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211 connects you to expert, caring help. Every call is completely confidential.

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This phone call has given me more hope than I ever thought possible. I have been beaten down for so long and told that I could never be anything. Just talking with you meant even more than all the resources you gave me.

United Way of Central Maryland 211 Client

Referrals to help and resources were made by the 211 network in 2022.

If it were not for your help, I don't know what I would have done without food. It's been too dangerous to go out and I can't afford to be at risk.

211 Miami Client

Average increase in 211 call volume throughout 2020 due to COVID-19 pandemic.

211 saved my life. It was below freezing, and I had nowhere to sleep. They helped me find a place to stay and create a plan to get my life back.

Cleveland 211 Client

People call 211 for assistance with housing, homelessness, and utility bills every year.

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Learn more about our work with partners like the Ad Council, IBM, Lyft, SingleCare, and join us today.

Not sure where to start? We can help. Call 211

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Get help paying bills, finding food, and locating other resources near you. Call 211 now for confidential help from a caring expert.

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LEGAL AND ETHICAL ISSUES IN REFERRALS TO MENTAL HEALTH PROVIDERS

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Scenario: When students need outside therapy, you always refer them to one particular counselor in the community, who came to your attention when a parent

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The purpose of the responsive services component is to intervene on behalf of those students whose immediate personal concerns or problems put their continued personal-social, career, and /or educational development at risk. Although counselors respond to any concerns presented by students, some topics have been identified as having high priority and/or relevance within the school setting. Topics of priority in Fort Worth ISD include:

School-based issues, such as

attendance

school attitudes and behaviors

peer relationships

study skills

being new to the school

emergent issues in intervention or prevention of a traumatic event; and

violence on campus (school safety)

academic success

school drop-outs

severe stress

substance abuse

school-age pregnancy

gang pressures/involvement

harassment issues

career decision

financial aid

college choice

Personal issues, such as

death of a family member or friend

family divorce

family abuse

harassment issues

adolescent and child suicide

child abuse and neglect

Parents Role in the Responsive Services
Parent involvement with and participation in activities of this component are essential to helping children overcome barriers to their educational process. They refer their children for help, work with school staff to specify their children's issues and give permission for needed student services including on-going counseling.

Some responses are preventive: interventions with students who are on the brink of choosing an unhealthy or inappropriate solution to their problems or being unable to cope with a situation. Some responses are remedial: interventions with students who have already made unwise choices or have not coped well with problem situations.

In this component as in the others, locally identified needs will dictate the priorities for problem topics and for the groups of students to be served. A developmental guidance and counseling program includes supplemental guidance and counseling services for students targeted by special funding sources such as students in compensatory, gifted, migrant, special, or career and technology education programs.

The school counselors counsel individuals or small groups of students, appraise individuals for the purpose of problem identification, consult with teachers and parents, refer students and/or their parents and teachers to other specialists or special programs, coordinate programs and services with other specialists, and follow-up with students to monitor their progress toward resolution of their problems. If applicable, they train and supervise peer facilitators. Often they conduct guidance sessions in response to teachers' requests to address problems of particular groups, such as competitiveness or stress with classroom groups of gifted students.

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Prevention & Crisis Response / Responsive Services

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The purpose of the responsive services component is to intervene on behalf of those students whose immediate personal concerns or problems put their continued personal-social, career, and /or educational development at risk. Although counselors respond to any concerns presented by students, some topics have been identified as having high priority and/or relevance within the school setting.

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Rex, M. (2017). What you say in here stays in here [Online Image]. Elementary School Counseling. http://www.elementaryschoolcounseling.org/

Smith, C. (2019). Let's check that self-care battery again [Online Image]. Counseling Essentials. https://www.counselorchelsey.com/

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Eating Recovery Center
4200 S Hulen St
Suite 436
Ft Worth, TX 76109-4914

The Eating Recovery Center provides comprehensive, integrated eating disorder treatment for female and male adults, adolescents and children.

Treatment programs, developed and overseen by a compassionate team of highly experienced eating disorders experts, include Inpatient, Residential, Partial Hospitalization and Intensive Outpatient levels of care.

Medical, psychiatric, psychological and nutritional programming elements give patients and families the necessary tools to achieve lasting behavioral change.

Resource services

Treatment, Eating Disorders, Partial Hospitalization Program (PHP), Intensive Outpatient Program (IOP), Telehealth, and Partial Hospitalization Program (PHP)

What is the phone number for your Crisis Hotline (if available)?

If you are familiar with this resource, we encourage the use of the Provide feedback option to inform us of anything that needs updating or you feel others should know about available services. Please be aware that we do not endorse or directly support any presented resource. Those seeking programs, services, or treatment are urged to verify each provider's credentials and certifications to confirm their expertise and quality of service.

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The Eating Recovery Center provides comprehensive, integrated eating disorder treatment for female and male adults, adolescents and children. Treatment programs, developed and overseen by a compassionate team of highly experienced eating disorders experts, include Inpatient, Residential, Partial Hospitalization and Intensive Outpatient levels of care.

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Home | NAMI: National Alliance on Mental Illness

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NAMI, the National Alliance on Mental Illness, is the nation's largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.

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My Health My Resources of Tarrant County - We change lives

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My Health My Resources of Tarrant County

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Centers for Disease Control and Prevention

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Being mentally healthy during childhood means reaching developmental and emotional milestones and learning healthy social skills and how to cope when there are problems. Mentally healthy children have a positive quality of life and can function well at home, in school, and in their communities.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, which cause distress and problems getting through the day. Many children occasionally experience fears and worries or display disruptive behaviors. If symptoms are serious and persistent and interfere with school, home, or play activities, the child may be diagnosed with a mental disorder.

Mental health is not simply the absence of a mental disorder. Children who don't have a mental disorder might differ in how well they are doing, and children who have the same diagnosed mental disorder might differ in their strengths and weaknesses in how they are developing and coping, and in their quality of life. Mental health as a continuum and the identification of specific mental disorders are both ways to understand how well children are doing.

What are common childhood mental disorders?

Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety (fears or worries), and behavior disorders.

Learn more about childhood mental disorders, symptoms, and treatment.

Other childhood disorders and concerns that affect how children learn, behave, or handle their emotions can include learning and developmental disabilities, autism, and risk factors like substance use and self-harm.

Read more about related conditions.

What are the symptoms of childhood mental disorders?

Symptoms of mental disorders change over time as a child grows, and may include difficulties with how a child plays, learns, speaks, and acts, or how the child handles their emotions. Symptoms often start in early childhood, although some disorders may develop during the teenage years. The diagnosis is often made in the school years and sometimes earlier; however, some children with a mental disorder may not be recognized or diagnosed as having one.

Can childhood mental disorders be treated?

Childhood mental disorders can be treated and managed. There are many treatment options based on the best and most current medical evidence. Parents and doctors should work closely with everyone involved in the child's treatment-teachers, coaches, therapists, and other family members. Taking advantage of all the resources available will help parents, health professionals, and educators guide the child towards success. Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders.

Get help finding treatment

If you have concerns about a child, you can use these resources to help you find a healthcare provider familiar with treatment options.

Who is affected?

Childhood mental disorders affect many children and families. Boys and girls of all ages and ethnic/racial backgrounds and living in all regions of the United States experience mental disorders. Based on the National Research Council and Institute of Medicine report, which gathered findings from previous studies, it is estimated that in 2007, 13-20% of children living in the United States (up to 1 out of 5 children) experienced a mental disorder in a given year, costing individuals, families, and society an estimated $247 billion per year.

What is the impact of mental disorders in children?

Mental health is important to overall health. Mental disorders are chronic health conditions-conditions that last a long time and often don't go away completely-that can continue through the lifespan. Without early diagnosis and treatment, children with mental disorders can have problems at home, in school, and in forming friendships. Mental disorders can also interfere with a child's healthy development, causing problems that can continue into adulthood.

Public health includes mental health

Supporting children's mental health also includes making sure children meet developmental milestones, understanding what to do when there is a concern, supporting positive parenting strategies, and improving access to care.

CDC works with partner agencies to better understand mental health and mental disorders and the impact they have on children.
Read more about research on children's mental health.
What you can do

Parents: You know your child best. Talk to your child's healthcare professional if you have concerns about the way your child behaves at home, in school, or with friends.

Youth: It is just as important to take care of your mental health as it is to take care of your physical health. If you are angry, worried or sad, don't be afraid to talk about your feelings and reach out to a trusted friend or adult.

Healthcare professionals: Early diagnosis and appropriate treatment based on updated guidelines are very important. There are resources available to help diagnose and treat children's mental disorders.

Teachers/school administrators: Early identification is important so that children can get the help they need. Work with families and healthcare professionals if you have concerns about the mental health of a child in your school.

Resources

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Learn more about mental health, mental disorders, treatments, prevention, and public health research on children's mental health.

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We are the only non profit organization directly involved with child abuse investigation.

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ACH works to protect children and preserves families. Our programs include Foster Care and Adoption, Crisis Intervention, Family Services, and Residential Services.

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Child Mind Institute | Transforming Children’s Lives.

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The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders.

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DropCatch.com helps you secure expiring domain names.

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In this 2-part podcast series, NAMI Chief Medical Officer Dr. Ken Duckworth guides discussions on early psychosis that offer insights from individuals, family members and mental health professionals. Read the transcript.
Note: Content includes discussions on topics such as suicide attempts and may be triggering.

Most people think of psychosis as a break with reality. In a way it is. Psychosis is characterized as disruptions to a person's thoughts and perceptions that make it difficult for them to recognize what is real and what isn't. These disruptions are often experienced as seeing, hearing and believing things that aren't real or having strange, persistent thoughts, behaviors and emotions. While everyone's experience is different, most people say psychosis is frightening and confusing.

Psychosis is a symptom, not an illness, and it is more common than you may think. In the U.S., approximately 100,000 young people experience psychosis each year. As many as 3 in 100 people will have an episode at some point in their lives.

Early or first-episode psychosis (FEP) refers to when a person first shows signs of beginning to lose contact with reality. Acting quickly to connect a person with the right treatment during early psychosis or FEP can be life-changing and radically alter that person's future. Don't wait to take the first step and prepare yourself with information by reviewing these tip sheets:

What is Early and First-Episode Psychosis?
Early Psychosis: What's Going on and What Can You Do?
Encouraging People to Seek Help for Early Psychosis
Early Intervention: Tips for School Staff and Coaches

Symptoms

Early warning signs before psychosis

Early psychosis or FEP rarely comes suddenly. Usually, a person has gradual, non-specific changes in thoughts and perceptions, but doesn't understand what's going on. Early warning signs can be difficult to distinguish from typical teen or young adult behavior. While such signs should not be cause for alarm, they may indicate the need to get an assessment from a doctor.

Encouraging people to seek help for early psychosis is important. Families are often the first to see early signs of psychosis and the first to address the issue of seeking treatment. However, a person's willingness to accept help is often complicated by delusions, fears, stigma and feeling unsettled. In this case, families can find the situation extremely difficult, but there are engagement strategies to help encourage a person to seek help.

It's important to get help quickly since early treatment provides the best hope of recovery by slowing, stopping and possibly reversing the effects of psychosis. Early warning signs include the following:

A worrisome drop in grades or job performance

Trouble thinking clearly or concentrating

Suspiciousness or uneasiness with others

A decline in self-care or personal hygiene

Spending a lot more time alone than usual

Strong, inappropriate emotions or having no feelings at all

Signs of early or first-episode psychosis

Determining exactly when the first episode of psychosis begins can be hard, but these signs and symptoms strongly indicate an episode of psychosis:

Hearing, seeing, tasting or believing things that others don't

Persistent, unusual thoughts or beliefs that can't be set aside regardless of what others believe

Strong and inappropriate emotions or no emotions at all

Withdrawing from family or friends

A sudden decline in self-care

Trouble thinking clearly or concentrating

Such warning signs often point to a person's deteriorating health, and a physical and neurological evaluation can help find the problem. A mental health professional performing a psychological evaluation can determine if a mental health condition is involved and discuss next steps. If the psychosis is a symptom of a mental health condition, early action helps to keep lives on track.

Psychosis

Psychosis includes a range of symptoms but typically involves one of these two major experiences:

Hallucinations are seeing, hearing or feeling things that aren't there, such as the following:

Hearing voices (auditory hallucinations)

Strange sensations or unexplainable feelings

Seeing glimpses of objects or people that are not there or distortions

Delusions are strong beliefs that are not consistent with the person's culture, are unlikely to be true and may seem irrational to others, such as the following:

Believing external forces are controlling thoughts, feelings and behaviors

Believing that trivial remarks, events or objects have personal meaning or significance

Thinking you have special powers, are on a special mission or even that you are God.

Causes

We are still learning about how and why psychosis develops, but several factors are likely involved. We do know that teenagers and young adults are at increased risk of experiencing an episode of psychosis because of hormonal changes in their brain during puberty.

Several factors that can contribute to psychosis:

Genetics. Many genes can contribute to the development of psychosis, but just because a person has a gene doesn't mean they will experience psychosis. Ongoing studies will help us better understand which genes play a role in psychosis.

Trauma. A traumatic event such as a death, war or sexual assault can trigger a psychotic episode. The type of trauma-and a person's age-affects whether a traumatic event will result in psychosis.

Substance use. The use of marijuana, LSD, amphetamines and other substances can increase the risk of psychosis in people who are already vulnerable.

Physical illness or injury. Traumatic brain injuries, brain tumors, strokes, HIV and some brain diseases such as Parkinson's, Alzheimer's and dementia can sometimes cause psychosis.

Mental health conditions. Sometimes psychosis is a symptom of a condition like schizophrenia, schizoaffective disorder, bipolar disorder or depression.

Diagnosis

A diagnosis identifies an illness; symptoms are components of an illness. Health care providers draw on information from medical and family history and a physical examination to diagnose someone. If causes such as a brain tumor, infection or epilepsy are ruled out, a mental illness might be the reason.

If the cause is related to a mental health condition, early diagnosis and treatment provide the best hope of recovery. Research shows that the earlier people experiencing psychosis receive treatment, the better their long-term quality of life.

Treatment

Early or first-episode psychosis

Early treatment of psychosis, especially during the first episode, leads to the best outcomes.

Research has shown significant success using a treatment approach called Coordinated Specialty Care (CSC). CSC uses a team of health professionals and specialists who work with a person to create a personal treatment plan based on life goals while involving family members as much as possible.

CSC has the following key components:

Case management

Family support and education

Psychotherapy

Medication management

Supported education and employment

Peer support

SAMHSA maintains an Early Serious Mental Illness (ESMI) Treatment Locator as a source of information for family members who are seeking CSC programs in the US. Portions of their website are available in Spanish.

Psychosis treatment

Traditional treatment for psychosis involves psychotherapy and medication. Several types of therapy have successfully helped individuals learn to manage their condition. In addition, medication targets symptoms and helps reduce their impact.

Related Conditions

Psychosis can be related to several mental health conditions:

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In this 2-part podcast series, NAMI Chief Medical Officer Dr. Ken Duckworth guides discussions on early psychosis that offer insights from individuals, family members and mental health professionals. Read the transcript. Note: Content includes discussions on topics such as suicide attempts and may be triggering. Most people think of psychosis as a break with reality.

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Psychotic disorders are a group of serious illnesses that affect the mind. They make it hard for someone to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality, and behave appropriately.

When symptoms are severe, people with psychotic disorders have trouble staying in touch with reality and often are unable to handle daily life. But even severe psychotic disorders usually can be treated.

Types

There are different types of psychotic disorders, including:

Schizophrenia: People with this illness have changes in behavior and other symptoms -- such as delusions and hallucinations -- that last longer than 6 months. It usually affects them at work or school, as well as their relationships. Know the early warning signs of schizophrenia.

Schizoaffective disorder: People have symptoms of both schizophrenia and a mood disorder, such as depression or bipolar disorder. Learn more about the symptoms of schizoaffective disorder.

Schizophreniform disorder: This includes symptoms of schizophrenia, but the symptoms last for a shorter time: between 1 and 6 months. Find out more on schizophreniform disorder symptoms to look for.

Continued

Brief psychotic disorder: People with this illness have a sudden, short period of psychotic behavior, often in response to a very stressful event, such as a death in the family. Recovery is often quick -- usually less than a month. Get more information about the different forms of brief psychotic disorder.

Delusional disorder The key symptom is having a delusion (a false, fixed belief) involving a real-life situation that could be true but isn't, such as being followed, being plotted against, or having a disease. The delusion lasts for at least 1 month. Read more on the types of delusions.

Shared psychotic disorder (also called folie à deux): This illness happens when one person in a relationship has a delusion and the other person in the relationship adopts it, too. Learn more about shared psychotic disorder and how it develops.

Substance-induced psychotic disorder: This condition is caused by the use of or withdrawal from drugs, such as hallucinogens and crack cocaine, that cause hallucinations, delusions, or confused speech. Find out more on substance-induced psychosis and other causes of secondary psychosis.

Continued

Psychotic disorder due to another medical condition: Hallucinations, delusions, or other symptoms may happen because of another illness that affects brain function, such as a head injury or brain tumor.

Paraphrenia: This condition has symptoms similar to schizophrenia. It starts late in life, when people are elderly.

Symptoms

The main ones are hallucinations, delusions, and disordered forms of thinking.

Hallucinations means seeing, hearing, or feeling things that don't exist. For instance, someone might see things that aren't there, hear voices, smell odors, have a "funny" taste in their mouth, or feel sensations on their skin even though nothing is touching their body.

Delusions are false beliefs that don't go away even after they've been shown to be false. For example, a person who is certain their food is poisoned, even if someone has shown them that the food is fine, has a delusion.

Other possible symptoms of psychotic illnesses include:

Disorganized or incoherent speech

Confused thinking

Strange, possibly dangerous behavior

Slowed or unusual movements

Loss of interest in personal hygiene

Loss of interest in activities

Problems at school or work and with relationships

Cold, detached manner with the inability to express emotion

Mood swings or other mood symptoms, such as depression or mania

People don't always have the same symptoms, and they can change over time in the same person.

Causes

Doctors don't know the exact cause of psychotic disorders. Researchers believe that many things play a role. Some psychotic disorders tend to run in families, which means that the disorder may be partly inherited. Other things may also influence their development, including stress, drug abuse, and major life changes.

People with certain psychotic disorders, such as schizophrenia, may also have problems in parts of the brain that control thinking, perception, and motivation.

In schizophrenia, experts believe that nerve cell receptors that work with a brain chemical called glutamate may not work properly in specific brain regions. That glitch may contribute to problems with thinking and perception.

These conditions usually first appear when a person is in their late teens, 20s, or 30s. They tend to affect men and women about equally.

Diagnosis

To diagnose a psychotic disorder, doctors will take a medical and psychiatric history and possibly perform a brief physical exam. The person may get blood tests and sometimes brain imaging (such as MRI scans) to rule out physical illness or drug use like cocaine or LSD.

If the doctor finds no physical reason for the symptoms, they may refer the person to a psychiatrist or psychologist. These mental health professionals will use specially designed interview and assessment tools to decide whether the person has a psychotic disorder.

Treatment

Most psychotic disorders are treated with a combination of medications and psychotherapy, which is a type of counseling.

Medication: The main type of drug that doctors prescribe to treat psychotic disorders are "antipsychotics." Although these medicines aren't a cure, they are effective in managing the most troubling symptoms of psychotic disorders, such as delusions, hallucinations, and thinking problems.

Older antipsychotics include:

Newer "atypical antipsychotics" include:

Doctors usually first prescribe the newer ones because they have fewer and more tolerable side effects than older antipsychotics. Some of the medications are available by injection and only need to be taken once or twice a month or even every three months. This can be easier to manage than remembering to take a daily pill.

Continued

Psychotherapy: There are different types of counseling -- including individual, group, and family therapy - that can help someone who has a psychotic disorder.

Most people with psychotic disorders are treated as outpatients, meaning they don't live in institutions. But sometimes people need to be hospitalized, such as if they have severe symptoms, are in danger of hurting themselves or others, or can't care for themselves because of their illness.

Recovery

Each person being treated for a psychotic disorder may respond to therapy differently. Some will show improvement quickly. For others, it may take weeks or months to get symptom relief.

Some people may need to continue treatment for an extended period of time. Some, such as those who have had several severe episodes, may need to take medication indefinitely. In these cases, the medication usually is given in as low a dose as possible to minimize side effects.

What Is the Outlook for People With Psychotic Disorders?

The depends on the type of psychotic disorder and the person who has it. But these disorders are treatable, and most people will have a good recovery with treatment and close follow-up care.

Can Psychotic Disorders Be Prevented?

No. But the sooner treatment starts, the better. It helps to prevent symptoms. Seeking help as soon as possible can help the person's life, family, and relationships.

For people who are at high risk for psychotic disorders, such as those who have a family history of schizophrenia, avoiding drugs such as marijuana and alcohol may help to prevent or delay these conditions.

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Psychotic disorders are a group of serious illnesses that affect the mind. They make it hard for someone to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality, and behave appropriately. When symptoms are severe, people with psychotic disorders have trouble staying in touch with reality and often are unable to handle daily life.

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Definition

Students with emotional disorders are a very heterogeneous group with a wide range of issues that are unique to each individual. However, there are some key characteristics that are used to define this disability category, mostly relating to issues of personal identity and emotional well-being. An emotional disorder may be present if a student responds to a situation with an inappropriate behavior or emotion, and particularly, if this emotion is depression or long term unhappiness. Students with emotional disorders typically have a very difficult time maintaining personal relationships with others, and these personal problems lead to physical symptoms in time. If the student has difficulty learning, but there is no intellectual or sensory cause of this difficulty, then an emotional disorder may be to blame. This disability category does include some mental illnesses such as schizophrenia.

It should be noted that one or more of the previously mentioned characteristics has to be present for an extended period of time, and must have a negative impact on the student's academic performance before being considered an emotional disorder. Signs of an emotional disorder need to be taken seriously, as they can lead to physical aggression and self-injurious behavior. However, care must also be taken to recognize the difference between emotional disturbance and general teenage angst. There are as many causes of emotional disturbance in children as there are children in this category, but they can generally be divided into either biological causes, environmental causes, or a combination of the two.

Prevalence

The U.S. Department of Education reports 5,971,495 students receiving special education services in the 2003-2004 school year. Of that number, roughly 7.7%, or 461,055 students, received special education services based on a classification of emotional disturbance. However, within this group of 461,055 students, there was a definite disproportionally between gender, race and socioeconomic background. African-American students were far more likely to be diagnosed as emotionally disturbed than white students, reflecting possible race bias in this category. Research has pointed to a direct correlation between low income status and emotional disorders, but the exact reasons for this correlation are unknown.

Characteristics

Each student with an emotional disturbance will have characteristics that are unique to that individual. However, these students will all share deficits in three specific areas, namely emotional development, behavioral development, and cognitive development.

These students may have specific emotional characteristics/conditions such as anxiety disorder, mood disorder, oppositional defiant disorder, conduct disorder, and schizophrenia. Not addressing any one of these disorders with the appropriate support system could have potentially tragic results. Behavioral characteristics of an emotional disorder include externalizing behavior and conversely internalizing behavior. The former can result in problem behavior and physical aggression while the latter results in depression and anxiety. Finally, students with emotional disorders have a number of academic issues as well, and each year half of the students in this category drop out of school entirely.

One intriguing possible contributing factor to emotional disturbance can be found in deficits in communication. An estimated 71% of students with emotional disorders also have expressive and receptive language disorders that impact their ability to understand and communicate with peers and adults.

Impact on Learning

Students with emotional disorders can be found at every level of cognitive functioning, but the majority of these students tend to have low average intelligence. Most achieve below grade level in academic achievement, with the greatest deficits in both math and spelling. Many have a coexisting learning disability of some type. Students that exhibit externalizing behaviors are at the greatest risk for continued deficits in academic functioning. Students with emotional disorders are less likely to attend post-secondary school than students in many other disability categories. An effective educational program for students with emotional disorders will provide emotional and behavioral supports that foster the replacement of problem behaviors with more appropriate behaviors. Positive behavior support systems are one especially effective strategy to achieve this goal, as are the implementation of wraparound services.

Teaching Strategies

Wraparound planning is a collaborative process that has shown great promise in supporting students with emotional disorders, both in research and in more practical application. This planning process brings all of the involved service providers (i.e., adult rehabilitation services, mental health services, guidance counselor) and individuals together to create a natural support system that is founded on the strengths of the individual student and the community in which that student lives. The family is an integral part of this process, and the overall goal is to devise a program that will capitalize on the strengths and interests of the student while utilizing community resources for placement and intervention.

Generally, academic achievement and problem behaviors often go hand-in-hand for students with emotional disorders. To put this another way, the more difficulty they have with a classroom task, the more likely that maladaptive behavior will result. Supporting the academic performance of these students will thus have the added benefit of decreasing externalizing and internalizing behaviors. Best practices for students with emotional disorders are often best practices for all students. A strategy such as allowing students to choose between classroom tasks, for example, is an effective way to decrease problem behaviors in general. Consistent and specific praise is also a great technique to utilize with all students in the classroom, but can be particularly effective with students with emotional disorders.

It is very important to not make assumptions about any family of a child with an emotional disorder. Many emotional disorders have an organic cause, and the parents of the child may well be loving and supportive in every way. However, some of these students have indeed been abused in some fashion in their young lives, and this too can be a cause of emotional or behavioral issues. Trust can be a very large issue for these children. Forming a relationship with these students that is built on empathy, trust, and mutual respect can often be the solution to many problem behaviors, and can have a lasting impact of the emotional development of the child.

Assistive Technology

Some modification in instruction will be necessary to allow a student with an emotional disorder to demonstrate mastery in a number of academic areas, and most especially in the area of writing. Word processing software can be an excellent supplementary aid for these students, allowing them to edit and revise their work as they produce it. These programs can strengthen spelling skills and writing cohesion simply by making the writing process easier overall. Of particular benefit are word processing programs that read the text as it is typed, providing an additional audio cue for the student.

Organizations

There are a number of excellent organizations that can help support classroom instruction for students with emotional and behavioral disabilities. The information presented in this module is intended as just a very brief description of emotional disorder and its impact on learning. Much more in-depth information and instructional strategies can be accessed through the following organizations:

American Academy of Child and Adolescent Psychiatry

The AACAP (American Academy of Child and Adolescent Psychiatry) is the leading national professional medical association dedicated to treating and improving the quality of life for children, adolescents, and families affected by these disorders. Composed of over 7,500 child and adolescent psychiatrists and other interested physicians, its members actively research, evaluate, diagnose, and treat psychiatric disorders and pride themselves on giving direction to and responding quickly to new developments in addressing the health care needs of children and their families.

Public Information Office
3615 Wisconsin Ave., NW
Washington, DC 20016-3007

Web: www.aacap.org

Center on Positive Behavioral Interventions and Supports

The OSEP-funded National Technical Assistance Center on Positive Behavior and Intervention Supports was established to address the behavioral and discipline systems needed for successful learning and social development of students. The Center provides capacity-building information and technical support about behavioral systems to assist states and districts in the design of effective schools.

5262 University of Oregon
Eugene, OR 97403-5262

Email: pbis@oregon.uregon.edu
Web: www.pbis.org

Center for Disability and Development

Dept. of Educational Psychology
4225 Texas A&M University
College Station, TX 77843-4225

Council for Exceptional Children

The Council for Exceptional Children (CEC) is the largest international professional organization dedicated to improving educational outcomes for individuals with exceptionalities, students with disabilities, and/or the gifted. CEC advocates for appropriate governmental policies, sets professional standards, provides continual professional development, advocates for newly and historically underserved individuals with exceptionalities, and helps professionals obtain conditions and resources necessary for effective professional practice.

1110 North Glebe Road, Suite 300
Arlington, VA 22201-5704

Federation of Families for Children's Mental Health

This organization is dedicated exclusively to helping children with mental health needs and their families achieve a better quality of life. They provide leadership to develop and sustain a nationwide network of family-run organizations; focus the passion and cultural diversity of our membership to be a potent force for changing how systems respond to children with mental health needs and their families; help policy-makers, agencies, and providers become more effective in delivering services and supports that foster healthy emotional development for all children.

1101 King Street, Suite 420
Alexandria, VA 22314

Email: ffcmh@ffcmh.org
Web: www.ffcmh.org

National Alliance for the Mentally Ill (NAMI)

NAMI is the National Alliance on Mental Illness, the nation's largest grassroots organization for people with mental illness and their families. NAMI is dedicated to the eradication of mental illnesses and to the improvement of the quality of life for persons of all ages who are affected by mental illnesses. NAMI members and friends work to fulfill our mission by providing support, education, and advocacy.

Colonial Place Three
2107 Wilson Boulevard, Suite 300
Arlington, VA 22203-3754

Web: www.nami.org

Mental Health America

Mental Health America is dedicated to helping ALL people live mentally healthier lives. They work to fulfill this mission by education the public about ways to preserve and strengthen mental health; advocating for access to effective care; fostering innovation in research, practice, services and policy; and providing support to individuals and families.

2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311

Web: www.nmha.org

National Mental Health Information Center

The National Mental Health Information Center was developed for users of mental health services and their families, the general public, policy makers, providers, and the media. They provide free information about mental health via a toll-free number, their website, and more than 600 publications.

P.O. Box 42557
Washington, DC 20015

Web: www.mentalhealth.org

References

Hunt, N., and Marshall, K. (2006). Exceptional children and youth. Boston, MA: Houghton Mifflin Company.

National Dissemination Center for Children with Disabilities (2004). Fact Sheet 5. Retrieved February 1, 2008 from www.nichcy.org/pubs/factshe/fs5txt.htm.

Turnbull, A., Turnbull, R. & Wehmeyer, M. L. (2007). Exceptional lives. Special education in today's schools. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

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Students with emotional disorders typically have a hard time maintaining relationships, and these personal problems may lead to physical symptoms in time.

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Offering kids choices, safe spaces, and positive reinforcement can help teachers avoid problems-or manage them when they arise.

Elliott Golden / The iSpot

Most children will, at times, argue and test limits. Yet some kids are defiant and hostile to a degree that interferes with their daily lives-behavior that's sometimes diagnosed as Oppositional Defiant Disorder, or ODD, according to a story by WeAreTeachers.

"Students with ODD disrupt their own lives and often the lives of everyone nearby," write the report's authors. "[They] push the limits of defiance far beyond reason. Their problem behavior is much more extreme than that of their peers, and it happens much more often."

According to the American Academy of Child & Adolescent Psychiatry, kids with ODD exhibit "an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the child's day-to-day functioning," for six months or more. Symptoms like frequent temper tantrums, excessive arguing with adults, and mean and hateful speech when upset, are usually seen across multiple settings, but especially at home or school. While a direct cause remains unclear, "biological, psychological, and social factors may have a role," the academy notes. Up to 16 percent of children may have the disorder, and children with ADHD are especially prone.

Though a teacher's first reaction to ODD might be to react defensively, this can backfire and create a power struggle with the student, say experts. Instead, teachers who've worked with students with ODD recommend a set of strategies that will address challenging behavior, and help you start building relationships with hard-to-reach students.

"We all have the capacity to learn, change, and grow," writes special education teacher Nina Parrish. "When given the right tools and environment, students with problematic behavior can learn more productive strategies that will help them have positive and effective interactions with others."

1. Be Calm and Consistent: As a new teacher, Parrish says she quickly learned that reacting with anger when her students with ODD acted out made the behavior worse and students became "amused or encouraged by upsetting an adult." Instead, Parrish recommends trying to keep a positive tone to your voice, adopting neutral body language, and being "cautious about approaching the student or entering their personal space as this might escalate the situation."

Consistency with words and actions is also important when working with kids with ODD. Teacher Brandy T. tells WeAreTeachers she routinely uses the same set of "trigger words" so her students know she's serious. When students in her class begin to argue with her, "I simply say either, 'not now,' 'later,' or 'fix the issue.'" When her students hear 'fix the issue,' for example, she says that's the signal to "go to their chill-out space if they need to calm down."

2. Reinforce Positive Behavior: For all kids, but especially children with ODD, it's important to "switch your focus from recognizing negative behavior to seeking out demonstrations of positive behavior," writes Parrish. She sends home positive notes when students show behavior improvements, even if they're small gains.

Additionally, consider offering students the opportunity to earn certain privileges, suggests WeAreTeachers, rather than "taking those privileges away as punishment." For example, give kids the opportunity to earn rewards-like a bit of iPad time or lunch with a teacher.

3. Find Out What's Going On: Behaviors, notes Parrish, help students "obtain something desirable, or escape something undesirable." She suggests thinking about behavior as feedback, or a way of communicating, an approach that's "helped me work more effectively as a teacher with students who display problem behaviors." Figuring out factors that contribute to students with ODD acting out can help you develop a plan for addressing their difficult behaviors in the classroom.

Sometimes, it's a matter of picking up on a student's signals that their emotions are building long before things reach a breaking point. When students who've experienced trauma are beginning to feel upset, they often show physical signs of their mounting distress: balling up fists, withdrawing from classroom interaction, or clenching their jaw, writes Micere Keels, an associate professor at the University of Chicago and a trauma-informed educator.

"Many educators tend to ignore students' increasing signs of agitation, hoping they'll eventually calm down. But when disregarded, these minor behaviors can quickly escalate," writes Keels, who also recommends identifying students' triggers, like touch or emotionally difficult anniversaries, to avoid situations entirely.

4. Create a Safe Reset Space: Kids with ODD "can learn to recognize when they're feeling overwhelmed and getting ready to challenge or defy," according to WeAreTeachers. "Giving them a safe space to calm down and rethink their choices can be beneficial."

At Fall-Hamilton Elementary, a trauma-informed school in Nashville, Tennessee, for example, every classroom has a nook-called a peace corner-with a comfortable seat, a timer, and items like stuffed animals, sensory squeeze toys, and simple drawing and writing supplies. It's a spot where kids can take a break and reset. The school also recognizes that teachers may need a time out too. Using a strategy called Tap-in/Tap-Out, teachers can ask a colleague via text message to briefly cover their class if they are about to lose their cool.

"A dysregulated adult cannot regulate a dysregulated child," says school principal Mathew Portell. "Use strategies that honor the student's emotions and need for space while also getting their systems to calm in a safe way."

5. Offer Choices: It's important to "affirm your students' autonomy by giving them choices," writes Keels, about best practices for de-escalation. When kids feel respected, "their sense of belonging and mood will often improve."

She recommends avoiding ultimatums like "You better sit back down or I'll send you to the office." Instead, clearly communicate expectations and limits so kids understand. You might say, "I see you're upset, but it's not OK to yell at me. You can either go get a drink of water and come back in five minutes, or sit in the reading chair and I will check in with you in five minutes," says Keels.

In the heat of the moment, it's important to avoid an argument, teacher Holli A. tells WeAreTeachers. "State your choices, then walk away," she says. "Give the student time to process and decide which choice to make. If they don't like the choices, don't engage. When they try to argue, repeat the choices, and walk away again. If the student still will not choose, they do not get to participate in their preferred activity."

6. Build Connections: Often, kids with ODD "are looking for a relationship with a teacher who can help them deal with problems on their own, instead of making them stand out in a negative way," according to WeAreTeachers. "Building a connection with them will help get to the root of the behavior."

Though teachers can feel the need to create boundaries with students, simply talking with them informally can build invaluable connections that influence their behavior in the classroom, says middle school math teacher Cicely Woodard.

Woodard says she intentionally makes herself approachable to students and tries to learn interesting details about them. "Some of my students tell me stories about their lives during the five minutes between classes," Woodard says. "I stop what I am doing, look them in the eyes, and listen."

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Offering kids choices, safe spaces, and positive reinforcement can help teachers avoid problems-or manage them when they arise.

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OCD is like an unwelcome guest with bad manners. It moves into a mind - and it doesn't want to leave.
Students with OCD may appear to be daydreaming, distracted, disinterested, or even lazy. They may seem unfocused and unable to concentrate. But they are really very busy focusing on their nagging urges or confusing, stressful, and sometimes terrifying OCD thoughts and images. They may also be focused on completing rituals, either overtly or covertly, to relieve their distress.

While frustrating to educators, OCD may be torture for the students who have it. This disorder may be difficult to identify because its observable symptoms are similar to other conditions and mental disorders, and mental rituals cannot be observed. Symptoms in children and adolescents can change over time, and they tend to wax and wane for no apparent reason. School personnel who have a good understanding of the variety of behaviors that may signal OCD are better equipped to initiate a plan to assist the student.

The Effect of OCD on Academic Performance

Even very bright and motivated students can struggle with OCD. Although students with OCD typically have average to above-average intelligence levels, they may be unable to learn the same way others do because their focus is frequently on their obsessions or compulsions. Depending on the severity of the symptoms, some students find it difficult to learn and, for some, it's almost impossible to concentrate on and complete schoolwork.

Although they want to pay attention, participate in discussions or presentations, study, and complete homework, they feel compelled to respond to their obsessions or urges.

Students who have untreated OCD re likely to have a very difficult time concentrating in the classroom and completing homework assignments. They may experience overwhelming anxiety or strong urges, possibly describing the feeling of mounting anxiety or intensifying urges as if they were a rising volcano or a tea kettle about to boil - and relief comes when the pressure is released. Unfortunately, the release is usually a compulsive behavior that may be disruptive to learning and possibly to the classroom.

It may not be long before the student who has OCD falls behind and sees a drop in grades. In some cases, academic performance deteriorates abruptly and dramatically. And it may be nearly impossible to catch up unless a student can learn to manage the symptoms. For these reasons, it's important that school personnel take OCD seriously and work with the student and the family to provide support.

What Does OCD Look Like at School?

A student may enter a classroom at the beginning of the school year with a diagnosis of OCD, or the disorder may develop later. Whenever a student begins to falter - academically, socially, or emotionally - educators need to intervene. A proactive approach can make an impressive difference in a student's coping ability, academic performance, and interpersonal capabilities.

The first step is being aware of the behaviors that can signal OCD. The disorder includes a wide variety of symptoms in children and adolescents, which are not always obvious. It is important to keep in mind that OCD symptoms can look like other disorders, so it is critical that a mental health specialist trained in OCD and related disorders conduct a diagnostic assessment OCD can be confused for symptoms of ADHD and anxiety disorders, as well as acting out" or misbehavior not associated with a neurobiological disorder. Also, OCD changes in nature or scope from one set of obsessions and compulsions to another, with differing behaviors, and symptoms can worsen and or seem to disappear, often for no obvious reason.

Common Symptoms of OCD at School

Below are common OCD symptoms of children and adolescents in school.

Obsession: Fears of germs or contamination
Compulsions
* Repeatedly washing hands, using antibacterial wipes or hand-sanitizer
* Protecting what is perceived as clean space -- personal desk, locker, or other property
* Avoiding touching surfaces that others may have touched, such as doorknobs, desks, shared supplies, lab tables or equipment, computer keyboards, paints, paste, soap, cafeteria trays, etc.
* Avoiding contact play or sports either because of a fear of catching a disease or fear of contaminating another student
* Avoiding the use of bathrooms
* Seeking reassurance that they or others are not sick or dirty
* Refusing to share items or supplies with others
* Refusing to eat in the cafeteria
* Avoiding certain products because they may contain poison, such as substances used in chemistry

Obsession: Fears that harm, illness, or death, will befall oneself or others; fear of causing harm to oneself or others, including violent or aggressive obsessions (Note: People with OCD who have violent or aggressive thoughts do not have a history of violence or act upon these urges or ideas.)
Compulsions
* Checking behavior, such as making sure doors or windows are locked or turning light switches on and off repeatedly
* Reading a paragraph over and over again to prevent harm from coming to a loved one, another person, or a pet.
* Asking the teacher for reassurance that the student is safe
* Avoiding leaving a perceived safe zone (classroom); avoiding going into unsafe zones (lunch or recess areas) or open spaces such as a gymnasium
* Unreasonable avoidance of peers, teachers, for fear of causing them harm

Obsession: Fears that harm, illness, or death, will befall oneself or others; fear of causing harm to oneself or others, including violent or aggressive obsessions ( Note: People with OCD who have violent or aggressive thoughts do not act upon these urges or ideas OR have a history of violence.)
Compulsions
* Checking behavior, such as making sure doors or windows are locked or turning light switches on and off repeatedly
* Reading a paragraph over and over again to prevent harm from coming to a loved one, another person, or a pet.
* Asking the teacher for reassurance that the student is "safe"
* Avoiding leaving a perceived "safe" zone (classroom); avoiding going into "unsafe" zones (lunch or recess areas) or open spaces such as a gymnasium
* Unreasonable avoidance of peers, teachers, for fear of causing them harm

Obsession: Fears, feelings, or urges related to numbers
Compulsions
* Counting, touching, or saying words a certain number of times due to believing in a magical significance to certain numbers or using those numbers to keep harm away; counting the number of steps between locations and having to start over if interrupted
* Touching objects a certain number of times; not being able to move on unless this touching has been accomplished
* Reading words or pages a certain number of times
* Going back and forth through doorways a certain number of times before it's OK to enter the room
* Avoiding using certain numbers that are perceived as unlucky or not safe; only using numbers that are perceived as safe or lucky. (math problems may be answered improperly, pages may not be read or pages may be numbered out of sequence )

Obsession: Fears, feelings, or urges related to discarding items because something bad will happen; feelings of incompleteness if something is discarded or the need document and preserve all life experiences; fears of contamination; need to buy items in multiples of a particular number; not discarding objects to avoid repetitive rituals such as washing or checking. (Note: This form of hoarding is related to the obsessions and compulsions of OCD and is distinct from hoarding disorder.)
Compulsions
* Saving scraps of paper, candy wrappers, bottle caps, broken items, or other useless items; inability to part with unneeded things
* Keeping books, toys, food, school papers, clothing, or other items for fear that they might be needed sometime in the future
* Buying every item in a store that one has touched (and therefore contaminated) to prevent others from being contaminated
* Accumulating items or objects in a particular area (desk drawer) because they are contaminated and cannot be touched
* Buying multiples of the same item (buying three of everything because it's a magic number)

Obsession: Scrupulosity, or the excessive fear of violating religious or moral rules
Compulsions
* Apologizing or confessing that something is wrong, such as breaking religious, classroom, or school rules
* Constantly seeking reassurance that a task has been completed right or perfectly; seeking affirmation that a mistake was not made
* Saying prayers a certain number of times; excessive praying to atone for being bad; repeatedly confessing perceived sins or bad behavior
* Repetitive praying, confessing to neutralize or undo bad thoughts, intrusive sexual thoughts, or visions of cursing or blaspheming in school or church
* Avoiding answering questions for fear of telling a lie

Obsession: Fears, feelings, or urges related to symmetry or order
Compulsions
* Constantly evening up books or other items on a shelf or desk; aligning edges to be even
* Rearranging items to be in a certain order, such as by color or alphabetical order
* Avoiding a room with square tiles because seeing the tiles would require tracing each of the edges visually
* Fears, feelings, or urges related to sexual content
* Seeking reassurance that one is not gay or lesbian, despite being heterosexual
* Excessive praying to atone for having inappropriate sexual thoughts or images
* Avoiding magazines, books, DVDs, websites, or other media for fear of seeing sexual content

Obsession: Excessive doubting or dread of uncertainty
Compulsions
* Constantly rechecking to see that everything is in a backpack or book bag
* Asking to leave the classroom to recheck a locker or its contents
* Avoiding a school locker to prevent checking the lock over and over again

Obsession: Fears, feelings, or urges related to having something just right or perfect
Compulsions
* Getting up and sitting down repeatedly at a desk, until feeling just right
* Repeatedly revising the way letters, words, or numbers are written to make them look just right; getting stuck rewriting the same letter or word
* Repeatedly filling in circles on answer sheets; getting stuck on one or two questions because too much time is spent carefully filling in the circles, erasing, refilling until it looks perfect
* Erasing and rewriting words over and over
* Extreme slowness with activities or school work until everything is just right
* Repeating various actions for no apparent reason
* Avoiding a hallway until walking in it until it feels just right

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OCD is like an unwelcome guest with bad manners. It moves into a mind - and it doesn't want to leave. Students with OCD may appear to be daydreaming, distracted, disinterested, or even lazy. They may seem unfocused and unable to concentrate.

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Strategies for Working with Students with ADHD

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Strategies for Working with Students with ADHD

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Strategies for ADHD: How Counselors Help Today’s Students Succeed

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An estimated 11% of school-aged children are diagnosed with attention deficit hyperactivity disorder (ADHD) — but what does that diagnosis really look like, and what strategies are available to students? Here, we spoke with Counseling@NYU’s Professor Anil Chacko about how parents, teachers and schoo…

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Anxious students may not be able to verbalize the specific cause of their anxiety; they just know they are experiencing excessive and ongoing worry and/or fear about something. They may avoid situations or activities in school. They may start to decline in academics and have trouble focusing and concentrating, which many school counselors and teachers may confuse with ADHD. However, anxious students also typically exhibit other symptoms, which tend to become a pattern, such as always being sick on test day. Students with anxiety also may have irrational and negative thoughts.

Anxiety symptoms may present differently among students at different ages, who may not be able to express what's causing their anxiety and may instead exhibit symptoms. It is vital to be on the lookout for any of these symptoms:

attendance problems

clinginess/separation anxiety

panic attacks

academic problems/decline in schoolwork

frequent urination

frequent crying

difficulty concentrating/staying focused

blushing/sweating

feeling weak/tired

excessive worrying

health problems such as headaches or an upset stomach

avoidance of people/situations

sleeping problems

lots of "what ifs?"

Everyone has bad days and may exhibit one or more of these symptoms, but a pattern should raise red flags. Although diagnosing anxiety is not the school counselor's job, it is important to be cognizant of the types of anxiety disorders. These can include generalized anxiety, separation anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety or panic disorder. Any of these can affect a student's ability to perform well in school. Students with anxiety may also be at risk for developing other mental health issues, such as depression, drug/alcohol use and suicidal ideation.
Steps to Support Students
Experiencing anxiety can be frightening, especially for young students. An urgent sense of nervousness and apprehension can be debilitating for anyone. These feelings are amplified when students don't understand why they feel this way or what they can do to feel better. One of the most beneficial things you can do for anxious students is to help them understand their why - not just the surface why, but the deep, underlying reason they become so anxious. A technique to accomplish this is "The 5 Whys," developed by Sakichi Toyoda, an industrialist, inventor and founder of Toyota Industries. He believed by asking "why" five times, the nature of a problem and its origins become clear.

To use this strategy with a student, first ask, "Why are you experiencing anxiety?" Use their answer to pose another why question, and repeat this five times. Here is an example from "Anxiety Annie," a sophomore student with test anxiety:

Why are you anxious about the test? I must get good grades, and tests count 80 percent of my final grade.
Why is it important to get good grades? I want to have happy parents.
Why is it important to have happy parents? It makes me feel good when they approve of me.
Why do you want your parents to approve of you? I want to achieve what my parents achieved; I want to have the kind of life they have.
Why do you want to have the kind of life your parents achieved? I don't want to be the odd man out.

Annie's fifth why indicates she doesn't want to "be the odd man out" - she wants to fit in with her family. Background information on Annie confirms that education is an important aspect of her family dynamic. All adults in her family (parents, grandparents, etc.) were excellent students and have pursued careers in education. Once Annie realized that fitting in was the root of her anxiety, she began to recognize that taking tests wasn't the issue; her sense of belonging was. This helped Annie put her anxiety into focus, and she began to view test taking in a different light.

With understanding, students can begin to determine how they can manage anxiety. You can teach students several techniques to use during class without drawing attention to themselves.

Deep breathing: Slowing heart rate, lowering blood pressure and increasing oxygen intake all have a calming effect. Common exercises are belly breathing and the 4-7-8 breathing exercise (inhale for four counts, hold for seven, exhale for eight).

Grounding: Grounding can distract students' mind from their anxiety and keep them grounded in the present. Common exercises include the 5-4-3-2-1 senses technique (five things you can see, four things you can feel, etc.), counting how many things in shades of a particular color can you see around the room and counting backward by 7, starting at 100.

Imagery: When students create a detailed mental image of a safe and peaceful place, they redirect attention away from what is stressing them and toward an alternative focus.

Progressive muscle relaxation: This is the practice of tightening one muscle group at a time followed by a relaxation phase with release of the tension. Students tense and relax the muscle groups one at a time in a specific order, beginning with the lower extremities and ending with the face.

Positive self-talk and affirmations: This helps students challenge self-sabotaging and negative thoughts. Students can practice through journal writing, negative-thought stopping or snapping a rubber band during negative thoughts. You can help students select affirmations that speak to them. When students repeat the affirmations - and believe them - they can start to make positive changes.

Journaling: Journaling helps students clarify their thoughts and feelings, gaining valuable self-knowledge. Students can process their anxiety by fully exploring and releasing the emotions involved.

Desk yoga: Neck rolls, cat-cow stretch, shoulder shrug, triceps stretch, seated twist and the seated pigeon pose are all exercises students can discretely practice at their desk.

Once students determine which techniques work for them, you can assemble a list with descriptions for the student to discretely tuck into a notebook as a quick reference. Or, the student can keep their journal, list of affirmations or picture of their peaceful place where they can access it without classroom disruption. Having this survival kit available can bring a feeling of control over their anxiety.

Strategies with Teachers
In addition to working with individual students, you can equip teachers with strategies to use with an entire class. All the techniques above can easily be modified for classroom use. Teachers may find these activities useful at the beginning of the day, during transition times or before a test. Teachers can also serve as compelling role models for students. As teachers model relaxation techniques during class time, students internalize the importance of lifelong stress management.

School counselors are tasked with working with the whole student, not just academic, career or social/emotional development. It is crucial that students with anxiety learn positive coping techniques now to become healthy and productive citizens in the future.

There is no quick, easy fix for students with anxiety, especially those who are diagnosed with an anxiety disorder. Offering support and flexibility, however, allows you to help students as they discover meaningful, effective ways to address their anxiety.

Anna Duvall is director of counseling at Lexington High School in Lexington, S.C. She can be reached at aduvall@lexington1.net. Crissy Roddy, Ph.D., is director of counseling at White Knoll High School in Lexington, S.C. She can be reached at croddy@lexington1.net.

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Anxious students may not be able to verbalize the specific cause of their anxiety; they just know they are experiencing excessive and ongoing worry and/or fear about something. They may avoid situations or activities in school. They may start to decline in academics and have trouble focusing and concentrating, which many school counselors and teachers may confuse with ADHD.

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What Teachers Should Know

Anxiety disorders cause people to feel frightened, distressed, or uneasy during situations in which most people would not feel that way. Left untreated, anxiety disorders can make it hard for students to get schoolwork done or study. It may affect their relationships with peers and teachers, too. In some cases, students with anxiety disorders miss a lot of school days. Or they may avoid school altogether.

Common anxiety disorders that affect kids and teens are:

Generalized anxiety disorder (GAD). With GAD, children have many worries and worry much of the time. They may also have physical symptoms, like headaches, stomachaches, muscle tension, or tiredness.

Phobias. A phobia is an intense, unrealistic fear of a specific thing. Some kids have a phobia of dogs. Others have a phobia of spiders or snakes. A child with a phobia will go to great lengths to avoid the thing they fear.

Social anxiety. Kids and teens with social phobia have an intense fear of being judged. It affects them in social or other situations. They will avoid situations where they may have to meet new people or perform.

Selective mutism. Some students are too fearful to talk at all in certain situations. Kids and teens with selective mutism are able to talk, and talk well. But they are too fearful to talk in some situations outside their home or with people other than friends.

Panic disorder. Some students have panic attacks, a sudden and intense episode of fear. They can include physical symptoms like a pounding heart, shortness of breath, or dizziness. Panic attacks can happen unexpectedly.

Separation anxiety. It's normal for babies and very young children to have some separation anxiety when they are apart from a parent or caregiver. But when separation anxiety lasts beyond the early school age years, students may have trouble coming to school.

Students with anxiety disorders may show symptoms that fit into one or more of these categories:

have trouble concentrating in class or completing classwork

feel self-conscious and avoid certain situations

have physical symptoms, such as a racing heart, fast breathing, tense muscles, sweaty palms, a queasy stomach, and trembling hands or legs

take medication to help reduce anxiety

may need to work with a school counselor or therapist

What Teachers Can Do

Teachers can help students by:

talking with parents to learn more about the student and how you can best support them

allowing students extra time to do work

learning how to coach students to self-calm with breathing and other relaxation techniques

giving them daily schedules

modifying assignments and reducing workloads when necessary

promoting relaxation techniques and allowing for breaks throughout the day

supporting parents in helping kids get to school, even if it means arriving late or adapting class schedules

allowing them a safe space and ability to go speak with a counselor, if needed

easing anxiety in the classroom by pairing with a peer

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Anxiety Disorders Factsheet (for Schools)

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Anxiety disorders cause people to feel frightened, distressed, or uneasy during situations in which most people would not feel that way. Left untreated, anxiety disorders can make it hard for students to get schoolwork done or study. It may affect their relationships with peers and teachers, too.

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Cook Children’s top medical minds, advanced technologies and treatments and leading-edge clinical research, all designed to meet the health care needs of children.

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SCHOOL COUNSELOR

Noun | / sk-ul /.c-oun-se-llor/

School leaders that provide support systems for all students, help students achieve academic success, career and social /emotional development, so students can become productive,well-regulated future adults.

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Noun | / sk-ul /.c-oun-se-llor/ School leaders that provide support systems for all students, help students achieve academic success, career and social /emotional development, so students can become productive,well-regulated future adults.

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Individuals With Disabilities Education Act

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Individuals With Disabilities Education Act

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Individuals with Disabilities Education Act

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Individuals with Disabilities Education Act (IDEA)

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The U.S. Department of Education’s Individuals with Disabilities Education Act website brings together department and grantee IDEA information and resources. The IDEA makes available a free appropriate public education to and ensures special education and related services to eligible children with disabilities.

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What is Section 504

The U.S. Department of Education enforces Section 504 of the Rehabilitation Act of 1973, as amended, (Section 504) a civil rights statute which prohibits discrimination against individuals with disabilities. The Office for Civil Rights (OCR) also enforces Title II of the Americans with Disabilities Act of 1990 (Title II), which extends this prohibition against discrimination to the full range of state and local government services, programs, and activities (including public schools) regardless of whether they receive any Federal financial assistance. The Americans with Disabilities Act Amendments Act of 2008 (Amendments Act), effective January 1, 2009, amended the Americans with Disabilities Act of 1990 (ADA) and included a conforming amendment to the Rehabilitation Act of 1973 (Rehabilitation Act) that affects the meaning of disability in Section 504. The standards adopted by the ADA were designed not to restrict the rights or remedies available under Section 504. The Title II regulations applicable to free appropriate public education issues do not provide greater protection than applicable Section 504 regulations. This guidance focuses primarily on Section 504.

Section 504 prohibits discrimination on the basis of disability in programs or activities that receive Federal financial assistance from the U.S. Department of Education. For more details, please refer to the United States Department of Education Section 504 Frequently Asked Questions document.

Students protected under Section 504

Section 504 covers qualified students with disabilities who attend schools receiving Federal financial assistance. To be protected under Section 504, a student must be determined to: (1) have a physical or mental impairment that substantially limits one or more major life activities; or (2) have a record of such an impairment; or (3) be regarded as having such an impairment. Section 504 requires that school districts provide a free appropriate public education (FAPE) to qualified students in their jurisdictions who have a physical or mental impairment that substantially limits one or more major life activities. For more details, please refer to the United States Department of Education Section 504 Frequently Asked Questions document.

Evaluation

At the elementary and secondary school level, determining whether a child is a qualified disabled student under Section 504 begins with the evaluation process. Section 504 requires the use of evaluation procedures that ensure that children are not misclassified, unnecessarily labeled as having a disability, or incorrectly placed, based on inappropriate selection, administration, or interpretation of evaluation materials. For more details, please refer to the United States Department of Education Section 504 Frequently Asked Questions document.

Placement

Once a student is identified as being eligible for regular or special education and related aids or services, a decision must be made regarding the type of services the student needs. For more details, please refer to the United States Department of Education Section 504 Frequently Asked Questions document.

Procedural Safeguards

Public elementary and secondary schools must employ procedural safeguards regarding the identification, evaluation, or educational placement of persons who, because of disability, need or are believed to need special instruction or related services. For more details, please refer to the United States Department of Education Section 504 Frequently Asked Questions document.

How to file a complaint

Online: You may file a complaint with OCR using OCR's electronic complaint form at the following website: http://www.ed.gov/about/offices/list/ocr/complaintintro.html.

Mail or Facsimile: You may mail or send by facsimile information to the address or phone number available at this link. You may use OCR's Discrimination Complaint Form or write your own letter. If you write your own letter, please include:

The complainant's name, address and, if possible (although not required), a telephone number where the complainant may be reached during business hours;

Information about the person(s) or class of persons injured by the alleged discriminatory act(s) (names of the injured person(s) are not required);

The name and location (city and state) of the institution that committed the alleged discriminatory act(s); and

A description of the alleged discriminatory act(s) in sufficient detail to enable OCR to understand what occurred, when it occurred, and the basis for the alleged discrimination.

Email: You may email OCR's Discrimination Complaint Form or your own signed letter to . If you write your own letter, please include the information identified above

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The U.S. Department of Education enforces Section 504 of the Rehabilitation Act of 1973, as amended, (Section 504) a civil rights statute which prohibits discrimination against individuals with disabilities. The Office for Civil Rights (OCR) also enforces Title II of the Americans with Disabilities…