Specialized academic coaching for improving anxiety response and executive function in twice-exceptional children: a case study

Laura Fragomeni, Ed.M

December 2021


This case study examines the trajectory of Student A, a twice-exceptional middle school student who received support from School Without Suffering during the 2020-2021 school year. The impact of specialized academic coaching support was first evaluated through the ongoing narrative assessment conducted while Student A received one-on-one support and was further assessed through an interview with her mother. Both demonstrated that the support from School Without Suffering was transformational for the student in improved anxiety response and executive functioning and raised confidence and a more positive relationship with her parents. As these results are typical for students who receive support from School Without Suffering, students with similar profiles are likely to benefit from being referred for support.


School Without Suffering is an academic coaching practice specializing in helping students who experience anxiety feel better and perform their best in school. School Without Suffering was founded by Laura Fragomeni, an award-winning master educator and academic coach with additional training in educational therapy.


School Without Suffering support programs include options for one-on-one academic coaching sessions, group coaching sessions, online courses, and formal skill assessment according to each student’s need. Those needs are informally evaluated when a student’s parent first reaches out for support, and a personal academic coaching plan is created for the student at that time. That plan is continuously re-evaluated and adjusted as needed so that the student is always getting the proper support at the right time.


This case study examines the trajectory of Student A, a twice-exceptional middle school student who received support from School Without Suffering during the 2020-2021 school year.


Student A’s mom, D, reached out to School Without Suffering for support late in August 2020, when Student A was beginning seventh grade. Student A struggled with anxiety and executive function deficits, manifesting as unfinished homework and assignments piling up, mom nagging her daughter, and eventually, Student A melting down each night, which was wearing on the entire family. D states that she wanted to pull herself out of that dynamic and find someone to fill the role of helping her daughter to manage her school work. Specifically, she was hoping to find someone who could help her daughter gain the executive function skills she needed to manage her work, though she wasn’t sure at the time whether that type of support for students existed.


Under the care of her pediatrician, Student A had been undergoing treatment for mood instability for several years. She had tried talk therapy but was refusing to attend sessions when her mom contacted School Without Suffering.


Despite her challenges, Student A had performed exceptionally well academically throughout elementary school and was even promoted from second to fourth grade, skipping the third grade. Her teachers consistently reported excellent behavior at school, and her school reported no discrepancy between her academic abilities and her performance. However, her grades were beginning to suffer from missing assignments.


Though Student A was adept at masking her challenges at school, the effort it took her to do so left her completely drained at the end of each school day.


When asked to think back to that August and identify what it would have meant to her to find the type of support she was looking for, D talks about relief and safety. She wanted for her daughter to be able to not only complete her assignments and live up to her brilliant potential but to be able to do it in a place where she felt encouraged and wanted to do her work rather than to continue fighting it.


After our phone consultation, D spoke with her husband and Student A about starting services. All agreed to a one-week trial, as Student A had a long history of losing interest in support programs, both academic and therapeutic, relatively quickly, after which it was challenging for her parents to get her back into them.


Student A found so much value in the first week that she and her parents were excited to start a six-week support plan the following week. All in all, Student A completed 12 weeks of one-on-one support followed by three months of group support.


Student A received support from School Without Suffering throughout the 2021-2022 school year.


In the first half of the school year, she received Intensive level support. At the Intensive level, students receive at least two 50-minute 1:1 academic coaching sessions per week and can drop in for Office Hours for additional support as needed after school Monday–Thursday. We start by teaching these students some basic neuroscience underlying their perception of school and school work as well as the fundamental neuroscience of anxiety. We then build on that background to teach the students specific strategies to help them feel better while completing their school work and improving their performance. We use our ongoing 1:1 and Office Hours sessions to support the students as they practice using their new strategies in the context of their school work and life circumstances over time.


Because the challenges causing Student A and her family the most pain were procrastination and resulting anxiety-induced meltdowns, our signature 4-step time and energy management system1 was the first strategy we taught her. The four-step process provides a structure for students to 1) identify each assignment a student needs to complete in a given week, 2) prioritize their tasks and activities, 3) schedule time to complete their work and participate in their other activities, and 4) reflect to improve their time and energy management every week.


The next two strategies that we focused on with Student A were Emotional Freedom Technique, also known as “Tapping,”2 and our signature strategy based on self-instruction, in which students induce self-statements to self-regulate while they work3. We call this strategy simply “Self-statements.”


Both 1:1 and Office Hours sessions were utilized to coach Student A to create and follow time management plans. This time was also used to coach her to use her stress management strategies in the context of her school work, and to provide tutoring-type support when Student A needed review or reinforcement of math, science, or humanities concepts and skills.


As is standard practice for all of our Intensive level students, we discussed progress with Student A and her parents each month to review her accomplishments, set new goals, and discuss next steps for her support. When Student A expressed that she was feeling the urge for more independence in the second half of the school year, we agreed with her parents to continue to support Student A at the Core level, where we would continue our work with her during Office Hours and hold 1:1 sessions only when they were requested.


The impact of specialized academic coaching support on Student A was first evaluated through the ongoing narrative assessment conducted while Student A was receiving one-on-one support. As is standard practice at School Without Suffering, parents of the student were provided updates weekly.


Student A’s mother, D, was later interviewed after Student A’s involvement with the School Without Suffering group coaching program had concluded.


The results are summarized below.

Ongoing Narrative Assessment

Within her first week working with School Without Suffering, Student A demonstrated that she met the following Understanding Goals for the basic neuroscience concepts:

  • Our brains can jump to conclusions about something we perceive, whether through sight, sound, touch, taste, or smell, and those conclusions can have a big impact on our thoughts, feelings, and physical experiences related to schoolwork. 
  • If your brain has learned to categorize school work as stressful, as soon as you perceive that it is time to go to class or start homework, your brain concludes that it will be stressful, and then you begin to feel stressed.
  • What we perceive about something depends on what we’re paying attention to. So, changing what we’re paying attention to can change our perception.
  • Anxiety is a normal, natural response our brain has to help protect us from harm.
  • Specific brain parts work together to produce an anxiety response in certain situations.
  • When the rest of our brain and body can listen to the message that we are safe, we can overcome our anxiety and do what we need and want to do.


Four weeks into our relationship with Student A, she began to truly open up about the anxiety she’d been feeling that was causing her to procrastinate and stay up very late at night to get her homework done. That allowed us to authentically and effectively reinforce the tapping and self-statements strategies in each of our sessions moving forward, and she began to report using them outside of our sessions to regulate her anxiety and mitigate procrastination.


Figure 1

Screenshots from Student A’s Self-statements workbook, taken September 15, 2020—her first week working with School Without Suffering. The left column displays examples of statements that the student may have chosen to say to herself while working. The column on the right displays the statements that she chose.


By the end of our second month working with Student A, she was consistently using her time and energy management system to stay on top of her work, no longer leaving it to the last minute and only in rare cases turning in assignments after their deadlines. By the third month, both she and her mom proudly reported that she was helping around the house for the first time since her school-related anxiety began. 


Figure 2

Screenshot of the Reflection step in Student A’s weekly planner taken October 22, 2020—the end of her second month working with School Without Suffering. The student answered these reflection questions at the end of each week before planning the next.


In our fourth month working with Student A, as the first half of the school year neared its end, we observed Student A taking the initiative to create a list of all of her end-of-semester work and create a plan for what days she would complete which assignments, all on her own. Student A expressed that she knew that even if she did not follow that plan perfectly, she would be able to make adjustments when she needed to and that just having the plan made her feel more in control. The amount of power and confidence she felt as this typically stressful time of the year progressed was also quite evident in our interactions with her.


Student A maintained this level of performance throughout the second half of the school year. As of now, she is still learning to express her feelings at home in a healthy way when she feels overwhelmed by schoolwork, but she has made tremendous progress in limiting the amount of stress and anxiety she experiences due to school.

Parent Interview

When Student A had completed her time with School Without Suffering, we spoke to her mother, D, about the experience.


D observed that Student A had a better sense of what to expect from her school work and was better able to keep herself on task. D attributed this change to Student A’s use of the time and energy management system described earlier.


D also reported that after starting the School Without Suffering program, Student A was much calmer when starting her homework. D attributed this new sense of calm to the tapping technique and the Self-statements strategy that Student A learned in her first week with School Without Suffering. 


Furthermore, D noticed that the way that Student A began talking to herself after that first week was strikingly different from what she had witnessed before. Whereas before beginning work with School Without Suffering, Student A’s dialogue with herself was critical, she quickly learned to reframe her thoughts and speak to herself with more compassion. D reported that she even taught her mom to make that change! 


Finally, D reported that Student A no longer felt shame about her homework because there was no more nagging. So, in addition to remaining calm, she was also feeling good about herself as she completed her assignments. In fact, D stated during the interview that “my favorite part of my daughter working with your program was watching her confidence grow.”


This case demonstrates that specialized academic coaching provided by School Without Suffering can improve anxiety response and executive function in twice-exceptional children like Student A. 


Student A’s results from the program were expected given that a) results similar to those that Student A experienced are typical for students who receive support from School Without Suffering and b) the program has been designed based on established learning science and is delivered by highly-qualified and highly-experienced academic coaches. Of course, every child’s success in any intervention program will be influenced by their unique life circumstances, and as such, results cannot be guaranteed for every student. 


Given our observations, however, we are confident in concluding that students with similar profiles to Student A are likely to benefit significantly from being referred for specialized academic coaching support provided by School Without Suffering.