504 plan for anxiety
By the IEP Atlas editorial teamLast updated
Short answer
A child with an anxiety disorder can get a 504 plan when anxiety substantially limits a major life activity such as thinking, concentrating, learning or sleeping. The plan lists supports like a check-in person, a set break routine, notice before changes and a quieter test room. Good plans help your child stay in class and build coping skills over time.
Anxiety at school can look like stomachaches every Monday, freezing during tests, refusing to present, or calling home from the nurse's office. A 504 plan writes down the supports that help your child stay in class and get work done. This page shows a sample plan with notes so you can compare it with your child's.
For a longer list of supports, see anxiety accommodations at school. For the basics of these plans, see what a 504 plan is.
Who qualifies
A child qualifies when anxiety substantially limits one or more major life activities. For anxiety these are often thinking, concentrating, learning, sleeping, eating and communicating.[1] The school decides this from more than one source, such as teacher reports, attendance records, counselor notes, a doctor or therapist's letter, and what staff see in class.[2]
Two points help many families:
- Treatment does not count against your child. The school must judge the limit as if your child did not have the benefit of medication or therapy.[1]
- Anxiety that comes and goes can still count. A condition that is episodic qualifies if it would substantially limit a major life activity when active.[1]
A sample 504 plan for anxiety, with notes
This is for Sam, a fictional 7th grader. The numbers are examples, not targets for your child.
Impairment and major life activity. "Generalized anxiety disorder. Substantially limits concentrating, thinking and communicating."
- What to look for: the activities match what the school sees, such as freezing on tests or not speaking in class.
Information used. "Attendance: 11 absences and 14 nurse visits from September to November. Therapist's letter. Teacher reports from 5 teachers. Counselor log of 3 classroom observations."
- What to look for: attendance and nurse visits are often the clearest data for anxiety.
Accommodations.
| Support | When | Who |
|---|---|---|
| Morning check-in with the counselor, 5 minutes | Every school day before first period | School counselor |
| Break pass: up to 2 breaks of 5 minutes per class, to the counselor's office, with sign-in on return | All classes | Classroom teacher, counselor |
| Tests over 20 minutes in a small-group room | All core classes | Resource staff |
| Notice of schedule changes and substitutes at least 1 day ahead, when known | All year | Counselor |
| Option to present to the teacher alone or to a small group first, then build toward the class | Oral presentations | Classroom teacher |
| Not called on to answer aloud without warning; teacher gives a signal one question ahead | All classes | Classroom teacher |
| Plan for missed work: 1 day per day absent, no more than 2 make-up tests per day | After absences | Counselor and teachers |
- What to look for: breaks have a limit and a place. Open-ended breaks can turn into hours away from class, which tends to make anxiety stronger, not weaker.
- What to look for: the presentation support has a direction. It moves toward the full task over time.
Return-to-class routine. "If Sam goes to the nurse with anxiety symptoms and the nurse finds no illness, Sam rests for up to 10 minutes, uses a calming strategy from the counselor's list, and returns to class. The nurse calls home only after a second visit the same day."
- What to look for: a routine that brings your child back. School psychologists and counselors often build this with the family.
Review date. "Check-in in 6 weeks: compare absences and nurse visits with the fall numbers."
When a 504 plan is not enough
A 504 plan gives access. If your child needs direct teaching in coping skills, or is missing so much school that they are falling behind, they may need an IEP with goals. Goals might target using a coping strategy, asking for help, or returning to class within a set time. You can see examples in the library under IEP goals for anxiety, emotional regulation goals and coping skills goals.
School psychologists and counselors can provide mental health support at school as part of a team that includes families.[6] Ask who at school will work with your child, and how often.
Questions to ask the team
- "What did you see in class when my child got anxious?"
- "Can we look at attendance and nurse visits together and agree on a goal for them?"
- "Who is my child's go-to adult, and what if that person is out?"
- "How long can a break last, and what brings my child back to class?"
- "When will the nurse call me, and when will my child go back to class instead?"
- "How will teachers handle presentations and being called on?"
- "Will substitutes know about the plan?"
- "Can my child's therapist talk with the counselor, if I sign a release?"
- "If things get worse, when would you consider an evaluation for an IEP?"
What to do next
- Write a request if your child has no plan. See how to get a 504 plan for a sample letter.
- Track two numbers at home: days missed and calls from the nurse. Bring them to each meeting.
- Read about the other plan type. The IEP vs 504 guide explains the difference.
- Know your rights. You can see records and ask for an impartial hearing if you disagree.[3] The Office for Civil Rights resource guide covers Section 504 in detail.[4]
- Call your Parent Training and Information Center. Every state has one, and help is free. Find yours through the Center for Parent Information and Resources.[5]
The glossary has short entries on self-regulation and Section 504.
Frequently asked questions
Does anxiety qualify for a 504 plan?
It can. A child qualifies when anxiety substantially limits a major life activity such as concentrating, thinking, learning or sleeping. The school decides from several sources, and treatment such as therapy or medication is not counted against the child.
Do I need a diagnosis from a doctor or therapist?
A diagnosis helps but is not required for the school to evaluate. The school can use its own observations, attendance records, counselor notes and teacher reports. A letter from your child's provider is often useful evidence.
Can a 504 plan help with school refusal?
It can include supports such as a morning check-in, a set break routine, a return-to-class plan and a make-up schedule. If your child is missing a lot of school, ask the team whether an evaluation for an IEP is also needed.
Will a 504 plan for anxiety follow my child to high school?
Many districts review the plan when a child changes schools. Ask for a meeting before the move so the new school has the plan and the supports can be updated for the new setting.
Use it in IEP Atlas
- IEP goals for anxiety
- Emotional regulation goals (social emotional)
- Coping skills goal hub
- Self regulation in the IEP glossary
- Section 504 in the IEP glossary
Related guides
- What is an IEP? A plain guide to the plan and what is in it
- What is a 504 plan? Eligibility, contents and an example
- 504 plan examples by condition
- 504 plan for ADHD
- How to get a 504 plan for your child
- 504 plan accommodations list
- IEP vs 504 plan: differences, examples and how to choose
Sources
- Questions and Answers on the ADA Amendments Act of 2008 for Students with Disabilities Attending Public Elementary and Secondary Schools (2012), U.S. Department of Education, Office for Civil Rights
- 34 CFR §104.35: Evaluation and placement, eCFR (National Archives)
- 34 CFR §104.36: Procedural safeguards, eCFR (National Archives)
- Parent and Educator Resource Guide to Section 504 in Public Elementary and Secondary Schools (2016), U.S. Department of Education, Office for Civil Rights
- Center for Parent Information and Resources, CPIR
- NASP Position Statement: School-Based Mental and Behavioral Health Services, National Association of School Psychologists
Written and checked by the IEP Atlas editorial team under our editorial policy. This guide describes general practice and federal rules. It is not legal advice; your state may add requirements, and the IEP team makes the decisions for each student.