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Anxiety is a common human experience. Children may fear separation from their parents; adults may go through stressful situations causing them worry. However, a person may be diagnosed with an anxiety disorder when these feelings are so significant and regular that they interfere with everyday activities (Centers for Disease Control and Prevention, 2023). Public school leaders may already recognize that students with anxiety disorders have legal protections, but private school leaders also have a legal obligation to provide accommodations. This article clarifies the legal landscape so both public and private school leaders can better serve students with anxiety disorders and their families.

Prevalence and Impact

Anxiety disorders are the most common mental health disorders affecting children and adolescents. Recent findings from the Centers for Disease Control and Prevention indicate that about 9% of U.S. children had diagnosed anxiety (2023). Considering that anxiety often goes undiagnosed, the percentage of young people who experience anxiety disorders could be as high as 15% to 32% (Chiu et al., 2016). Many students are susceptible to developing anxiety disorders, as the risk factors include experiencing stressful life events, having relatives with mental disorders, and having certain health conditions (National Institute of Mental Health, 2024). Additionally, anxiety disorders disproportionately impact students of color, students from families with low socioeconomic status, and students from other vulnerable communities.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) includes 11 distinct subcategories of anxiety disorders, such as generalized anxiety disorder, panic disorder, and social anxiety disorder (National Institute of Mental Health, 2024). Each type of anxiety disorder may have distinct triggers and symptoms, but they all have the similar potential to disrupt a child’s education.

Students with anxiety disorders can exhibit a range of behaviors that cause challenges in the classroom, such as inattention, restlessness, disruptive behavior, social avoidance, and failure to submit assignments (Ehmke, 2023). Students also may exhibit patterns of school avoidance or school refusal, which is particularly problematic when public schools are legally obligated to ensure students are not truant.

The COVID-19 pandemic exacerbated a variety of mental health challenges, including anxiety disorders. The U.S. Department of Education (USDOE, 2021) reported that between January and October 2020, emergency room visits related to mental health increased 31% for 12- to 17-year-olds. In the same report, the department found that during the pandemic, “LGBTQI+ students were among those at highest risk of increases in anxiety symptoms” (USDOE, 2021, p. 12).

Accommodations Required in Public and Private Schools

Like other mental health disorders, an anxiety disorder is a qualifying disability under the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973 (Section 504), if the disorder “substantially limits one or more major life activities” (USDOE, 2023). Therefore, students with anxiety disorders have the right to receive accommodations in both public and private schools. A school must evaluate each student’s eligibility, using diagnoses and recommendations from medical professionals, and/or through its own evaluation process (USDOE, 2023). Accommodations are intended to allow students an equal opportunity to access their education. As with other accommodations for students with disabilities, confusion sometimes arises in a private school as to what the school is required to do.

All educational institutions accepting or benefiting from federal funds, which includes many private schools, are subject to the requirements of Section 504 (Shaver & Decker, 2017). Section 504 regulations expressly state that private schools receiving federal funds cannot exclude a student with a disability “if the person can, with minor adjustments, be provided an appropriate education” (Nondiscrimination on the Basis of Handicap in Programs or Activities Receiving Federal Financial Assistance, 2000, § 104.39(a)). However, “minor adjustments” is a lower bar than the “reasonable accommodations” that are required in public schools. Section 504 provides a basis for litigation if a family feels that their child’s rights have been violated by a private school, but it does not require the private school to provide specific services. Neither private nor public schools are required to “fundamentally alter” programs for which students with disabilities do not meet the basic participation requirements (Shaver & Decker, 2017, p. 32).

The question of what constitutes a “minor adjustment” for a private school has resulted in litigation. In Hunt v. St. Peter School (1997), a private Catholic school decided that it could no longer enroll a student whose life-threatening asthma was aggravated by an allergy to scents. The family claimed that the school violated Section 504 by not providing their daughter with a scent-free environment to accommodate her asthma. The federal district court found in favor of the private school, noting that the school had worked with the family over the years to accommodate the student by providing a voluntary scent-free environment, including education to teachers and classmates about the student’s condition, as well as allowing in-classroom monitoring by the parents. The court reasoned that these efforts had surpassed the bar of “minor adjustment,” and that when these accommodations proved unacceptable to the family, the school was then within its rights to exclude the student. Interestingly, the judge also wrote that “
[w]hile I have been unable to identify a case interpreting minor adjustment, it is clear that [a] minor adjustment is less than a reasonable accommodation. Minor indicates a minimal burden and adjustment implies a small correction” (p. 852). While these words are not legally binding outside of this jurisdiction, the decision does provide some helpful guidance regarding how courts might address the “minor adjustment” standard.

Common Accommodations

In public schools, qualifying students with anxiety disorders would typically receive a written “504 plan” from the school district, which summarizes the student’s reasonable accommodations. Although it is not legally required for private schools to create a written agreement of what the student’s accommodations will include, it may be prudent for them to do so.

School leaders should engage with the student’s family to create accommodations based on data from the student’s health providers. Accommodations should be tailored to the student’s social and academic needs (Green et al., 2017). For example, teachers could ask students to give special cues or signals when they feel they need to opt out of participation or allow them to leave class early to avoid hallway congestion. Because some students find that timed assignments can be triggers for their anxiety, teachers might grant them extended time on tests and deadlines. Schools may also loosen their attendance policies to allow students with anxiety disorders to take extended absences, or to miss more school than is allowed for other students.

Some of these accommodations are likely to go far beyond the minimal “minor adjustment” standard for private schools. Private school leaders should, however, recognize their ethical obligation to create a welcoming and inclusive environment for their students (Bonfiglio & Kroh, 2020).

Recommendations

Communicate with staff about anxiety disorders and how to accommodate students. Clarify the difference between everyday anxieties and anxiety disorders. Teach staff how anxiety disorders make it difficult for students to meet certain expectations. Considering the increasing prevalence of anxiety disorders, ask staff to make adjustments and extend compassion. At private schools, there is a lot of room for discretion with the “minor adjustment” standard, so discuss what this means with your staff, and articulate the general approach the school will take. Share examples of ways that schools have accommodated students and articulate how accommodations are consistent with your school’s mission and values.

Educate staff about their legal obligations under Section 504. Because these legal requirements are widely misunderstood among private school educators (Bonfiglio & Kroh, 2020), it is important to increase the legal literacy of teachers, counselors, and other staff in both public and private schools.

Identify symptoms of anxiety disorders early. While private schools do not have the proactive “child find” obligations of public schools where students with disabilities must be identified, both public and private school leaders should create systems to proactively identify students so that they can be supported.

Make sincere efforts to accommodate the student’s needs and be honest and upfront about what the school cannot provide. Both public and private schools should draft and implement a written accommodation plan. However, most private school parents understand that private schools have less of a legal obligation than public schools. Therefore, regardless of the legal obligations, school leaders should reassure parents that the school is doing what it can to promote the well-being of their children.

Greg VanSlambrook is the principal of Brebeuf Jesuit Preparatory School in Indianapolis, IN, and a doctoral student at Indiana University. Morgan S. Kelly, JD, is a graduate of Indiana University’s Maurer School of Law and an adjunct professor at Indiana University. Janet R. Decker, JD, PhD, is an associate professor of education at Indiana University and a co-author of Legal Rights of School Leaders, Teachers, and Students.

References

Bonfiglio, C., & Kroh, K. (2020, December 21). Inclusion in Catholic schools: From inception to implementation. Journal of Catholic Education, 23(2), 138–164. doi: 10.15365/joce.2302122020.

Centers for Disease Control and Prevention (2023). Anxiety and depression in children. cdc.gov/childrensmentalhealth/depression.html.

Chiu, A., Falk, A., & Walkup, J. T. (2016, January 14). Anxiety disorders among children and adolescents. Focus, 14(1): 26–33. doi: 10.1176/appi.focus.20150029.

Ehmke, R. (2023). How does anxiety affect kids in school? Child Mind Institute. childmind.org/article/classroom-anxiety-in-children/.

Green, J. G., Comer, J. S., Donaldson, A. R., Elkins, R. M., Nadeau, M. S., Reid, G., & Pincus, D. B. (2017). School functioning and use of school-based accommodations by treatment-seeking anxious children. Journal of Emotional and Behavioral Disorders, 25(4), 220–232. doi: 10.1177/10634266166643.

Hunt v. St. Peter School, 963 F. Supp. 843 (W.D. Mo. 1997).

National Institute of Mental Health. (2024). Any anxiety disorder. nimh.nih.gov/health/statistics/any-anxiety-disorder.

Nondiscrimination on the Basis of Handicap in Programs or Activities Receiving Federal Financial Assistance, 34 C.F.R. § 104 (2000). ed.gov/policy/rights/reg/ocr/edlite-34cfr104.html.

Shaver, E., & Decker, J. (Eds.) (2017). A Guide to Special Education Law. Education Law Association.

U.S. Department of Education. (2023). Protecting students with disabilities. ed.gov/about/offices/list/ocr/504faq.html.

U.S. Department of Education. (2021). Supporting child and student social, emotional, behavioral, and mental health needs. ed.gov/documents/students/supporting-child-student-social-emotional-behavioral-mental-health.pdf.