methods for teachers to make appropriate adaptations and

accommodate students experiencing anxiety in the school setting. As school avoidance is a

common symptom for students with anxiety (Hanie & Stanard, 2009), the first step for educators

is to get students into the building. This can be done by creating a place in the school, which can

be an office or sensory room for example, where the student feels comfortable, safe and can have

access to at any point when they feel the need to leave the classroom. Once the student is

regularly coming to school, Hanie and Stanard (2009) caution that it is important to involve the
student in the process of creating a manageable plan and setting goals to increase motivation for

success. These goals need to be specific and measurable so the student can recognize their

accomplishments, but must also take place in small steps so the student does not get

overwhelmed or discouraged (Hanie & Stanard, 2009). 

Cognitive behavior therapy (CBT) is an effective method, as suggested by Killu et al.,

(2016), to teach students new approach behaviors, problem solving skills, and strategies for

challenging anxious thoughts or beliefs. There are a variety of accommodations suggested by

Killu et al., (2016) that are available to address the cognitive, socioemotional, behavioral, and

physiological needs of students with anxiety in the classroom. Anxiety often affects a student’s

memory, their ability to concentrate, and attention which in turn negatively affects their

academic performance on assignments or tests (Killu et al., 2016). Some accommodations for

concentration problems or attention deficits can be using a “peer buddy” to stay on task, oral

assessments, reduced workload, and extended time to complete assignments (Killu et al., 2016).  

When academic achievement is affected, social consequences that may produce

inappropriate behavior can result in limited social growth and emotional development (Killu et

al., 2016). Children with anxiety disorders often have difficulty interacting with their peers and

may experience terror, panic, tension, or shyness (Killu et al., 2016). To address these

socioemotional characteristics, Killu et al., (2016) recommends providing prearranged breaks to

manage stress, teach positive self-talk strategies, and bridge social gaps by creating social

experiences for small groups of students. According to Killu et al., (2016), children with anxiety

disorders often experience restlessness, task avoidance, erratic behavior, and withdrawal which

can be counteracted by allowing movement breaks, extra time for transitions, and acknowledging

their comfort level for class participation. 

 “The physiological impact of anxiety can be debilitating for students with anxiety, and

that may be exacerbated by the fear and embarrassment induced by an anxiety attack” (Killu et

al., 2016). Classroom accommodations to address students experiencing symptoms such as ticks,

body aches, hyperventilation, and muscle twitching include allowing the student to leave the

room to go to their safe place in the school and providing calming activities. Educators need to

be flexible and supportive towards students with anxiety, and must provide an inclusive,

accepting class atmosphere.  

Who Should Be Involved in Planning for Anxiety Based Interventions

When considering prevention and intervention for anxiety in a school setting, there are

essential people who need to become involved. These include the student, classroom teacher,

resource teacher, guidance counselor, psychologist, doctor and parents (Waterloo Region, n.d).

The primary person to be aware of the situation is the classroom teacher. They will be aware of

the symptoms of anxiety to watch for concerning that particular child. The classroom teacher is

also the person who will spend the most time with this student, so they should be a part of the

planning process for when there is an anxiety attack or it becomes unmanageable for the student.

The teacher's role during an episode is, “in collaboration with the student, determine what would

help the student become calmer and less distressed, give the student time to calm down” (p.12).

 The guidance counselor plays an important role in being the communication between

school and home. They are able to make connections with the student and discover what makes

them feel anxious. They also share their documentations of discoveries of the student with the

resource teacher to monitor student progress and to reflect on the intervention plan. The resource

teacher or school psychologist will spend time in the classroom to observe the students behavior.

From their observations they may suggest accommodations to implement to aid the student or the
entire class. Suggestions could include incorporating mindfulness breaks, visual schedules or

creating a safe zone. All those who are involved in the school setting must collaborate to assess

the student’s needs, share observations and create a plan to help support their learning. 

The support outside of the learning environment is just as important for an effective

intervention plan. Parents and families should be in communication with the school team.

Anything they are noticing at home in terms of behaviours or triggers could help the school team

adapt their plan. Helpful things to note are if they are medicating their child for anxiety or seeing

a therapist. Does talking about their feelings help relieve their anxiety? Are they more relaxed

and settled with medication? Has their personality changed from medication? These are just a

few questions that could be answered through communication and relationships between home

and school.

Trauma Informed Wellness Lesson Plan

Lesson: Identifying Living and Non Living Things (Adapted from education.com)

Grade: One/Two

Objective: Students will be able to think critically through their investigations about what things

are classified as living or nonliving and why, using vocabulary that applies. 

Classroom anxiety/trauma informed adaptations:

Displayed Classroom Schedule-This allows students to know what is coming up

throughout the school day.

 A Feelings Scale- Students have these at their desks and can move the bead

to show how they are feeling throughout the day.

Flexible seating and auditory sensory tools-Students are given a variety of

seating options and an option for noise canceling headphones to use as needed.

Quiet break area-Only one student is able to use this area at a

time. Students are able to use this space throughout the day as needed. This area has a comfy

bean bag chair, books, hand fidget tools, a clip board for drawing/writing, pencils, crayons, and
pencil crayons, a leaf shade to block fluorescent lighting in the classroom, noise canceling

headphones, a lamp, and a sand timer.

Intention: Process: Trauma Informed Adaptations:

Activation -Introduce a conversation on -To alleviate the stress of speaking in a

whether students are living or large group, the option will be given to

nonliving. students to either raise their hands and share

-Build list together on board of their answers/ideas or write them on sticky

what we need to survive: food, notes.

water, oxygen, shelter.

-Ask students to brainstorm

questions they have, or something

they are curious about living or

nonliving things and record on

board.

Acquire -Play students the video -Speak to Anna before the start of the

-Initiate turn and talk based on the lesson. Inform her that we will be viewing a

following questions: “What are video, share what the video is about and

some examples from the video of check for comfort level. Answer any

living things?”, “What are some questions/concerns that she may have. Let

examples from the video of her know that she can take walking breaks

nonliving things?” Share answers. as needed if she feels uncomfortable while

-Read book. Pause during read- watching the video.

 aloud for students to turn and talk -Have Anna work with a familiar friend

about what they see in the pictures, during the turn and talk piece.

such as “What is living in the -During discussion time after the story give

picture?”, “What is nonliving in students the option again to share their ideas

the picture?” by speaking or writing them down on a pre-

-After reading, facilitate made sheet that can be handed in and shared.

discussion: “How are you the same

as a cat?”, “What do living things

need to survive?”

Apply -Place two hula hoops on the -As an alternative to the walkabout activity,

carpet. Label one living and one give students the option to work on a  pre-

nonliving. Lay out examples of made worksheet to share their understanding

living and nonliving objects from about living and nonliving things.

the classroom.

-Direct students to take turns

picking up objects and placing

them in the hula hoop where the

child thinks it belongs while the

student asks: “is a ____ living or

nonliving?”

-Students will now do a walkabout

around the classroom identifying

objects that are living and

 nonliving and answering questions

about important clarifications from

the book and video discussed. 

Assess -Observe if a student is able to -Give students the option to list their

classify objects. Listen to questions and answers on paper.

questions and answers for

understanding.

The adaptations put in place will help Anna because they will allow her to know what to

expect during the lesson and give her choices when it comes to sharing her ideas and questions.

Conclusion

In conclusion, anxiety in the classroom can look different for every student who is

experiencing it. For teachers, being knowledgeable in ways of supporting anxious students will

help them succeed, grow and feel safe. Involving the right people to support students inside and

outside of the school, implementing physical and visual adaptations within the classroom

environment to meet needs and creating a student-specific intervention plan will all assist in

attending to a child with anxiety. The goal is to make the changes and modifications necessary to

ensure that an anxious student feels safe, comfortable and capable.

References 

Ehmke, R. (2022, August 5). How does anxiety affect kids in school? Child Mind
 Institute. Retrieved October 23, 2022, from https://childmind.org/article/classroom-

anxiety-in-children/ 

Hanie, E. H., & Stanard, R. P. (2009). Students with Anxiety: The Role of the Professional 

School Counselor. Georgia School Counselors Association Journal, 16(1), 49-55.

Identifying living and nonliving things (2022). Education.com. Retrieved October 25, 2022,

from https://www.education.com/lesson-plan/living-and-nonliving-things/

Kane, Stephanie. (2021). Anxiety in Elementary Classrooms. In BSU Honors Program Theses 

and Projects. Item 480. Available at: https://vc.bridgew.edu/honors_proj/480 

Killu, K., Marc, R., & Crundwell, A. (2016). Students with Anxiety in the Classroom: 

Educational Accommodations and Interventions. Beyond Behavior, 25(2), 30–40.

doi:10.1177/10742956160250020510.1177/107429561602500205

Waterloo Region (n.d.). School Information & Strategies to Support Students with Anxiety. 

Retrieved October 26, 2022, from

https://www.rainbowschools.ca/wp-content/uploads/2019/04/WRDSB-Secondary-

Teacher-Anxiety-Support-Guide.pdf