Almost every child experiences some fear and anxiety when starting day care, preschool or kindergarten. But for a small percentage of children, fear of attending school can become exaggerated and actually translated into physical illness. Some children develop stomachaches or headaches because they are so frightened of going to school. In the worst cases they actually refuse to go to school, causing a major struggle at home.
WHEN SHOULD I SUSPECT THAT MY CHILD HAS SCHOOL AVOIDANCE?
Children rarely complain directly about fearing school. Instead, they develop various, non-specific symptoms that keep them out of the classroom, such as abdominal pain, malaise, headaches, vomiting and muscle aches.
One clue that such complaints are related to school avoidance is that the symptoms rarely occur during summer vacations or on weekends or holidays. The symptoms may become more obvious on Sunday nights or on school mornings, and be gone by the afternoon. Unlike a chronic class-cutter who prefers other activities to school, a child with school avoidance often wants to go to school but simply cannot face it. Another difference is that children who play hooky rarely stay home, while children with school avoidance do.
School avoidance occurs most frequently at three stages of life; at the start of school life, between the ages of 5 and 7; at the beginning of junior high, at age 11 or 12; and at around 14 years of age, when high school starts.
WHAT CAUSES SCHOOL AVOIDANCE?
There are probably several causes; most likely, a unique combination of factors brings the problem on in each child. For some children, school avoidance is a form of exaggerated separation anxiety in which the child worries some harm will befall the parent during the school day. In these cases, the parent may consciously or unconsciously encourage the child to stay home because of the parent's need for the child's continued attachment.
Some children may not like being compared in their abilities to other children. Attending school with peers may be challenging and threatening because they have not established a firm sense of self-worth and self-confidence. Still, others may actually have reason to be afraid; they may be victimized by bullies or afforded no privacy in the bathroom or locker room.
Finally, an identifiable, traumatic event outside school precipates a child's school avoidance in some cases. Potential triggers include birth of a sibling or the absence of a parent or other significant family member.
WHAT SHOULD I DO IF MY CHILD SHOWS SIGNS OF SCHOOL AVOIDANCE?
First, have the child checked by his pediatrician to make sure there is no underlying physical illness. Try to observe any pattern in the child's symptoms to help the doctor reach a diagnosis.
If the pediatrician finds no physical cause for your child's complaints and the evaluation suggests the presence of school avoidance, you may be referred to a mental-health professional, such as a child psychiatrist or psychiatric social worker.
IS MEDICAL ATTENTION NECESSARY?
Yes. School avoidance is unlikely to go away by itself unless there is a precipitating event at home or at school that somehow gets resolved. Fortunately, a brief, focused course of treatment usually gets the problem under control, particularly if the child is in the early elementary grades.
WHAT IS THE TREATMENT FOR SCHOOL AVOIDANCE?
The exact form of treatment depends on the underlying problem. It is usually helpful if the whole family participates in the treatment plan. This may mean that the parents (and possibly the siblings) will receive counseling along with the child.
The approaches that have proved helpful in treating other kinds of phobias also have been successful for school avoidance. One of these, called gradual desensitization, involves slowly reintroducing the child to the school environment, starting with a few hours in a relatively nonthreatening part of the school (such as the nurse's or counselor's office) and gradually adding more time moving close to the classroom. Eventually, the child is eased back into the daily routine.
COPING WITH SCHOOL AVOIDANCE
Any parent who has dealt with the problem of school avoidance knows how painful it is to force a crying child onto a school bus or into a classroom. However, the number one concern should be to return the child to school as quickly as possible. Parents can help by doing the following:
• Making school attendance a non-negotiable item (Staying home from school should not be an attractive option)
• Enlisting the help of school authorities in gradually returning the child to school
• Examining their own needs in relation to the child and seeking help if personal problems are identified
