Jacy’s first became exposed to the importance of developing executive function skills when she was in a Montessori early childhood classroom.  The children were learning social and academic concepts that were often reserved for older children.  They were excelling in these areas due to the intentional focus on developing executive functions.  Later, when Jacy earned her MS from Erikson Institute, she was able to add another layer of understanding to the importance of these skills.  She strongly believes they form the foundation of life-long learning, as well as provide an avenue for a better quality of life. 

As a part of the McCormick foundation’s grant for 8 Big Shoulder Fund Catholic Schools, Jacy is helping to guide teachers in learning about executive functions through In-service sessions, modeling lessons in the classroom, and is revising the Primary and Intermediate Executive Functioning Curriculum Notebooks.  She will also be engaging with students in one-to-one tutoring sessions focused on developing executive function skills.

In the school setting, Terese works to incorporate RNBC’s Executive Functions Curriculum into the school curriculum. By supporting teachers with their implementation of Executive Functioning lessons in the class, students receive skills needed to be successful in their academics.  

As an Executive Functions tutor, Terese assists in the coordination and implementation of the tutoring program for RNBC.  In doing so, she helps students to incorporate skills that are necessary for success in their school work and beyond.

Terese received her Master of Arts degree in Curriculum Development from De Paul University. As an educator in the Chicago land area for over 16 years, her professional experience includes teaching at the Middle School, High School and Post-Secondary level. She has assisted in developing intervention plans for both ESL and at risk students. Her primary goal as an educator is to assist students to become lifelong learners. Terese is excited to be part of the extraordinary team of professionals here at RNBC.

What is school-based anxiety and school refusal?

Anxiety disorders are one of the most common problems among children and adolescents with rates varying from 10% to 20%. While a little worrying is normal, anxiety is defined as excessive worrying that is irrational or out of proportion to the feared stimulus. Symptoms of anxiety can interfere with everyday functioning as well as interpersonal relationships and school achievement. School can be an especially daunting place for children with anxiety because of the enormous interpersonal and academic demands. School-based anxiety is defined as a developmentally inappropriate reaction to the perceived consequences associated with school (e.g., failing a class, fears of getting picked on). School refusal behavior, also known as school phobia, occurs when the anxiety becomes so distressing that children and adolescents miss days, weeks, or months of school. The most common age of school refusal is 10 to 13 years, but can occur at any point in development. Parents are also more likely to see anxiety and avoidance behaviors occur during transition years (e.g., from elementary to middle school).

How does anxiety and school refusal impact youth?

Children with excessive anxiety present with a range of behaviors. Some children withdrawal from social activities or avoid difficult tasks for fear of failing or being embarrassed. They may appear inattentive, forgetful or unmotivated to engage in classroom discussions. Academic performance starts to suffer and teachers may interpret their behavior as defiant, disorganized or lazy. Socially, children may isolate themselves to avoid participation in peer interactions. They may have a poor self-concept and believe they lack the skills to initiate and sustain a friendship, which leads to further worries about being rejected by peers. Over time, children are more likely to develop sadness and develop a stable pattern of anxious thinking. Avoiding school or minimizing academic and social activities offer youth effective, short-term relief to reduce anxious feelings, but over time have serious negative consequences. Additionally, families are affected by this problem. Parents often feel blamed by the school given the common misperception that the issue is simply a matter of discipline. In reality, parents struggle to manage conflicting feelings around empathic desire to comfort their children and exasperation associated with the battle to get them to school.

 Warning Signs and Symptoms

Some warning signs that your child might be experiencing increased anxiety or school refusal include:

-       Excessive reassurance-seeking behavior

-       Clinging to an adult

-       Temper tantrums, crying

-       Sleep difficulties

-       Depressed mood, irritability

-       Difficulty concentrating

-       Complaints of physical problems that are absent on weekends or breaks

-       Frequent tardiness or absences

-       Absent on important days (tests, presentations)

-       Frequent trips to the nurse’s office

-       Frequent requests to call or go home

-       Refusal to get out of bed or go to school

-       Running away from home or school

What You Can Do

If you are concerned that your child is experiencing an increase in stress and anxiety or you have observed changes in his/her behavior that lead to school-based problems, it’s important to take steps to indentify the problem and develop an intervention plan. Parents may wish to consider one or more of the following actions:

 Medical and Psychological Evaluation

Having a routine medical check-up might be a good place to start, especially if you child is complaining of physical problems (e.g., headaches, stomach aches). Many of the symptoms commonly seen in children with anxiety can also have a medical explanation. Ruling out physical problems is critical before taking further action. On a related note, there are also a number of psychological conditions that could better explain the kinds of problems associated with school refusal. For example, a mood disorder such as depression may also cause a child to withdraw from school or lack motivation to go to school. Also, conduct problems, attention deficits and learning disabilities might manifest as school refusal and poor classroom connectedness. Finally, many children are unfortunately the targets of bullying, which can make school very unpleasant and lead to unwillingness to attend. In these cases, intervention efforts would take a different form. A comprehensive psychological evaluation would identify these or other potential contributors to your child’s school difficulties as well as guide treatment decisions.

School-Based Interventions

Parents are strongly encouraged to work closely with the school in developing an intervention plan. In order to be successful, the plan should start with a school refusal assessment that identifies the target behaviors, as well as antecedents and consequences (i.e., what happens before and after the behavior) at home and school. For example, if the child’s refusal seems to occur on days when there are tests, the school might implement a plan providing accommodations and support around test taking. Other common school-based interventions include structured behavior plans with rewards and consequences, social work support, reduced time spent at school, reduced or modified work expectations, or a systematic re-entry plan.

Home-Based Interventions

Parents play an important role in their children’s treatment plan. Successful interventions will include ongoing, consistent communication with the school and specific ways of handling anxiety and school refusal at home. Parents may be guided on how to respond to children’s complaints of feeling sick or temper tantrums. Forcing your child to go to school when the child is having a meltdown is one of the hardest things parents face. The result is feelings of guilt and frustration; parents may feel compelled to let the child stay home. This response inadvertently reinforces the anxiety and makes the problem worse. Establishing a contingency plan that involves the school will be helpful in guiding your decisions during these intense moments.

There are a number of other things parents can do to support anxious children, in general. Being supportive and consistent in discipline as well as providing a structured, predictable routine can alleviate anxiety symptoms. Be patient and avoid being overly critical or punitive. Praise effort over outcomes and be prepared to listen and encourage expression of feelings. Also, be mindful of your own anxiety and make efforts to model relaxation strategies such as positive self-talk and deep breathing

Other Considerations

Seeking outside help is strongly recommended if the problem persists and continues to impact the child’s ability to attend school or engage in daily activities. Individual or family therapy can be very helpful to reduce anxiety and support parents. Cognitive-Behavioral Therapy is a well-supported treatment approach that teaches children to manage anxiety using a combination of physiological, behavioral and thinking strategies. For extreme cases, parents may consider enrolling their children in partial– or full-hospitalization programs designed specifically to treat school refusal. Also, anti-anxiety or anti-depressant medication may also be a component of treatment.

If you have concerns about your child experiencing anxiety or school refusal and would like an evaluation and/or treatment through our Stress and Anxiety Clinic, please call 847–933-9339 to schedule an appointment.

 1. Diagnostic Clarity

Does Joe have ADHD? A learning disability? Executive functioning problems? Anxiety? Depression? A combination of things? These are all potentially valid hypotheses.  Children are complicated and a host of factors may account for a similar behavioral presentation.  For instance, children who look like they are not paying attention often have undiagnosed learning disabilities.  The reverse is also true in that children who have attention deficit disorders may appear to have learning difficulties because they cannot consistently produce academically.  Similarly, children who are anxious or depressed may have difficulty concentrating or be unavailable for new learning. One major goal of a comprehensive evaluation is to determine which problem areas are primary and which are secondary, and ascertain whether the data are suggestive of a specific diagnosis.  Often, there is a combination of factors which need to be understood.

 2. Learning style

In addition to diagnostic clarification, another major purpose of a comprehensive evaluation is to understand how a child like Joe learns the best.  One size does not fit all.  Testing provides a profile of a child’s unique strengths and weaknesses across multiple areas of functioning and sheds light on how a child processes information.  Such information is invaluable for teachers and other professionals who are working with children on a daily basis and may be unclear about how to most effectively intervene.

 3. Road Map

A comprehensive evaluation should provide a road map for parents, teachers and other pertinent professionals about how to address their child’s needs. Such interventions may include tutorial support, medication, psychotherapy, speech/language therapy, occupational therapy, social skills groups or school-based learning resource support.  Sometimes, a change in school placement is recommended.  Regardless of the type of intervention, once a full evaluation has been completed, the best combination of supports and specific goals for each is more readily understood.

 4. Monitoring Tool

Comprehensive evaluations provide concrete data about a child’s level of intellectual, academic, social/emotional and attentional functioning at a snap shot in time.  Nonetheless, children are moving targets.  As such, children like Joe need to be monitored over time to determine whether in fact they are progressing, hitting a plateau or falling behind.  Periodic evaluations are a very helpful tool in this monitoring process.  Interventions often need to be updated or changed to accommodate children’s continual development.  As such, 2–3 year re-evaluation intervals are typically recommended for school-aged children, while annual re-evaluations are ideal for children under age 5.

 If you have questions about psychological/neuropsychological evaluations at RNBC, please contact our office at (847) 933‑9339

Many of the kids I treat really do count the days. The effort to produce academically when there’s a difficulty with learning or regulating behavior can push children to the limit. The relief of being free of school, of no longer being judged on the basis of activities that often make these children feel they are at a disadvantage, creates a sense of buoyancy and lightness. Everything in daily life gets easier over the summer for the children, but also for their parents. Or it can, if you keep a few simple guidelines in mind.

1. Don’t recreate the pressures of school at home. Some parents are so focused on the challenges of the school year that they forget to create an atmosphere in which a child can relax and feel good about himself or herself. Even kids who benefit from tutoring over the summer should have at least one week of every four when there’s no work to do. This is the time to travel, play, pursue a hobby or sport, sleep late, and see friends.
2. Monitor screen and phone time. A couple hours a day of computer time, video games, or talking on the phone can be a pleasure for a child and is often a social experience. But too much time in front of a screen interferes with the chance to focus on a personal passion – an activity that the child really loves or a skill that a child could develop.
3. Monitor your own screen and phone time, too! If you have a chance to be with your child—pushing a stroller, driving a car pool, or spending an evening at home—stay off the computer and/or phone and talk to your kid about what you’re both seeing, feeling and thinking. Discuss movies, books, a game you’ve seen. Make a meal together and eat it at leisure.
4. Relax! Not every moment should be purposeful and productive. Don’t pack your child’s schedule or your own. Leave time to think and take walks. Give in to (positive!) impulses. If your child comes down to breakfast talking about dinosaurs, draw dinosaurs together, jump in the car and go to the Field Museum,  head for the library to get dinosaur books, or together do a computer search on dinosaurs.
5. Model the behaviors you want your children to learn. Sign up to clean a beach or deliver meals on wheels. Build something for Habitat for Humanity with your teenager.
6. Foster relationships with your extended family. A visit to grandparents, a week playing with cousins, going to museums with a favorite aunt, or learning to fish with a favorite uncle, can make a child’s summer memorable.
7. Let children help to plan and organize trips and activities. All too often children who lack organizational skills are asked to develop them around activities they don’t enjoy such as homework or tutoring. They’ll have a lot more incentive to strengthen their skills planning a trip to Great America or scheduling things to do during a cousin’s visit.
8. Let summer be a time to experience new possibilities. Children—particularly those who struggle during the school year – need to know they’re not boxed in by the status quo. One of the activities they try for the first time this summer—horseback riding, painting, SCUBA diving—could become a long-term passion, a source of self-worth, and a connection to the world.