Module 3: Anxiety in Special Needs

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Part 1: About Anxiety in Autistic Children and Teenagers

  Autistic children feel many of the same worries and fears as other children. But autistic children might also worry or feel stressed about things that are less worrying for typically developing children. These include things like:

• small disruptions to their routines or new sensations they feel in their bodies.
• unfamiliar or unpredictable social situations
• situations where it is hard to know what other people are thinking or feeling.
• their own thoughts and feelings, especially unfamiliar or unpleasant physical symptoms that are related to worried thoughts and feelings.

Reducing a child’s anxiety might reduce the behaviour associated with the core characteristics of autism, but it will not get rid of the characteristics or behaviour.

Signs of anxiety in autistic children and teenagers

When autistic children get worried or anxious, the way they show their anxiety can look a lot like common characteristics of autism:

• Stimming
• obsessive and ritualistic behaviour
• resistance to changes in routine.

Also, because autistic children have trouble recognising their own anxious thoughts and feelings, they cannot always tell you that they are feeling anxious. Instead, you might notice an increase in challenging behaviour. For example, your anxious child might:

• insist even more on routine and sameness.
• have more trouble sleeping.
• have meltdowns or emotional outbursts.
• avoid or withdraw from social situations.
• rely more on obsessions and rituals, like lining up or spinning objects.
• stim by rocking, spinning or flapping hands.
• do things to hurt themselves, like head-banging, scratching skin or hand-biting.

Anxiety is a natural part of life and something that everyone experiences at some stage. But there are some things you can do to help ease your child’s worries and encourage your child to manage their own anxiety levels.

Anxiety triggers: how to identify them in autistic children and teenagers.

Finding out what makes your autistic child anxious is a first step in reducing your child’s anxiety and helping them to manage it. Because autistic children and teenagers can have trouble with understanding and communicating emotions, you might need to read your child’s signals and work out what makes your child feel anxious or stressed. Some of the common triggers for anxiety in autistic children include:

• changes in routine – for example, not going to a weekly piano lesson because the teacher is sick.
• changes in environment – for example, a new house, new play equipment at the local park, or furniture in different places at home
• unfamiliar social situations – for example, a birthday party at an unfamiliar house
• sensory sensitivities – for example, sensitivities to particular noises, bright lights, specific flavours, or food textures
• fear of a particular situation, activity, or object – for example, sleeping in their own bed, going to the toilet, balloons, or vacuum cleaners.
• times of transition – for example, moving into a new school year, starting secondary school, or the start of puberty.

Once you have worked out some of the things that make your child feel anxious, it can help to make a list of them, so that you can find ways to help your child manage these situations. Give your child lots of opportunities to practise dealing with these things and situations in safe environments. It helps if other people who look after your child – for example, childcare workers, teachers, and family members – also know what makes your child feel anxious and what they can do to help your child with managing anxiety in these situations.

Ways to help autistic children recognise anxiety.

Your autistic child might need to learn what anxiety feels like in their body. For example, when your child feels anxious:

• their palms get sweaty.
• they get a strange feeling in their stomach.
• their heart beats faster
• their hands flap.

You could try drawing an outline of a person’s body. Inside the outline, help your child draw or write what happens in each part of their body when they feel scared or worried.

Relaxation and calming strategies for when autistic children feel anxious.

You can help your child learn ways to calm down when they start feeling anxious or stressed. These might include:

• counting slowly to 10
• taking five deep breaths
• running around the yard five times
• doing 50 jumps on the trampoline
• looking at a collection of favourite or special things
• reading a favourite book
• closing eyes for a few moments
• going to a quiet part of the house.

Get your child to practise these strategies when they are calm. Once your child knows the strategies well, you can gently guide your child to try them when they feel anxious.

Visual tools to help autistic children prepare for anxious situations.

If visual supports and social stories work well for your child, you could use these tools to help your child prepare for situations that make them anxious. For example, if your child gets anxious when you drop them off at school, you could take some photos of what your child will be doing – walking in the school gate, sitting in the classroom, playing sport, eating lunch and so on. You could also take photos of what you will be doing while you are not together, like driving home, grocery shopping, gardening and so on. A clear picture of you coming back to pick your child up would be important too. If your child gets anxious when there is a change in routine, daily or weekly visual schedules can help prepare your child. When you know a change is coming up – for example, no swimming lessons in the school holidays – you can show this on your schedule. Leading up to the change, look at the schedule regularly with your child so that your child knows the weekly routine will be different. Some children like to be warned about a change or an event a day in advance. Some like to know a week in advance. But for some, too much warning can mean they worry until the event happens.

Opportunities to practise stressful or anxious situations.

If you give your child opportunities to practise for situations that they find stressful, it can help your child understand these situations and feel more prepared for them. For example, if going to the hairdresser makes your child feel anxious, you could try taking your child for a practice run. You could ask the hairdresser if you could come at a time of day when it is quiet and calm, then go through the steps with your child. Or perhaps your child could watch someone else get their hair cut. If your child gets anxious in social situations you could practise these together. You could practise different situations and take turns playing different roles. Try to keep the scenarios short and simple and encourage and praise your child.

Getting help with managing anxiety in autistic children and teenagers.

A psychologist might be able to help if your child is very anxious. Psychologists have specialised training in mental health conditions and can work directly with your child and family to develop strategies for reducing anxiety. Psychologists use a range of approaches, including:

• cognitive behaviour therapy – this helps children develop skills to change their thinking in situations that make them anxious.
• therapies and supports that use gradual exposure to help children face their fears – for example, the stepladder approach.
• social stories – these can help prepare children for unfamiliar or stressful situations that generally make them anxious.
• relaxation training to help your child learn to relax.

Mental health occupational therapists are another option to help your child with managing anxiety. You can ask your GP or paediatrician to recommend a psychologist or therapist. Medication can also help reduce anxiety symptoms in autistic children. It is usually recommended only when anxiety is affecting a child’s everyday life and behaviour strategies have not reduced the anxiety enough. You can speak to your GP or paediatrician about this option.  

Part 2: ADHD and anxiety

• Some of the challenges that come with ADHD can make children anxious.
• Many children with ADHD may have trouble managing emotions.
• Some children may have an anxiety disorder as well as ADHD.

  Anxiety is common in children with ADHD. Many of the challenges that come with ADHD can make children anxious. Children with ADHD are also more likely to have an anxiety disorder than other children. It can be hard to tell whether a child has ADHD or anxiety because there’s so much overlap in how they look in children. Here is what you need to know about ADHD and anxiety—and what you can do to help your child.

The ADHD-Anxiety Connection

Children with ADHD have trouble with executive functions. These are the skills that help us get organized, plan, manage time, and follow daily routines. Struggling with these skills day after day can be stressful. And chronic stress can lead to anxiety. Children with ADHD often have more trouble managing stress than children who do not have ADHD, too. That is because ADHD affects how children manage their emotions. Children with ADHD may get so flooded with emotion that they have trouble thinking clearly about how to cope with the situation. Therefore, having ADHD can lead to anxiety. But children with ADHD are also up to three times more likely to have an anxiety disorder than other children. Because ADHD and anxiety disorders often occur at the same time, some researchers think children may be pre-wired to be both anxious and inattentive.

What an Anxious child with ADHD may look like

Trouble managing emotions can affect children’s’ behaviour in different ways. Some act up and draw attention to themselves. Others sit quietly and try not to be noticed. Here are some behaviours that may be signs of anxiety in a child with ADHD:

• Clowns around too much in class
• Seems irritable or argumentative.
• Lies about schoolwork or other responsibilities that have not been met.
• Withdraws from people, maybe by retreating to the bedroom or bathroom.
• Plays video games or watches TV nonstop.

 

Why Anxiety is sometimes misdiagnosed as ADHD.

Sometimes children with anxiety can be misdiagnosed with ADHD, or vice versa. That is because on the surface, the two can look similar. Here are some of the ways children with either may act—but for different reasons:

• Have trouble paying attention. Children with anxiety may seem tuned out or preoccupied, but they are really distracted by worries. Children with ADHD are inattentive because of differences in the brain that affect focus.
• Fidget constantly. Children with anxiety may tap their foot nonstop during class because of nervous energy. Children with ADHD fidget because of hyperactivity or trouble with impulse control.
• Work slowly. Children with anxiety may work slowly because they feel like they must do something perfectly. Children with ADHD take a long time to get things done because they have trouble starting tasks and focusing on them.
• Do not turn in assignments. Children with anxiety might get stuck on a task and be too anxious to ask for help. Children with ADHD often do not turn in assignments because of poor planning skills and forgetfulness.
• Struggle to make friends. Children with social anxiety might be too fearful of social situations to make friends. Children with ADHD might have trouble picking up on social cues because they struggle with focus. Or their impulsive behaviour might annoy or alienate other children.

  There are lots of overlapping symptoms between ADHD and anxiety. But there are also key differences:

• Children with anxiety disorders often show compulsive or perfectionist behaviour. This is not as common in children with ADHD.
• Children with ADHD tend to struggle with organization. This is not as common in children with anxiety.
• Children with anxiety tend to worry more about socializing than children with ADHD.
• Children with anxiety may also develop physical symptoms like sweaty palms, rapid breathing, and stomach-aches.

 

How you can help

Get to know signs of anxiety in younger children or teens and tweens and take notes on what you see. Using an anxiety tracker can help you better understand when and why your child feels anxious. Here are some other ways to help:

• Tune in to your child’s behaviour. Try not to chalk them all up to ADHD. Acting up more than usual or disappearing into video games can be signs of anxiety. Ask if something is causing worry or uneasiness.
• If your child talks about anxiety, validate those feelings. Rather than telling your child to “calm down,” work together to figure out next steps to take.
• Be mindful of your own anxiety. Some parents of anxious children struggle with anxiety themselves. Remember that your child is learning how to respond to stressful situations by watching how you react to them. Children often have an easier time coping with anxiety if their parents stay calm and positive.
• Try not to take things personally. It can be upsetting when your child comes home from school and says something rude or offensive. But when children do this, they are often letting off steam after a stressful day. When things have calmed down, brainstorm ways to decompress, like offering quiet time before you start asking about school.
• Help your child see the big picture. If your child blows up when doing math homework, wait for things to calm down. Then encourage your child to reflect on what caused those feelings. Talk about what you both might be able to do next time to relieve some of that anxiety.
• Consider outside help. If your child’s anxiety gets in the way of functioning or enjoying life, talk to your health care provider. If need be, they can refer you to a mental health professional who can help you and your child find the best path forward.

  Keep in mind that getting a thorough evaluation is key to determining if your child has ADHD, an anxiety disorder, or both. This is especially important if you are considering medication. ADHD medication may relieve anxiety in some children. But there is also a chance it may make some children more anxious. It all depends on how sensitive a particular child’s body is to a particular medication. Anxiety can be a lifelong reality for some children with ADHD. But with the right support, children can manage both ADHD and anxiety, and thrive in school and in life.

Key Takeaways

• Children with ADHD are more likely to have anxiety than children who do not have ADHD.
• Sometimes children with anxiety can be misdiagnosed with ADHD, or vice versa.
• Keep track of signs of anxiety you see and reach out to your health care provider if you have concerns.

Part 3: Sensory Processing Issues and Anxiety

 

Briefly

• Children with sensory processing issues can often feel anxious.
• Anxiety is most common in children who experience sensory overload.
• There are things you can do to help your child with her anxiety and fears.

• Bright lights, loud noises, unfamiliar surroundings, and situations. All of these can create stress—and sensory overload—for children with sensory processing issues. It can also create anxiety over situations that lie ahead. That is especially true if children are not prepared or are worried about unexpected things happening.
• Learn more about sensory processing issues and anxiety, and how you can help your child.

Sensory Overload and Anxiety

Most children have no trouble organizing the information they get from their senses. But children with sensory processing issues struggle with it. Some may be oversensitive to sounds, sights, textures, flavours, smells and other sensory input. Others may be undersensitive to things like temperature and noise. Some children are both oversensitive and undersensitive. Anxiety is most common in children who are oversensitive. They can experience sensory overload, which can make basic activities seem like an assault for them. So, they may come to dread everyday situations that are stressful, like trips to the mall. Or they may worry about finding themselves in situations they find intolerable. Here is what anxiety might look like in a child with sensory processing issues:

• A child who cannot tolerate the sound of “buzzing” insects may fret about playing kickball outside or panic if a bug (buzzing or not) comes too close.
• A grade-schooler who is oversensitive to food flavours and textures may worry she will have to eat certain things if she goes to someone’s house for dinner or a sleepover and refuses to go.
• A teen who is oversensitive to touch may not be able to tolerate being hugged or kissed. So, he stands off by himself at family gatherings, worrying that his most affectionate aunt will spot him and come over.

How the Signs Can Be Confusing

Sensory issues often trigger anxiety and fears. But sometimes parents are concerned about sensory processing issues when their child could be struggling with an anxiety disorder. A child may be anxious because of something totally unrelated. Only an evaluation by a professional can pinpoint what is going on. Without one, it can be hard to tell what is behind the anxiety and the behaviour it creates. For example: A child dreads getting dressed in the morning and regularly bursts into tears or starts yelling. It could be that oversensitivity makes clothes feel terrible on his skin and is causing sensory meltdowns. But there might be a different reason for his behaviour. He might be having tantrums, rather than sensory meltdowns, because he is anxious about going to school. Maybe an undiagnosed learning difference is the root cause. He might dread being called on in class because he does not understand the lesson. He might also be feeling so much ongoing stress that he has developed an anxiety disorder. One big clue is that sensory processing issues impact a range of senses, in many different situations. It is rare for signs to be limited to one thing—like getting dressed. Another clue is timing. A child with sensory issues might dread getting dressed every morning. But a child with anxiety might only dread getting dressed on school days.

How to find out what is behind the behaviour

• An occupational therapist (OT) can evaluate children for sensory issues, and then work with them on those issues. Your child’s doctor or school may be able to refer you to one.
• A child psychologist can evaluate your child for an anxiety disorder. She can also treat him for anxiety, no matter what the cause is.
• The psychologist can also check for other conditions that may be present. Children with ADHD often have sensory issues. They also commonly struggle with anxiety. The same is true for children with autism spectrum disorder.

How You Can Help

Understanding your child’s sensory processing issues (and what is causing his anxiety) is key to helping him. Here are some things you can do.

• Learn what his common triggers are and tell him you are aware of them. For example, if your child hates crowds and noise, plan to go to the toy store with him when there will not be a lot of people there. Or let him know that you will not mind leaving the amusement park early if it becomes too much for him.
• Take time to prepare. Talk about what to expect before you enter a situation that could be overwhelming. Build in time for some quick jumping jacks or toe touches to help him regulate his sensory system. Pick out comfy clothing together at night so your child will not wake up worrying about what he might “have” to wear the next day.
• Brainstorm strategies and encourage self-advocacy. Find a calm time when your child is in a good mood and well-regulated to talk about situations that worry him. Discuss things he might to do make them less stressful. For instance, would he like to ask Grandma if she can give him a high five instead of a hug when she sees him? Or talk to her together to explain that there are certain foods he just cannot eat?

• There are other ways you can help your child manage both sensory issues and anxiety. Work on strategies you can try at homefor sensory processing issues. Get a sense of a typical day in the life of a child with sensory issues. And learn the signs of anxiety at different ages. If you have concerns, be sure to reach out to your child’s doctor. (Please see our course, Understanding Sensory Processing for more information on this topic)

Key Takeaways

• Children with sensory processing issues often have anxiety because everyday life can make them so uncomfortable.
• Sometimes anxiety disorder can be mistaken for sensory processing issues, and vice versa.
• If you notice signs of anxiety in your child, it is important to reach out to your child’s doctor.

 

Part 4: Signs of Anxiety and Depression in different grades

When children learn and think differently, it can impact their emotions. In some cases, there is a greater chance they will experience anxiety or depression. Use this information to get to know the signs of anxiety and depression at different ages. Look for patterns and take notes on what you are seeing. And be sure to reach out to your child’s doctor if you have concerns.  

Signs of Anxiety in Young Children

It is not unusual for children, even young ones, to sometimes feel anxious. But how do you know if anxiety is a problem for your child? It can be confusing. You might see some anxious behaviours even when children do not have an anxiety problem. So, they may not jump out as signs, unless they happen a lot or interfere with everyday life. For example, not wanting to eat lunch at school or being grouchy for no reason could be caused by all kinds of things, or by nothing at all. If you’re wondering if your pre-schooler or grade-schooler may be struggling with anxiety or stress, here are signs you might see, according to John Piacentini, PhD, and Lindsey Bergman, PhD, experts from the UCLA Child Anxiety Resilience Education and Supports (CARES) Centre.

Physical Signs of Anxiety

• Often complains of headaches or stomach-aches, even though there is no medical reason for them.
• Refuses to eat snacks or lunch at daycare or school.
• Will not use bathrooms except at home.
• Is restless, fidgety, hyperactive, or distracted (even without having ADHD)
• Starts to shake or sweat in intimidating situations.
• Constantly tenses muscles.
• Has trouble falling asleep or staying asleep.

 

Emotional Signs of Anxiety

• Cries a lot.
• Is extremely sensitive.
• Becomes grouchy or angry without any clear reason.
• Is afraid of making even minor mistakes.
• Has panic attacks (or is afraid of having panic attacks)
• Worries about things that are far in the future, like worrying about starting middle school in third grade.
• Is worried or afraid during drop-offs (at daycare, school, relatives’ homes, etc.)
• Has frequent nightmares about losing a parent or loved one.

 

Behavioural signs of Anxiety

• Asks “what if?” constantly (“What if an earthquake happened?”)
• Avoids joining in during class activities like circle time.
• Remains silent or preoccupied when expected to work with others.
• Refuses to go to school.
• Stays inside alone at lunch or recess.
• Avoids social situations with other children, like birthday parties or extracurricular activities.
• Constantly seeks approval from parents and caregivers, teachers, and friends.
• Says “I can’t do it!” without a real reason.
• Has meltdowns or tantrums.

 

How You Can Help

To find out what might be causing anxiety, observe your child and take notes on what you are seeing. You can try tracking patterns in your child’s behaviour. Then share it with your child’s teacher and health care provider and talk about next steps. Keep in mind that anxiety is common in children who struggle in school. Ask your child’s teacher if your child is having any learning or behaviour challenges. Find out from the doctor whether your child’s anxiety is something you should investigate. There are many types of emotional support for children with anxiety. And learn more about why some children struggle to manage their emotions.

Signs of Anxiety in Tweens and Teens

For tweens and teens, life can be a giant emotional roller coaster, with mood swings, unpredictable behaviour, and endless drama. You can chalk some of it up to hormones. But children this age also face a lot of pressure—especially children who learn and think differently. Everything is getting more complicated; school, their social lives, responsibilities at home. Plus, they are supposed to start thinking about their future. Many tweens and teens can cope with the stress. Some even find it energizing. But for others, stress can build and build, leading to anxiety. If your child bursts into tears all the time or has trouble sleeping, how do you know whether it is typical stress or anxiety? You can get an idea by looking for patterns in your child’s behaviour and by knowing what anxiety looks like at this age. Here are some signs to look out for, according to John Piacentini, PhD, and Lindsey Bergman, PhD, experts from the UCLA Child Anxiety Resilience Education and Support (CARES) Centre.  

Physical Signs of Anxiety

• Often complains of headaches or stomach-aches, with no medical reason.
• Refuses to eat in the school cafeteria or other public places.
• Changes eating habits suddenly.
• Will not use restrooms away from home.
• Gets restless, fidgety, hyperactive, or distracted (but does not necessarily have ADHD)
• Starts to shake or sweat in intimidating situations.
• Constantly tenses muscles.
• Has trouble falling asleep or staying asleep.

Emotional Signs of Anxiety

• Cries often.
• Becomes cranky or angry for no clear reason.
• Is afraid of making even minor mistakes.
• Has extreme test anxiety.
• Doubts their skills and abilities, even when there is no reason to.
• Cannot handle any criticism, no matter how constructive.
• Has panic attacks (or is afraid of having panic attacks)
• Has pressing fears or phobias.
• Worries about things way off in the future.
• Often has nightmares about losing a parent or loved one.
• Has obsessive thoughts or worries about bad things happening or upsetting topics.

Behavioural signs of Anxiety

• Avoids participating in class activities.
• Stays silent or preoccupied when expected to work with others.
• Refuses to go to school or do schoolwork.
• Avoids social situations with peers.
• Refuses to speak to peers or strangers in stores, restaurants, etc.
• Becomes emotional or angry when separating from family or loved ones.
• Begins to have explosive outbursts.
• Starts withdrawing from activities.
• Constantly seeks approval from parents, teachers, and friends.
• Has compulsive behaviours, like frequent handwashing or arranging things.

 

How You Can Help

If you see some of the signs of anxiety on a regular basis, talk to your child’s teacher to find out what is happening at school. You can also talk to your child’s health care provider. Together, you can come up with a plan for how to help your child. Try keeping track of when your child seems anxious and look for patterns. And learn more about why some children struggle to manage their emotions.  

Part 5: Signs of depression at different ages

Depression is not uncommon for children who learn and think differently. Depression often runs in families. But even for children who do not have a family history of depression, the ongoing challenges they face in school and life can take a toll. Depression is more than just feeling or seeming sad. It can affect children in many ways. Even at young ages, children who are depressed might talk about wanting to harm themselves. It is important that you take this behaviour seriously and seek medical attention right away. This checklist includes signs of depression you may see at different ages. Every parent or caregiver will notice a few of these behaviours from time to time. But if your child starts showing many of them, do not wait to talk to your health care provider.    

Signs of Depression in Preschool

• Seems to have lost skills and gone backwards. Might use baby talk again or resume thumb-sucking.
• Has returned to having separation anxiety.
• Has become aggressive.
• No longer likes to play. Withdraws during playdates and puts up a fight about going on them.
• Goes off a regular sleep schedule. Might start napping at odd hours throughout the day.
• Is sluggish during the day.
• Is losing weight. Might have no interest in treats or in what is being served at meals.

 

Signs of Depression in Grade School

• Frequently complains about aches and pains, but nothing is physically wrong.
• Has a negative outlook on life in general.
• Talks often about feeling sad or lonely, despite having friends.
• Talks about being bullied, even when there are no signs of it.
• Does much worse in school or in sports. No longer cares about doing well in anything.
• Loses interest in daily activities. Says things are “boring.”
• Spends most free time on the couch in front of the TV.
• Is not gaining weight at a time when children are growing rapidly.

     

Signs of Depression in Tweens and Teens

• Seems distant. Has closed off emotionally to family and friends.
• Spends a lot of time behind closed doors.
• Seems uncharacteristically irritable and angry. Loses it over little things.
• Often lashes out in anger, including physically.
• Talks about feeling stupid, worthless, or hopeless.
• Thinks one bad outcome means everything else will be a disaster, too.
• Obsesses about shortcomings.
• Feels hopeless about the future.
• Is acting out with risky behaviour.
• Has had dramatic changes in daily habits. Might start to binge on junk food or skip meals.

  If you are noticing many signs of depression in your child, do not hesitate to reach out to your health care provider. Read about why children who learn and think differently might feel lonely. And if your child has ADHD, learn about the connection between ADHD and depression.

Part 6: Types of emotional help available for your child

 

Briefly

Children who learn and think differently are more likely to be diagnosed with mental health issues than their peers. Psychotherapist is a general term to describe professionals who evaluate and treat mental health disorders. Not all psychotherapists provide the same services.   It might not surprise you that children who learn and think differently may also struggle emotionally. Research shows that these children are four to six times more likely to be diagnosed with a mental health disorder than other children their age. Deciding that your child needs outside help with emotional issues can be tough. But getting children the help they need can make a big difference in their life. There are many kinds of services available, but they are all generally called psychotherapy. This is because they all provide therapy for mental health issues. Not all the professionals who provide these services have the same training or can meet the same needs. Therefore, it is important to choose the option that works best for you and your child. Here is a brief look at some of the choices you may have when your child needs psychotherapy. Make sure whichever professional you choose is licensed to practice.

School Psychologists

Training: Master’s degree (some schools may require a PhD). Specializes in school psychology and education. How they can help: School psychologists can observe your child in the context of everyday life and counsel your child. Individual counselling can be added to your child’s Individualized Education Program (IEP) if your child has one. Possible drawbacks: You or your child might not feel comfortable with the psychologist on the school’s staff. And your child may feel self-conscious about having sessions in school. A school psychologist who does not have a PhD may be trained to focus on school-related issues and not have the background to handle broader issues. Additionally, if your child doesn’t already have an IEP, it can take time to set one up so your child can get the counselling they need.  

Licensed Clinical Social Workers

Training: Master’s degree in social work. Has training and a license to provide individual and group psychotherapy. How they can help: LCSWs can evaluate your child and provide therapy. LCSWs may be more affordable and accessible than other professionals, like psychologists. Possible drawbacks: LCSWs don’t have the same in-depth training as psychologists. Some may not be as well-versed in learning and thinking differences.

Psychiatrists

Training: A doctoral degree in medicine, with four years of medical school, plus a four-year psychiatric residency. How they can help: Psychiatrists can provide diagnoses and prescribe medication that may help with your child’s anxiety, depression, or other mental health issue. If a psychiatrist feels talk therapy is needed, they may provide that, too, or refer you to a therapist. Possible drawbacks: Ongoing talk therapy with a psychiatrist can be expensive; many do not accept insurance. Some psychiatrists also may focus more on medication management than on therapy.  

Advanced Practice Registered Nurses

Training: Master’s degree and/or doctoral degree in psychiatric mental health nursing. (Psychiatric mental health nurse practitioners, also called nurse practitioners or clinical nurse specialists, have doctoral degrees, and earn additional degrees, such as a PhD or an EdD.) How they can help: Certified nurse practitioners can evaluate your child and provide therapy. Possible drawbacks: It may not be easy to find an APRN with a clinical practice in your area.

Psychologists

Training: Doctorate (PhD, PsyD), clinical practice, one-year residency, and postdoctoral training. Psychologists can have postdoctoral training in different specialties. You may want to find a psychologist who has received postdoctoral training in paediatrics. How they can help: Psychologists are extensively trained to assess, diagnose, and treat learning and psychological issues. Possible drawbacks: Psychologists can be expensive, and medical insurance may not cover all costs.

Mental Health Counsellors

Training: Master’s degree in counselling or counselling-related work. (In some states, mental health counsellors may be called professional counsellors or clinical professional counsellors.) How they can help: Mental health counsellors are trained to counsel you and your child. They are usually less expensive than more extensively trained practitioners, like psychologists. Possible drawbacks: The quality of training for mental health counsellors can vary widely. Some particularly good practitioners are available, but even these ones generally do not have an educational background in assessment and psychological theory.

Marriage and Family Therapists

Training: Master’s degree, at minimum; some may have a PhD and postdoctoral training. How they can help: These practitioners are trained in therapy and family systems. They can treat emotional and mental illnesses in the context of the family. If your biggest concern is about how you and your child are relating to each other or how your child’s issues are affecting your family, this type of counselling may help. Possible drawbacks: Family counselling on its own may not be enough to address your child’s individual emotional or mental health needs. Your child’s doctor may be able to give you more options and guidance. No matter which professional you choose, be sure to check references carefully. Learn more about what to consider when looking for a therapist and get more information on mental health issues in children. Keep in mind that while training matters, a practitioner’s experience, and the chemistry they have with you and your child have can be equally important.

Key Takeaways

• A school psychologist can help your child at no cost to you but might not have a background working with your child’s specific issues.
• Psychiatrists, and in some areas, advanced psychiatric nurses, can prescribe medication.
• Length and depth of experience and your comfort with a practitioner can matter more than the practitioner’s title or training.

Part 7: Warning signs of teacher burnout

Burnout. It is something most teachers will face at some point in their careers. While this job is one of the most rewarding out there, it is also one of the most demanding. If you are going to find fulfilment in your career as a teacher, you are going to need to know how to identify and avoid, teacher burnout. Here are some warning signs that may indicate you are on the path to a burnout problem.

• Feeling irritable and quick to anger Most teachers have a naturally friendly personality. You must be if you are going to do well interacting with parents and students day in and day out. When you start to notice your mood slipping, feeling irritable and angry instead of happy and excited, it may indicate you are starting to get burned out. Typically, this happens because the demands of the job leave little time for self-care. When you are not getting enough sleep or eating healthy, you are going to suffer low moods and emotions. This leads to a quick temper and an overall feeling of irritability.
• No desire to attend social gatherings Teachers who are burnt out will not want to go to social gatherings. They stay in their classrooms on their lunch breaks rather than enjoying lunch with their colleagues. Outside of school, they turn down invitations when social events take place. The cut themselves off from the rest of the world as they try to manage all that is on their plates. They may even end up taking mental health days during the year to regroup and prepare to return to the classroom. If you notice yourself pulling away from social functions, you may be nearing the burnout stage.

 

• Increased complaints Burnout often leads to complaints. If you are noticing that the few conversations you have with your fellow teachers are all about complaints, then you may need to take a closer look at your emotional health. While teachers often have legitimate complaints, an overall complaining attitude, with the feeling that nothing can fix the problem, can be due to something a little deeper.
• Chronic fatigue or exhaustion Low energy levels that hit on an emotional level can be attributed to teacher burnout. Sure, all teachers go through periods, like the close of the quarter or the start of parent/teacher conferences, when they have a heavier than normal load and are tired, but if the fatigue and exhaustion have become chronic, leading to a dread of getting up and going to work the next day, then it could be due to burnout.
• Chronic insomnia On the other hand, some teachers will experience insomnia when they enter the burnout stage. If you are finding that you simply cannot sleep at night, or stay asleep, for more than a couple of nights per week, then you may have insomnia because of burnout. Sometimes insomnia and the chronic fatigue seem to be linked. You find yourself fully and completely exhausted long before the end of the day, but when the time comes to sleep, you cannot. Insomnia, especially when coupled with fatigue, is a sure sign of burnout.
• Change in appetite Teachers who are burnt out may stop eating, or they may find themselves eating more or less healthy options than they normally do. Changes in appetite and eating are often attributed to stress, and burnout is one of the highest levels of stress there is.
• Physical symptoms Physical symptoms, like a headache, stomach-ache, heart palpitation, chest pain, dizziness, or shortness of breath, occur when stress is overwhelming. Someone who has a sudden onslaught of these symptoms is likely experiencing teacher burnout or at least nearing the point of burnout.
• Brain fog Are you finding that it is difficult to pay attention to things that are normally important to you? Are your papers that need to be graded piling up, yet you simply cannot seem to focus to get them done? Are you becoming increasingly forgetful? These types of mental symptoms and brain fog concerns are a sure sign of teacher burnout.

  The solution to burnout If you feel that you are facing teacher burnout, or you notice some of these symptoms in one of your co-teachers, it is time to act. Building up resilience in yourself and the other teachers in your school will help you get through these challenging periods. If you are struggling, consider seeking outside professional help or implementing some of the methods discussed at a later stage in this course.[/vc_column_text][/vc_column][/vc_row]