Reference Tool — Not an Assessment

Anxiety Disorders

Purpose: an educator reference guide covering GAD, social anxiety, separation anxiety, panic, phobias, school avoidance, classroom strategies and differentials for anxiety disorders. Australian context, 2026. It explains classroom-observable presentations and practical responses; it is not a diagnostic or screening instrument.

If a student is at immediate risk: self-harm/suicide, severe medical compromise or other immediate danger — follow emergency procedures and call 000 in Australia.

The core idea: “What is this student avoiding or trying to make certain, and how can we support them to participate without making avoidance stronger?”

Start with a presentation

Click the one closest to what you're seeing. Each page covers what it is, what it can look like at school, and what helps.

Foundations

Normal anxiety, the avoidance cycle and physical symptoms.

Instructional Demand System

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Functional Out System

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Adult Language Scripts

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Generalised Anxiety Disorder (GAD)

Difficult-to-control worry across multiple areas.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

GAD involves difficult-to-control worry across multiple areas rather than one specific trigger.

@What it can look like at school

School worries: Grades, mistakes, family safety, future events, friendships, being late, forgetting things.
What staff see: Repeated “what if?” questions, reassurance seeking, perfectionism, slow starts, mental exhaustion.

✓What helps

Break uncertainty into manageable next steps rather than trying to guarantee every outcome.

Social Anxiety Disorder

Fear of negative evaluation, embarrassment or humiliation.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Social anxiety centres on fear of negative evaluation, embarrassment or humiliation.

@What it can look like at school

Avoids speaking, presentations, group work, eating publicly, asking for help, entering late.

✓What helps

Predictability, graded participation, private correction and alternatives that build toward – not permanently replace – participation.

!Keep in mind

Misread as rude, antisocial, lazy, defiant or “not trying”.

Separation Anxiety Disorder

Intense distress about being away from attachment figures.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Separation anxiety can involve intense distress about being away from attachment figures or fear something will happen to them.

@What it can look like at school

School signs: Repeated calls home, difficulty entering school, clinginess, physical symptoms before separation, refusal of camps/excursions.
Older students: May disguise the fear as illness, anger or refusal.

✓What helps

Predictable arrival routine, clear contact plan, gradual independence, consistent family-school response.

Panic attacks

A sudden surge of intense fear/discomfort with strong physical symptoms.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

A panic attack is a sudden surge of intense fear/discomfort with strong physical symptoms. It does not always mean panic disorder.

@In school

May include: Racing heart, breathlessness, chest tightness, dizziness, shaking, derealisation, fear of losing control/dying.
In school: Student abruptly leaves, seeks nurse, says they cannot breathe or feels they will faint.

✓Response

Calm presence, quiet area, slow simple communication, follow health plan and assess for medical emergency if uncertain.

Panic Disorder

Recurrent unexpected panic attacks plus ongoing fear of more.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Panic disorder involves recurrent unexpected panic attacks plus ongoing fear/behaviour change about having more attacks.

@What develops

Avoidance of assembly, transport, sport, crowded rooms or situations where escape feels hard.

✓Support

Follow clinical plan and gradually rebuild normal participation.

!Adult mistake

Telling the student “there's nothing wrong” while they feel physically terrified.

Specific Phobias

Marked fear of a particular object or situation.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

A specific phobia is marked fear of a particular object or situation that leads to avoidance.

@School impact

Examples: Needles, dogs, vomiting, storms, insects, enclosed spaces.
School impact: Avoids science practical, excursions, health procedures, playground areas or particular media.

!Do not

Force exposure as punishment or make the fear entertainment for peers.

Agoraphobia

Fear of situations where escape or help may feel difficult.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Agoraphobia involves fear of situations where escape or help may feel difficult if panic-like symptoms occur.

@School presentation

Possible triggers: Crowds, public transport, assemblies, large shopping centres, open/enclosed spaces.
School presentation: Avoids buses, excursions, assemblies, large transitions.

✓Support

Plan graded participation and safe access to help without making avoidance permanent.

Selective Mutism

Consistently cannot speak in particular situations despite speaking elsewhere.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Selective mutism is a separate anxiety disorder in which a child consistently cannot speak in particular social situations despite speaking elsewhere.

@School signs

Speaks at home but not at school, uses gestures/writing, may whisper to one trusted person.

✓Support

Coordinate a graded communication plan with family and clinician.

!Do not

Force speech, demand public answers or frame silence as defiance.

Anxiety: normal response vs anxiety disorder

A disorder when fear/worry is excessive, persistent and interferes with functioning.

Reference tool — informs practice, does not diagnose or label.

iNormal response vs anxiety disorder

Anxiety is a normal protective response. It becomes a disorder when fear/worry is excessive or persistent and interferes with school, social life or everyday functioning.

Normal anxiety: Temporary worry around tests, change, conflict, performance or unfamiliar situations.
Disorder-level pattern: Intensity, duration, avoidance and functional impairment are disproportionate.
Educator role: Notice patterns, support participation and refer when anxiety is persistently restricting life.

The anxiety-avoidance cycle

Short-term relief, long-term maintenance of fear.

Reference tool — informs practice, does not diagnose or label.

iThe anxiety-avoidance cycle

Avoidance usually reduces anxiety immediately, which teaches the brain that escape was necessary. Over time the feared situation can become harder to approach.

Trigger: Uncertainty, evaluation, separation, bodily sensations, feared object or social situation.
Response: Escape, refusal, reassurance, procrastination, safety behaviour.
Result: Short-term relief; long-term maintenance of fear.

Support should reduce unnecessary threat while helping the student keep approaching life – not remove every uncomfortable situation forever.

Physical anxiety symptoms

Heavily bodily — students may not identify the feeling as anxiety.

Reference tool — informs practice, does not diagnose or label.

iPhysical anxiety symptoms

Anxiety is heavily bodily. Students may not identify the feeling as “anxiety”.

Common: Racing heart, short breath, nausea, dizziness, sweating, shaking, headaches, muscle tension, butterflies.
School presentation: Frequent sick bay visits, toilet use, asking to go home, reluctance to eat, inability to concentrate.
Always consider: Medical causes when symptoms are new, severe or unexplained.

School refusal / school avoidance

A behaviour pattern, not a single diagnosis.

Reference tool — informs practice, does not diagnose or label.

iSchool refusal / school avoidance

School refusal is a behaviour pattern, not a single diagnosis. Anxiety is one common driver.

Possible functions: Escape social threat, separation distress, panic, academic failure, bullying, sensory overload or trauma reminders.
Useful: Identify the feared part of school, reduce barriers and build attendance gradually with family/clinical support.

!Do not assume

Laziness or manipulation.

Performance and test anxiety

Evaluation can trigger threat responses even when the material is known.

Reference tool — informs practice, does not diagnose or label.

iPerformance and test anxiety

Evaluation can trigger threat responses even when the student knows the material.

What staff see: Blanking, tears, refusal, rushing, perfectionism, repeated checking, stomach aches.
Support: Predictable test conditions, preparation, realistic practice, calm entry routine, accommodations if warranted.

!Avoid

Public comparison, surprise high-stakes performance and shame-based motivation.

Perfectionism and fear of mistakes

Can be an anxiety strategy rather than simple conscientiousness.

Reference tool — informs practice, does not diagnose or label.

iPerfectionism and fear of mistakes

Perfectionism can be an anxiety strategy rather than simple conscientiousness.

Possible pattern: Won't start, restarts repeatedly, refuses to submit, becomes distressed by minor errors.
Why: Mistake is interpreted as threat to safety, identity, approval or future outcome.
Support: Define “good enough”, time-box tasks, model normal mistakes, grade process where appropriate.

Reassurance seeking

Constant certainty can maintain dependence on reassurance.

Reference tool — informs practice, does not diagnose or label.

iReassurance seeking

Students may repeatedly ask whether they are safe, correct, liked, in trouble or going to cope.

Short-term: Reassurance lowers anxiety.
Long-term risk: Constant certainty can maintain dependence on reassurance.
Better: Answer once where appropriate, then prompt coping/decision steps and tolerate uncertainty gradually.

Somatic complaints

Physical discomfort rather than verbalised fear.

Reference tool — informs practice, does not diagnose or label.

iSomatic complaints

Anxiety frequently presents as physical discomfort rather than verbalised fear.

Examples: Headache, nausea, stomach pain, dizziness, chest tightness, needing toilet.
Important: Physical symptoms are real, even when anxiety contributes.
Action: Follow medical/sick-bay procedures while looking for consistent context patterns.

Irritability, anger and aggression

Threat can produce fight responses, not just fear.

Reference tool — informs practice, does not diagnose or label.

iIrritability, anger and aggression

Anxious young people do not always look scared. Threat can produce fight responses.

What staff see: Snapping, refusal, swearing, aggression when cornered, angry reaction to uncertainty.
Ask: What feared outcome or loss of control occurred immediately before the behaviour?

!Avoid

Assuming calm compliance is the only “real” form of anxiety.

Freeze and shutdown

Quiet, blank, immobile or unable to answer when anxiety peaks.

Reference tool — informs practice, does not diagnose or label.

iFreeze and shutdown

Some students become quiet, blank, immobile or unable to answer when anxiety peaks.

What staff see: Staring, “I don't know”, no speech, head down, cannot initiate.
Adult mistake: Increasing questions and pressure because the student is not responding.
Support: Reduce verbal demand, offer time, one simple next step and lower the audience.

Procrastination and task avoidance

Often looks like poor motivation.

Reference tool — informs practice, does not diagnose or label.

iProcrastination and task avoidance

Anxiety-driven avoidance often looks like poor motivation.

Patterns: Starts irrelevant tasks, asks to leave, loses equipment, waits until deadline, refuses difficult subjects.
Possible fear: Failure, judgement, uncertainty, not knowing how to start.
Support: Shrink first step, clarify success criteria, start alongside student, then fade support.

Attendance deterioration

Can produce lateness, partial attendance and disengagement.

Reference tool — informs practice, does not diagnose or label.

iAttendance deterioration

Repeated anxiety around school can produce lateness, partial attendance and long-term disengagement.

Monitor: Which days/lessons/events are hardest; what happens immediately before absence?
Plan: Consistent arrival routine, graded goals, one contact person, avoid punitive catch-up overload.
Escalate: Persistent attendance loss warrants coordinated wellbeing/health intervention.

Peer avoidance and social safety behaviours

Often misread as disinterest or disrespect.

Reference tool — informs practice, does not diagnose or label.

iPeer avoidance and social safety behaviours

Students may protect themselves from judgement by staying silent, rehearsing speech, avoiding eye contact, sitting at edges or using phones/headphones as shields.

Misread as: Disinterest or disrespect.
Support: Low-pressure entry, predictable partner/grouping, role clarity, gradual increase in participation.

!Do not

Humiliate the student into social exposure.

Anxiety vs ADHD

They frequently coexist.

Reference tool — informs practice, does not diagnose or label.

iAnxiety vs ADHD

Anxiety can look inattentive because worry occupies working memory; ADHD can create anxiety through repeated failure and uncertainty. They frequently coexist.

Anxiety clue: Attention worsens around feared/evaluative situations.
ADHD clue: Attention/inhibition difficulties are broader and more longstanding.
School role: Document contexts and baseline rather than deciding which label fits.

Anxiety vs autism

Anxiety disorders are also common in autistic students.

Reference tool — informs practice, does not diagnose or label.

iAnxiety vs autism

Autistic distress around uncertainty, sensory load and social demands can resemble anxiety disorders; anxiety disorders are also common in autistic students.

Look at: Developmental history, sensory/social profile and whether fear is disproportionate beyond baseline autistic needs.
Support: Concrete predictability and reasonable sensory adjustments can reduce background threat.

Avoid calling every autistic refusal “anxiety”.

Anxiety vs DLD / language difficulty

Language processing difficulty can create apparent anxiety.

Reference tool — informs practice, does not diagnose or label.

iAnxiety vs DLD / language difficulty

Language processing difficulty can create apparent anxiety around instructions, speaking and social interactions.

Clue: Distress increases with verbal complexity or open-ended questioning.
Support: Reduce language load and check comprehension before assuming fear is primary.
Can coexist: Repeated communication failure can itself create anxiety.

Anxiety vs trauma / PTSD

PTSD adds trauma exposure and trauma-specific intrusions.

Reference tool — informs practice, does not diagnose or label.

iAnxiety vs trauma / PTSD

Both involve threat, avoidance and hyperarousal. PTSD additionally involves exposure to trauma and trauma-specific intrusions/avoidance/altered threat responses.

Trauma clue: Strong connection to reminders, re-experiencing, dissociation.
Anxiety clue: Fear may centre on future possibilities without trauma re-experiencing.
School role: Describe triggers and responses; clinicians determine diagnosis.

Anxiety vs depression / DMDD

Look at the whole pattern rather than one feature.

Reference tool — informs practice, does not diagnose or label.

iAnxiety vs depression / DMDD

Withdrawal, poor concentration and irritability can occur across anxiety, depression and DMDD.

Anxiety: Fear/worry and avoidance are central.
Depression: Persistent low mood/loss of interest/energy may dominate.
DMDD: Chronic irritable baseline plus recurrent severe outbursts.
Action: Look at the whole pattern and refer when functioning is significantly impaired.

Anxiety vs OCD

No longer grouped with anxiety disorders in DSM.

Reference tool — informs practice, does not diagnose or label.

iAnxiety vs OCD

OCD is no longer grouped with anxiety disorders in DSM, although anxiety is often prominent.

Anxiety disorders: Fear/worry + avoidance/safety behaviour.
OCD: Obsessions plus compulsions/mental rituals to reduce distress or gain certainty.
Why this matters: Repeated reassurance or ritual participation may require OCD-specific treatment planning.

Anxiety vs emerging psychosis

Psychosis involves more significant problems interpreting reality.

Reference tool — informs practice, does not diagnose or label.

iAnxiety vs emerging psychosis

Severe anxiety can create suspiciousness, derealisation and catastrophic thoughts; psychosis involves more significant problems interpreting reality.

Anxiety: Usually recognises fear as possibility: “What if they hate me?”
Psychosis: May develop fixed conviction: “They are sending messages to target me.”

Refer new hallucinations, fixed unusual beliefs or major functional decline for prompt clinical assessment.

Medical and medication mimics

Several medical conditions can mimic anxiety symptoms.

Reference tool — informs practice, does not diagnose or label.

iMedical and medication mimics

Thyroid problems, asthma, cardiac issues, low blood sugar, medication effects, caffeine/stimulants and other conditions can mimic anxiety symptoms.

Red flag: New severe physical symptoms, fainting, chest pain, breathing problems or sudden change.
School: Use medical procedures; do not automatically label symptoms psychological.
Medication: Report observations through family/health plan, not informal advice.

Responding to a panic episode

Needs calm containment, not a lecture.

Reference tool — informs practice, does not diagnose or label.

iResponding to a panic episode

A panic episode needs calm containment, not a lecture.

Do: Reduce audience, speak slowly, orient to the present environment, follow medical/mental-health plan.
Avoid: Crowding, rapid questioning, “calm down”, threatening consequences.

!Safety

If symptoms could be medical or there is loss of consciousness/severe breathing difficulty, follow emergency procedures.

Predictability and reducing uncertainty

Should support participation, not guarantee nothing unexpected happens.

Reference tool — informs practice, does not diagnose or label.

iPredictability and reducing uncertainty

Many anxious students function better when they know what will happen, what success looks like and who will help if they struggle.

Useful: Visual schedule, warning of changes, clear start/finish, written steps, predictable seating.
Balance: Predictability should support participation, not guarantee that nothing unexpected ever happens.
Goal: Build tolerance gradually once the student is stable enough.

Adult language that helps

Language can either reduce or amplify threat.

Reference tool — informs practice, does not diagnose or label.

iAdult language that helps

Language can either reduce or amplify threat.

Use: Short, concrete, neutral statements; acknowledge difficulty; offer one manageable next step.
Example: “You don't have to solve the whole assignment. Start with question one and I'll check back.”

!Avoid

“There's nothing to worry about”, “everyone else can do it”, “stop being dramatic”.

What commonly makes anxiety worse

Punishment can increase threat without teaching coping.

Reference tool — informs practice, does not diagnose or label.

iWhat commonly makes anxiety worse

Punishment can increase threat without teaching coping.

Avoid: Public shaming, surprise exposure, forced eye contact/speaking, repeated threats about consequences, inconsistent routines.
Also avoid: Removing every demand or feared situation permanently.
Better: Calm boundaries, planned exposure/participation and gradual independence.

The reassurance trap

Repeated reassurance can maintain anxiety rather than resolve it.

Reference tool — informs practice, does not diagnose or label.

iThe reassurance trap

Adults naturally want to remove fear by providing certainty, but repeated reassurance can maintain anxiety.

Instead of: endless “Yes, you will definitely be fine.”
Try: “We've checked the plan once. What can you do if the worry comes back?”
Exception: Provide clear factual information when the student genuinely lacks information; do not turn uncertainty into a game.

Graded exposure and approach

Gradually approaching feared situations rather than avoiding them indefinitely.

Reference tool — informs practice, does not diagnose or label.

iGraded exposure and approach

Evidence-based anxiety treatment usually involves gradually approaching feared situations rather than indefinite avoidance.

School role: Support clinician/family plans, help create manageable steps, reinforce approach behaviour.
Measure: Participation and recovery, not whether anxiety instantly disappears.

!Do not

Invent high-intensity exposure or force the student into overwhelming situations.

Useful classroom accommodations

Reduce unnecessary barriers while keeping the student connected.

Reference tool — informs practice, does not diagnose or label.

iUseful classroom accommodations

Accommodations should reduce unnecessary barriers while keeping the student connected to learning.

Examples: Advance notice, reduced public performance, alternative response mode initially, quiet test space, predictable breaks.
Review: Some supports should fade as skills improve; others may remain reasonable adjustments.
Question: Does this increase access, or does it allow fear to control more of the timetable?

Treatment: CBT and exposure

A common evidence-based treatment for child/adolescent anxiety.

Reference tool — informs practice, does not diagnose or label.

iTreatment: CBT and exposure

Cognitive behavioural therapy is a common evidence-based treatment for child/adolescent anxiety, usually including gradual exposure to feared situations.

Focus: Understand anxiety, reduce avoidance, test predictions, build coping and flexible thinking.
School contribution: Support practice and attendance goals without becoming the therapist.
Consistency: Coordinate language and expectations with the treatment plan where possible.

Medication and return to function

Prescribing is a medical role.

Reference tool — informs practice, does not diagnose or label.

iMedication and return to function

Medication is sometimes used when anxiety is severe or persistent, usually alongside psychological treatment. Prescribing is a medical role.

School: Observe function, fatigue, agitation or concentration changes if relevant to care plan.
Return: Build attendance, assessment and social participation gradually.
Goal: Function and engagement – not a requirement that the student feel zero anxiety.

What educators should document

Helps distinguish triggers, patterns and functional impact.

Reference tool — informs practice, does not diagnose or label.

iWhat educators should document

Good documentation helps distinguish triggers, patterns and functional impact.

Record: Situation, worry/fear behaviour, avoidance/safety behaviour, physical symptoms, duration, recovery, supports tried.
Track: Attendance, subject/context patterns, assessment effects, peer situations.

!Avoid labels

Write what happened, not “had anxiety attack” unless clinically confirmed/clearly described.

When to seek professional assessment

When anxiety is persistent, escalating or restricting functioning.

Reference tool — informs practice, does not diagnose or label.

iWhen to seek professional assessment

Refer when anxiety is persistent, escalating, causing marked distress or restricting education/social functioning.

Examples: School avoidance, repeated panic, inability to eat/sleep, severe social withdrawal, compulsive reassurance/avoidance.
Pathways: Family/GP, psychologist, paediatrician/psychiatrist, school mental-health pathway, headspace where age-appropriate.
Early help: Reduces the chance that avoidance becomes entrenched.

Urgent mental-health risk

Can coexist with depression, self-harm and suicidal thinking.

Reference tool — informs practice, does not diagnose or label.

iUrgent mental-health risk

Anxiety can coexist with depression, self-harm and suicidal thinking.

Urgent: Expressed suicidal intent/plan, severe self-harm risk, inability to remain safe, extreme agitation or medical crisis.
Australia: Call 000 for immediate danger and follow local crisis procedures.
School: Do not leave a high-risk student unsupported while waiting for ordinary referral.

Severe anxiety is not automatically an emergency, but safety concerns are. Treat risk directly rather than assuming “it's just anxiety”.

Educator working summary

Often hides inside avoidance, anger, perfectionism and physical complaints.

Reference tool — informs practice, does not diagnose or label.

iNotice, respond, refer

Anxiety often hides inside avoidance, anger, perfectionism, reassurance and physical complaints.

Notice: What is feared, what the student does to feel safer, and what activities are shrinking.
Respond: Reduce unnecessary threat, make the next step clear, avoid shame and support gradual approach.
Refer: When anxiety is persistent, severe or substantially restricting education and everyday life.

The classroom question: “What is this student avoiding or trying to make certain, and how can we support them to participate without making avoidance stronger?”

Evidence base & reference links

Sources

Reference tool — informs practice, does not diagnose or label.

iSelected Australian / clinical sources

Healthdirect — Anxiety in teenagers healthdirect.gov.au — Anxiety in teenagers
Healthdirect — Anxiety in children healthdirect.gov.au — Anxiety in children
headspace — Anxiety in young people headspace.org.au — Anxiety in young people
Raising Children Network — Anxiety disorders in pre-teens and teenagers raisingchildren.net.au — Anxiety disorders
NICE — Social anxiety disorder nice.org.uk — Social anxiety disorder (CG159)

Anxiety Disorders

Generalised Anxiety Disorder (GAD)

Social Anxiety Disorder

Separation Anxiety Disorder

Panic Attacks

Panic Disorder

Specific Phobias

Agoraphobia

Selective Mutism

Instructional Demand System

Functional Out System

Adult Language Scripts

Generalised Anxiety Disorder (GAD)

iWhat it is

@What it can look like at school

✓What helps

Social Anxiety Disorder

iWhat it is

@What it can look like at school

✓What helps

!Keep in mind

Separation Anxiety Disorder

iWhat it is

@What it can look like at school

✓What helps

Panic attacks

iWhat it is

@In school

✓Response

Panic Disorder

iWhat it is

@What develops

✓Support

!Adult mistake

Specific Phobias

iWhat it is

@School impact

!Do not

Agoraphobia

iWhat it is

@School presentation

✓Support

Selective Mutism

iWhat it is

@School signs

✓Support

!Do not

Anxiety: normal response vs anxiety disorder

iNormal response vs anxiety disorder

The anxiety-avoidance cycle

iThe anxiety-avoidance cycle

Physical anxiety symptoms

iPhysical anxiety symptoms

School refusal / school avoidance

iSchool refusal / school avoidance

!Do not assume

Performance and test anxiety

iPerformance and test anxiety

!Avoid

Perfectionism and fear of mistakes

iPerfectionism and fear of mistakes

Reassurance seeking

iReassurance seeking

Somatic complaints

iSomatic complaints

Irritability, anger and aggression

iIrritability, anger and aggression

!Avoid

Freeze and shutdown

iFreeze and shutdown

Procrastination and task avoidance

iProcrastination and task avoidance

Attendance deterioration

iAttendance deterioration

Peer avoidance and social safety behaviours

iPeer avoidance and social safety behaviours

!Do not

Anxiety vs ADHD

iAnxiety vs ADHD

Anxiety vs autism