Exploring Anxiety and Attachment Disorders

Today we will discuss some of the root causes

of two of the most commonly referred concerns

including:

Anxiety Disorder, and Attachment Disorder

Some strategies for dealing with students with these disorders

HM - Give samples of case studies and sample classroom level support plans for each disorder

HandoutCauses, Signs & Symptoms,

Strategies, A Case Study, & Sample Support Plan

Anxiety is a sense of worry, apprehension, fear and distress. Symptoms of anxiety typically fall into two groups:

Physical symptoms – headache, feeling sick

Emotional symptoms - nervousness and fear

Anxiety disorders, when severe, can affect a child’s thinking, decision-making ability, and perception of the environment, learning and concentration.

It raises blood pressure and heart rate and can cause vomiting, stomach pains, ulcers, diarrhea, tingling, weakness and shortness of breath among other things.

There is no single known cause of social anxiety disorder but research suggests that biological, psychological and environmental factors may play a role in its development.

Biological: Social anxiety disorder may be related to

an imbalance of the neurotransmitter serotonin.

Neurotransmitters are special chemical messengers that help to move information from nerve cell to nerve cell

in the brain.

When the neurotransmitters are out of balance, stressful situations can lead to anxiety.

Biological: In addition, social anxiety disorder

appears to run in families.

This means that the disorder may be passed on in families through genes.

Psychological: The development of social anxiety

disorder may stem from an embarrassing or humiliating experience in the past.

Environmental:

People with social anxiety disorder may develop their fear from observing the behavior of others or seeing what happened to someone else as the result of their behavior, for example, being laughed at or made fun of. - See this in bullying bystanders

Children who are sheltered or overprotected by their parents may not learn good social skills as part of their normal development.

We see this quite a bit with our “One-Child” families.

Environmental:

It is important not to dismiss a child’s anxiety by expecting that they will grow out of it. Many will need help.

appropriate assistance from other people such as parents, family members, teachers, counselors

treatment by the appropriate mental health professionals.

Environmental:

All children experience some anxiety. This is normal and expected.

For example:1. When left alone at school for the first time

many children will show distress. 2. A young child in his or her own room may

develop a fear of the dark. Such anxiety becomes a problem when it

interrupts a child’s normal activity like attending school and making friends, or sleeping.

Signs of Anxiety Disorder:

There is no one sign that indicates that a child has social anxiety. However some common signs of excessive shyness are as follows: Crying, throwing tantrums, clinging and freezing Poor eye contact Speaking very softly and/or saying very little, even nothing when at

school Frequent claims of illness so as to avoid going to school Refusing to go to school i.e. school refusal Experiencing severe anxiety about exams Appearing very anxious when the centre of attention Unwillingness to participate in class activities such as: show and tell,

debating, reading aloud, raising their hand to answer and ask questions

Devoting an excessive amount of time to computer games Being constantly alone in the playground, hovering on the edge of

groups, not joining in, having no friends or one or two friends Spending a lot of time alone in their room. (Schneider and Welowitz,

1996)

Some Strategies for Dealing with Anxiety Disorder:

Always gently encourage socially anxious students to confront their feared situations.

  Be mindful of not doing anything to

embarrass or humiliate a student and to insist on a safe, humiliation free environment in the classroom.

Some Strategies for Dealing with Anxiety Disorder:

Make a shy student a special helper in the classroom or provide them with some ‘special’ duties to reinforce self-esteem and confidence.

Make an effort to foster friendships between a shy student and a more outgoing student, taking care to choose an individual who will be a willing partner for the socially anxious one. Such ‘buddy’ systems are generally very effective as long as the buddy is also provided with appropriate support and monitoring and has an adult available with whom to discuss any concerns and issues.

Implement the “circle of friends” group program. This program aims to provide peer support for more vulnerable students.

Some Strategies for Dealing with Anxiety Disorder:

Slowly reward small steps toward social independence

Give praise where praise is due but ensure that this is authentic and not manufactured.

Have a zero tolerance policy for bullying and enforce it because obviously bullying can be very detrimental to a student’s self-esteem. Try to supported within the units of enquiry.

Causes, Signs & Symptoms, Strategies, A Case Study, & Sample

Support Plan

Children with attachment disorders or other attachment problems have difficulty connecting to others and managing their own emotions.

This results in a lack of trust and self-worth, a fear of getting close to anyone, anger and a need to be in control.

A child with an attachment disorder feels unsafe and alone.

Why do some children develop attachment disorders while others don’t?

The answer has to do with the attachment process, which relies on the interaction of both parents and child.

Attachment disorders are the result of negative experiences in this early relationship.

FACT: Asian mothers love their children just as much as Western mothers.

So why do some children develop attachment disorders while others don’t?

Is it because what works in one culture may not necessarily work in another?

How can we tell that what we are observing in the classroom coincides with signs and

symptoms of Attachment Disorder?

Initially We Can’t…It’s a Process

Reactive Attachment Disorder and other attachment problems occur when children have been unable to consistently connect with a parent or primary caregiver.

This can happen for many reasons including the following:

A baby cries and no-one responds or offers comfort. A baby is hungry or wet and they aren’t attended for

hours. No-one looks at, talks to or smiles at the baby, so

the baby feels alone. A young child gets attention only by acting out or

displaying other extreme behaviors. A young child or baby is mistreated or abused. Sometimes the child’s needs are met and sometimes

they aren’t. The child never knows what to expect.

A baby or young child is moved from one caregiver to another. This can be the result of many transitions, adoption, foster care or the loss of a parent.

The parent is emotionally unavailable because of depression, an illness or a substance abuse problem. (in many of our cases both parents are out of the house working)

As the examples show, sometimes the circumstances

are unavoidable.

It is interesting and important to note that many of these early symptoms are similar to those of ADHD and

Autism.

Some common signs and symptoms of Reactive Attachment Disorder are as follows:

An aversion to touch and physical affection. Students with Reactive Attachment Disorder often flinch, laugh or even say, ‘Ouch,’ when touched. Rather than producing positive feelings, touch and affection are perceived as a threat.

Control issues. Most students with Reactive Attachment Disorder go to great lengths to prevent feeling helpless and remain in control. They are often disobedient, defiant and argumentative.

Anger problems- Anger may be expressed directly, in tantrums or acting out, or through manipulative, passive-aggressive behavior.

Students with Reactive Attachment Disorder may hide their anger in socially acceptable actions, like giving a high five that hurts or hugging someone too hard. (we see this a lot on the soccer field)

Difficulty showing genuine care and affection.

An underdeveloped conscience. Students with Reactive Attachment Disorder may act like they don’t have a conscience and fail to show guilt, regret or remorse after behaving badly.

As young people with Reactive Attachment Disorder grow older they often develop either an inhibited or a disinherited pattern of symptoms:

Inhibited symptoms of Reactive Attachment Disorder:▪ The student is extremely withdrawn, emotionally

detached and resistant to comforting. ▪ The child is aware of what’s going on around him or

her, hyper vigilant even, but doesn’t react or respond. ▪ He or she may push others away, ignore them or even

act out in aggression when others try to get close.

Disinherited symptoms of Reactive Attachment Disorder : The student prefers strangers and other people over his or

her parents. The student seeks comfort and attention from virtually

anyone, without distinction. He or she is extremely dependent (but not attached,

engaged) , acts much younger than his or her age. Many of these students will have developmental delays in

several areas. The care-giver/child relationship provides the vehicle for

developing physically, emotionally and cognitively. In this relationship the child learns language, social behaviors and other important behaviors and skills. The lack of these experiences can result in delays in motor, language, social and cognitive behaviors.

Disinherited symptoms of Reactive Attachment Disorder : The student may have difficulty completing homework and

classroom-based tasks. They often fail to remember assignments and/or have difficulty understanding assignments with multiple steps. They may also have problems with comprehension, especially in longer passages of text.

Fluctuations in energy and motivation may be evident, and they may often have difficulty concentrating both in and out of the classroom context.

The student with attachment disorder often feels a need to be in control and may exhibit bossy, argumentative and/or defiant behavior, which may result in frequent classroom disruptions and power struggles with teachers.

Some Strategies for Dealing with Attachment Disorder

Be predictable, consistent and repetitive as they are very sensitive to changes in schedules, transitions, surprises and chaotic social situations.

(If they were engaged they would be better able to predict transitions and changes in

schedules)

Model and teach appropriate social behaviors. Always be explicit and keep language clear, precise and simple.

Avoid power struggles. When possible use humor

Some Strategies for Dealing with Attachment Disorder

Address comprehension difficulties by breaking assigned reading and other literacy-based activities into manageable segments. Monitor progress by periodically checking if the student understands the material.

Break assignments into manageable steps to help to clarify complex, multi-step directions and ensure that the student understands each step as they proceed through the activity.

 

Some Strategies for Dealing with Attachment Disorder

Be immediately available to reconnect following a conflict or tantrum where you’ve had to discipline the student. This reinforces your consistency and support and will help the student to develop a trust that you’ll be there for them.

LASTLY:

Have realistic expectations. Helping the student with an attachment disorder may entail a long journey. Focus on making small steps forward and celebrate every sign of success.

Stay patient. The process may not be a fast one and there will be bumps along the way. But by remaining patient and focusing on small improvements it is possible to create an atmosphere of safety for the student.

Some Strategies for Dealing with Attachment Disorder

Consider a Functional Behavioral Assessment (FBA). Understanding the purpose or function of the student’s behaviors will help you to respond with effective interventions. (For severe or persistent behavior)

Continually check that the student has and maintains a healthy lifestyle with a good diet, adequate sleep and appropriate levels of exercise.

Always refer and ask for help. The student with an attachment disorder presents a significant and stressful challenge for all involved.

Read the two case studies in your handout:

Anxiety Disorder Case Study – AdamAttachment Disorder Case Study –

Ellen

Make a two separate simple support plans:

Look through the strategies in your handout and put together for each case, a support plan of about six

strategies

http://www.uisgreferrals.com/

•Move your cursor over the Teacher Resource Tab

•Then over he ‘Behavior Management’

•Then over to ‘Classroom Behavior Management Strategies and click on it.