Helping Children with Special Needs Cope with Fears, Anxieties,

and Worries

A guide for parents and teachers

This presentation

is for adults who help

children

through their hard times;

their anxiety, worries, &

fears.

It is meant to be a

stand-alone presentation

to help parents and

teachers work with

children to cope

with those feelings

that interfere with daily

life.

The ideas for this presentation

come from years of experience

in schools and community

settings from Susan Hepburn,

Judy Reaven,

and Audrey Blakeley-Smith;

all Clinical Psychologists at

JFK Partners, University of

Colorado.

Susan Hepburn, PhD

Judy Reaven, PhD

Audrey Blakeley-Smith, PhD

OverviewOverviewfor this presentation

Signs to help determine if a child’s behavior is typical or a concern.

Strategies to help children cope with anxiety.

Selecting the best approach.

Words parents and teachers can say to help children. Ideas for prevention of anxiety, worry, or fear.

How do you know

if a child’s behavior

is typical or a

concern?

Avoids new

experiences

Resists change

Irritable

Dreads future events

Signs of anxietySigns of anxiety

Sleep problems

Narrow focus of

interest

Difficulty

concentrating

Withdrawn

Many children experience anxiety, worry, and fear in their daily lives but are unable to verbalize their feelings. Instead, you might see some of these signs.

Many of these

signs

are typical

signs of anxiety

that

most children go

through.

Experiencing

anxiety, fear, and

worry

is part of growing

up.

The problem is

when these signs

turn into excessive,

persistent, ongoing

issues…

When anxieties,

worries, and fears

interfere with

daily activities.

Anxiety is

common for

children with

developmental

disabilities,

especially

children with

autism.

HowHow can we help?

Most children prefer to

avoid facing their fears,

worries, or anxieties.

When a child avoids a

difficult situation, he or

she does not have the

opportunity to learn to

cope with that situation.

As a result, when facing

with the same situation in

the future, anxiety will

likely continue.

Understanding the

Cycle of Anxiety

and teaching the

concept to children

with anxiety, will help

them understand

why it’s important to

face their fears.

AvoidanceAvoidanceThe cycle of

cycle

starts here

The Cycle of Anxiety usually begins with physical reactions to fear, anxiety, or worry such as increased breathing, racing heart, sweating, or dizziness.

AnxietyAnxietyThe cycle of

cycle

starts here

Negative thoughts like, “I can’t do this!” or exaggerated thoughts like, “That snake is going to bite me!” when the snake is behind a glass window can take over.

AnxietyAnxietyThe cycle of

cycle

starts here

Behaviors may become explosive suddenly, and irritation and upset may appear.

AnxietyAnxietyThe cycle of

cycle

starts here Children become distracted by the physical reactions, negative thoughts, & behaviors. As a result, there is decreased learning and coping and more anxiety if avoidance continues.

How we can helpHow we can help

Awareness that when children experience physical reactions, negative thoughts, or difficult behaviors, it might be because they are afraid, anxious or worried about something.

Increasing awareness helps children understand their feelings better.

Help children become aware

Help children become aware

How we can helpHow we can help

Many times, children may need to name their fear in order to understand it.

For example…“I get shaky and sweaty when I see snakes because I’m afraid of them.”

Help children put a name to itHelp children put a name to it

How we can helpHow we can helpTeach children to breathe

slowly and deeplyTeach children to breathe

slowly and deeply

• Breathe in slowly through your nose.

• Hold it.

• Exhale through your mouth.

• Feel your stomach go up and down as you breathe.

• Repeat for at least 3 breaths.

How we can helpHow we can helpTeach children to relax their

bodyTeach children to relax their

bodyShake out their arms.

Relax their shoulders.

Let go of stiffness in their body.

How we can helpHow we can helpTeach children positive

self-statementsTeach children positive

self-statementsModel positive statements like, “I know you can do this.”

Practice positive statements they could use in the future like, “This is no big deal.” “I can handle this!” “I’ve done it before, I can do it again!”

How we can helpHow we can helpFind the teachable momentsFind the teachable moments

Avoid teaching children how to cope better in the moment of their fear, but instead wait for a time when they are calm to reflect on how they might handle that same situation differently next time.

How we can helpHow we can helpEncourage brave behaviorsEncourage brave behaviors

Provide examples of how they could cope with their fear, anxiety, or worry next time.

Coach them through practicing their brave behaviors.

How we can helpHow we can helpReward brave behaviorsReward brave behaviors

Give encouragement for their brave behaviors.

Use frequent, small, yet meaningful rewards specific to each child.

Brave BehaviorsBrave Behaviors

Brave behaviors are any attempt to face a fear, worry, or anxiety.

They are different for every child and every situation.

What are they?

Brave BehaviorsBrave Behaviors

Start with easy tasks and move to more difficult.

Encourage partial success or attempts of brave behavior.

Brave behaviors build confidence so the more they try brave behaviors, the more confident they’ll be.

How to encourage them

Brave BehaviorsBrave BehaviorsExample: Chris is afraid of cats. Example: Chris is afraid of cats.

Easy task – Look at pictures of cats.Less easy – Look at cat through window.More difficult – Look at cat 10 feet away.More difficult – Look at cat 5 feet away.Harder – Walk closely past a real cat.Even harder – Touch a cat.Hardest – Pet a cat.

Easy

Hard

More difficult

Brave BehaviorsBrave Behaviors

Allow children to decide when to go to next task.

Try brave behaviors daily in small steps.

Encourage children to stay in feared situation until anxiety goes down.

How to Select the How to Select the Best ApproachBest Approach

Try strategies you think your child will best respond to.

Ask your child what works best for him or her.

Repeat coping strategies that work best will help children remember what to do under stress.

WhaWha

tt can parents and teachers say?

Words We Can SayWords We Can Say

Ever stuck for what to say or do when children are very upset?

Here are some ideas that might work for you…

Not that…

Say this …“I know this must feel scary.”

“You don’t need to be afraid of that.”

Validate FeelingsValidate Feelings

Not that…

Say this …“It’s a little scary.”

“It’s the scariest thing ever.”

Avoid ExaggeratingAvoid Exaggerating

Not that…

Say this …“You can handle it.”

“I’ll handle it for you.

Express confidenceExpress confidence

Realistic Realistic

ReassurancesReassurances

Anxiety always goes away.

Everyone feels worried sometimes.

Missing one night of sleep isn’t a disaster.

You’ll bounce back!

Can we prevent anxiety,

worry, fear?

HowHow

PreventionPreventionMake sure children get plenty of exercise and sleep.

Limit caffeine.

Practice coping strategies with children.

Narrate when you or others demonstrate coping.

Post schedules to increase predictability.

Identify heroes and how they cope with adversity.

Identify when family members are coping.

PreventionPrevention

ConclusionConclusion

We hope this presentation has helped spark ideas you can use with the children in your life needing help learning how to cope with their anxieties, worries, and fears.

In ReviewIn Review

Signs of Anxiety

How We Can Help

Words to Say Prevention

Examples: AvoidanceWithdrawnNarrow focusIrritable

Cause for concern when signs are:PersistentOngoingInterfere with daily life

Understand & teachCycle of Avoidance

Help kids become aware of their reactions to anxiety & name it

Teach to relax body & breathing

Positive statements

Encourage brave behaviors

Determine best approach

Validate feelings

Avoid exaggerating

Express confidence

Provide realistic assurances

Exercise daily

Get enough sleep

Practice coping skills

Identify when others are coping

Post schedule to increase predictability

ResourcesResources

Keys to Parenting Your Anxious Child (2nd Edition) Katharina Manassis, MD, FRCP

Helpful websites:www.jfkpartners.org www.telecopes.org www.childanxiety.org www.myanxiouschild.com

Coming soon:Facing Your Fears Group Therapy for Managing Anxiety in Children with High-Functioning Autism Spectrum Disorders (Brookes Publishing)Judy Reaven, PhD, Audrey Blakeley-Smith, PhD, Shana Nichols, PhD, and Susan Hepburn, PhD

Photographs used in this presentation are from:

Microsoft Office and

Fotolia

Photo AttributionPhoto Attribution

Content Experts:Susan Hepburn, PhD, Judy Reaven, PhD, Audrey Blakeley-Smith, PhD, all Clinical Psychologists and Kristen Kaiser, Parent Liaison, JFK Partners, University of Colorado School of Medicine.

Grant funding supporting this work:TeleCopes: Telehealth for Families of Children on the Autism Spectrum with Anxiety, Health Services Resource Administration, Award #1R40MC15593, Sept 2009 - Aug 2011.

Training Clinicians to Deliver Cognitive Behavior Therapy to Children with High-Functioning ASD and Anxiety Grant, National Institute of Health, Award #1R21MH089291-01, Oct 2009 – Sept 2013.

Produced by:Dina Johnson, Training CoordinatorJFK Partners, University of Colorado School of MedicineFeb/Mar 2011

AppreciationAppreciation