V.8 #2 Social-Emotional Development - Learning Disabilities and Anxiety: Common Undesirable Partner
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As parents and teachers, we see first hand the difficulty that our students with specific learning disabilities (SLD) experience with regard to academic tasks. What are often overlooked are the serious social and emotional difficulties that accompany the academic concerns. One recent investigation (Margari, Buttiglione, Craig, Cristella, de Giambattista, & Matera, 2013) found that anxiety disorders co-occur with SLD in 28.8% of identified students. Although a relationship between anxiety and academic achievement makes intuitive sense, the cause is not the same in all individuals, making the experienced anxiety that much more complicated to treat. For some students, anxiety may negatively impact the learning process exacerbating academic difficulties; alternatively, students with SLD may develop anxiety problems, because they experience adverse academic outcomes due to their learning challenges. In either circumstance, symptoms of anxiety are frequently present in students with SLD and these students have a great awareness of the struggles they experience with ongoing learning and anxiety difficulties.
As noted, anxious children, both with and without SLD, experience great difficulty in school. In order to perform well, anxious students must exert extra cognitive effort, and sometimes this intellectual load can become an exhausting proposition. Students in this position must try to manage their anxiety all the while that they are executing academic tasks. One study of first grade students demonstrated that those who were the most anxious in the fall of the school year were more likely to have lower math and reading achievement scores in the spring. Left untreated, anxiety causes students to fall behind academically (as cited in Minahan & Rappaport, 2012).
Avoidance behavior in students is a crucial factor in the maintenance of anxiety disorders. Again that makes intuitive sense; no one wants to have to deal with situations that make him or her uncomfortable. Avoiding a feared situation is something that all living things practice; humans have learned that the avoidance of a feared situation results in a diminished experience of fear, a conditioning experience known as negative reinforcement. However, if a student actively avoids the feared situation they will not learn how to change their experience; if we don’t approach the fear, new learning and extinction of the fear does not occur (In-Albon, Meyer, Schneider, 2013). If the situation we feel anxious about doesn’t regularly interact with our daily life, it may not be a big deal. However, what if the anxiety-producing situation is an academic task or school in general? If academic tasks and school were avoided, then those students who avoid those situations would not have the opportunity to be exposed to the tools that will ultimately turn them into successful contributing members of society. The answer is to help students engage successfully with the anxiety producing tasks so as to create positive learning outcomes (see articles in this edition of SSL from Benhar, Test Anxiety, and Gujarati, Math Anxiety). In order to tame the pattern of interconnected SLD and anxiety, students need understanding and support from their two main environments: home and school.
Home: Parental Connection
Research tells us that anxiety typically runs in families; children of parents with anxiety disorders tend to develop anxiety, and children diagnosed with anxiety have parents, typically mothers, who also suffer from anxiety (Pereira, Barros, Mendonc, & Muris, 2014). Mothers, more often than fathers, express common worries associated with their child’s poor school performance and the difficult behaviors associated with this, such as self-esteem, frustration, withdrawal, and aggression (Karande, Kumbhare, Kulkarni, & Shah, 2009). As there is a symbiotic relationship of anxiety in families, it is important to treat the whole family system in order to see improvement in the presentation of anxiety symptoms in children.
Both mothers and fathers should participate in cognitive-behavioral treatment of their own feelings of anxiety in order to achieve the following goals in their children:
Reduction in the modeling of anxious behaviors in the home by parents.
Reduction of their children’s exposure to anxious beliefs and behaviors in the home.
Increase in the parental role of helping children to gradually confront anxiety-provoking situations.
Encouragement of children’s independent actions toward anxiety reduction by their parents.
School: Teacher’s Role
Teachers have many of their own worries and difficulties associated with being in the classroom; annual performance reviews, student test performance, classroom management issues, and job security to name just a few. Although teachers may have increasing levels of anxiety associated with their profession, students in their classrooms look to them to set the tone and model desired cognitions and behaviors. Therefore it’s imperative that teachers have anxiety management procedures in place throughout the day that focus on teaching students to cope with their anxiety and to use acceptable alternative responses. If the teacher has thought about ways that she can manage rising anxiety in the classroom before levels escalate, procedures can be implemented that avoid overwhelming fragile students and provoking behavioral outbursts. Ninety percent of every teacher’s classroom management plan should be dedicated to prevention and skill building so that teachers can instruct students in adaptive behaviors (Minahan & Rappaport, 2012). Until the student can consistently apply the anxiety reducing skills independently, accommodations and environmental modifications will need to stay in place. It is important for teachers to keep in mind that frequently it is underdeveloped skills that cause negative behaviors in anxious students (Minahan & Rappaport, 2012).
Teachers may consider the benefit of incorporating preventive strategies as part of an overall anxiety management plan such as the following strategies excerpted from Minahan and Rappaport (2012):
Regularly schedule anxiety reducing breaks to help students calm down; try starting with two – 10 minute breaks a day. Through the use of regular breaks teachers can learn what helps individual students calm down. During breaks teachers will need to avoid exposing students to anxiety provoking situations and make sure that students don’t use the breaks to escape anxiety-provoking situations.
Recognize that unstructured times may be anxiety-producing for some students due to skills deficits in areas such as social skills, executive functioning skills, and self-regulation skills. Alternative situations can be set up for these students. One example is an alternative lunch setting with a small group of students that are monitored by a teacher or paraprofessional to foster appropriate interaction. Another idea is an alternative recess, again provided to a small group of students and facilitated by a teacher, paraprofessional or a school based related service provider (e.g. occupational therapist, social worker, or school psychologist).
All-or-nothing thinking hinders many students and once adopted, this thought pattern, anxiety, and avoidant behavior escalates. Teachers can work to replace students’ unproductive thoughts with more realistic and optimistic thoughts. Students can learn that taking a deep breath or counting to 10 is more effective than behavioral outbursts; leading to confidence, competence, and a reduction of anxiety.
While the right dose of anxiety benefits the learning process, nudging students to prepare and study, chronic anxiety strips students of the necessary persistence and fortitude associated with academic situations. This is especially true for students who struggle with academic tasks like students with SLDs. A large body of research confirms that excessive anxiety impairs the brain’s ability to acquire new information. In a state of intense anxiety, the processing and storage of new information is hindered; anxiety impacts a student’s ability to attend in learning situations, behave appropriately, and complete schoolwork.
Effective parents and teachers can learn ways to recognize when the children in their care seem anxious and upset. At these times, the trusted adults can de-escalate worries by providing helpful strategies and words of encouragement, preventing worried children from descending further into the grip of anxiety. If a child has a history of negative affect and anxiety, catching it early is the best way to head off the challenging behavior and academic problems that ensue.
In-Albon, T., Meyer, A., Schneider, S. (2013). Separation Anxiety Avoidance Inventory-Child and Parent Version: Psychometric properties and clinical utility in a clinical and school sample, Child Psychiatry Hum Dev., 44, 689–697. doi:10.1007/s10578-013-0364-z
Karande, S., Kumbhare, N., Kulkarni, M., & Shah, N. (2009). Anxiety levels in mothers of children with specific learning disability. J Postgrad Med, 55, 165-70. doi:10.4103/0022-3859.57388.
Margari, L; Buttiglione, M.; Craig, F; Cristella, A; de Giambattista, C; & Matera, E. (2013). Neuropsychopathological comorbidities in learning disorders. BMC Neurology, 13, 198. doi: 10.1186/1471-2377-13-198
Minahan, J. & Rappaport, N. (December 2012/January 2013). Anxiety in students. A hidden culprit in behavior issues, Kappan.
Pereira, A., Barros, L., Mendonc, D., Muris, P. (2014). The relationships among parental anxiety, parenting, and children’s anxiety: The mediating effects of children’s cognitive vulnerabilities. J Child Fam Stud, 23, 399–409. doi: 10.1007/s10826-013-9767-5)
Micheline Malow, Ph.D. is an Associate Professor in the Department of Special Education at Manhattanville College located in Purchase, New York. Dr. Malow teaches courses in Foundations of Special Education, Child Development and Research in Special Education. She has presented at numerous professional conferences and published articles on risk taking behavior and students with disabilities. She has co-authored a book with Greenwood Press, Adolescents and Risk. Dr. Malow can be reached at email@example.com.