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We all get anxious once in a while - the dry mouth, sweaty palms. Adults go through it, and kids feel it, too. In the worst cases, it can make them so stressed they can't even go to school. Kavitha Cardoza of member station WAMU visited a program in Fairfax, Va. that's trying to help kids with extreme anxiety.
KAVITHA CARDOZA, BYLINE: A red or green piece of paper taped to the front door. That's the signal these parents, Mia and Chris, use every morning. It's to let the bus driver know whether their oldest son, Jared, is going to school. Today, they're not sure what color it'll be.
CHRIS: He hasn't been going to school for three weeks.
MIA: Yeah, three weeks. And I pushed him hard yesterday just to go for, like, one hour. I caused him to go into a fetal position.
CARDOZA: We're not using Jared's last name to protect his privacy. He struggles with debilitating anxiety. When he was younger, he was a straight-A student and a perfectionist. Then at 13, he was hospitalized for a simple appendectomy. He only missed a few days of school, but...
MIA: This fear of going back to school and having to make up all this work - he was really, really upset with himself and would still continue to have these stomach cramps, which in hindsight was related to anxiety.
CARDOZA: Mia and Chris felt increasingly helpless. Their gentle, funny son was refusing to go to school. They tried everything - cajoling, calling the police and once even carrying him to the bus stop. Over the past three years, Jared's been through therapists, hospitalizations and medications. He's been diagnosed with severe anxiety.
ERIN BERMAN: Anxiety feels no different if you're being chased by a lion or you have to go to school.
CARDOZA: That's Erin Berman, a clinical psychologist with the National Institute of Mental Health. Research suggests about 3 percent of all children in the U.S. suffer from anxiety. Many grow out of it or learn how to deal with it - others don't. Berman says kids with anxiety want to take part in school activities. They want to make friends. They're just too nervous.
BERMAN: They may look like they're not doing their homework or they're not paying attention. The not paying attention may come from that their mind is thinking about all the scary things.
CARDOZA: Jared has good days and bad days. I spoke to him at school on one of the good days. He says the worst part about anxiety is the choices he has to make. It starts first thing in the morning with what to eat for breakfast.
JARED: I might be cranky if I eat cereal, the wrong type of cereal. And if I eat the wrong type of cereal, maybe I won't be able to taste the milk.
CARDOZA: Jared says the constant noise in his head is unrelenting and exhausting.
JARED: You think back, oh, I shouldn't have eaten that cereal and now I'm cranky because of this. Why am I talking to people? Now I'm probably making them feel like I'm a bad person, and I'm not a bad person.
CARDOZA: The worst part? Crawling under the blankets doesn't make the noise go away.
JARED: At the end of the day when you think back to all those choices you didn't make and that you decided to stay home you realize, oh, that wasn't the right choice either.
CARDOZA: When his parents do put out that green signal and Jared does go to school, it's to a very special one, a program in Northern Virginia called Aspire specifically geared to students with severe anxiety. It's run by the public school district in Fairfax County.
SHARITA MARSHALL: And if you don't want to come to the front, your parents can drop you off on the side over there.
CARDOZA: Sharita Marshall is a social worker here. Today, there's a new student enrolling. She shows him a secluded back entrance that leads straight into the classroom.
MARSHALL: You can just knock right here on one of these windows like this (knocking). And once you walk around, Ms. Bottle will be at the front to let you in.
ROSE BOTTLE: Come on in.
CARDOZA: Rose Bottle runs the Aspire program. She says being able to come in the back is just one of the accommodations here. Teachers are told, don't make eye contact or say good morning in hallways. And inside this classroom, windows are covered with an opaque film so no one can look in.
Usually when I go into a classroom, all the kids turn to look at, like, who's the stranger? And no one turned around.
BOTTLE: They're very reluctant to speak. They often are isolated. They'll sit alone or with just one person who they feel comfortable with.
CARDOZA: I'm looking at two large partitions between desks so some students literally can't see the person beside them.
BOTTLE: And I have a couple kids who really prefer that separated space.
CARDOZA: Most of the 17 students in this program have missed more than six months of school before coming here. They take online courses so they work by themselves, at their own pace. And there are also several therapists and social workers, like Sharita Marshall.
MARSHALL: During the day, I keep my basketball hoop here. Sometimes, for some of the boys, it's a lot easier for them to talk with the basketball. And so they're able to, you know, not look at me, which helps for some of them. Let's see, what other bag of tricks do I normally use here?
CARDOZA: Stress balls, games, little rewards - Marshall uses a form of exposure therapy. It may start in the parking lot.
MARSHALL: The mom or dad or family maybe just sit with the kid in the car maybe for 15 minutes, 20 minutes, and then they leave. And maybe they do that for a week.
CARDOZA: From there, maybe into the office for a few minutes, then a conference room, and then a classroom. She says this specialized program can speed things up. It's expensive, though. The Fairfax district spends on average just under $14,000 for each of its students - the Aspire program about twice that. And it doesn't guarantee a straight line to recovery. That's something Jared's parents, Chris and Mia, know all too well. This morning, their other children are heading off to school.
MARCUS: Bye, mom. Bye, dad.
UNIDENTIFIED CHILD #1: I will.
UNIDENTIFIED CHILD #2: Half-day today.
CARDOZA: But Jared still hasn't left his room. Mia and Chris have taped a large red piece of paper outside their front door. The bus driver won't stop. Tomorrow, maybe, things will be different. For NPR News, I'm Kavitha Cardoza.
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