I just wanted to hop on here and thank the the OP and all that have replied and advised on this thread. My son has anxiety and is similar to your DD where those sticker chart type behavioral controls cause him great anxiety to the point where he completely detoriates and has OCD symptoms. I thought I was the only one with a kid like this!!! For example, his first year in public school (kindy) last year he had a paraprofessional (the kids broke into three groups each day to do reading and fine motor tasks with a paraprofessional leading each group) who triggered his anxiety so acutely he became completely unable to swallow his salivia. He has this fear of something "disgusting, bad or dangerous" going into his body. he usually keeps this fear under control but when he had to work with this parapriofessional (who shamed him, was completely inflexible, etc) he became so anxious he really had trouble swallowing. Then, in order to force him to work with the said assistant the school psych instituted some sort of sticker reward chart and he deteriorated completely! He couldn't swallow at all - his throat was sore from being unable to swallow and his lips were all chapped form him pushing the salvia out of his mouth on to his lips and then wiping the salivia away with his sleeve. His tops were soaked from his salvia! it was truly shocking frown He had to carry a couple of handkerchiefs to wipe away his salavia. it was awful. I eventually flipped out a bit on them and insisted they move him to a different group run by a different assistant and he recovered and had a great 2nd half of the year. Since then we got an anxiety diagnosis. we are planning to institue an IEP for next year (I just cannot have him go through that and deteriorate like that again). But all of this is very helpful background info for the upcoming IEP meeting. I *pretty* sure our district will work well with us - they are supposedly a very good district for special needs, accomodations, etc... but we'll see. And this is my first experience with any type of IEP so... Anyway, the info here is great. And it is comforting to knwo that other kids have this problem! I plan now to record our IEP meeting(s) as well. I am nervous b/c the psych running the show for meeting (I think) is the same psych who crafted and instituted the 'sticker reward chart' that really just destroyed my DS. I am hoping I don't have too much trouble with her! I have to admit, I have a bit of a bias aganst her and am wary of her and I really didn't like how she handled the situation with my son last year. But that was before they knew he had an anxiety disorder and before a diagnosis.