School Phobia

As many as one out of four children regularly refuses to go to school.  For 2% of children school refusal becomes a routine problem.  It is extremely frustrating to parents to have to deal with a upset child who does not want to go to school, in the midst of having to get everybody in the house washed, dressed, fed and on time for school. It seems that the more upset and demanding you become, the more reluctant your child becomes.  It becomes a vicious cycle that gets repeated every day of the week.  Weekends truly become something to look forward to!

We expect fears around going to school, when children start going to school for the first time  (5 – 7 years) and again when they have to make the move from primary to secondary school (11 – 14 years).

Why would children refuse to go to school?

  • Many children refuse to go to school, because they fear being separated from their parents.
  • When a parent is ill, they may develop a fear of losing that parent while at school
  • A child might feel overwhelmed at school, not knowing his way around and feeling lost
  • Many children fear that they will be left at school – sometimes due to parents being unreliable and not picking children up on time or keeping simple promises.Are You a Mom? Join CafeMom Today!
  • Children sometimes start to refuse to go to school when parents are separating, have marital problems, divorcing  or constantly arguing.
  • A death of friend or family member, can lead to a child refusing to go to school, because they are reminded of mortality and he fears losing his parents.
  • Moving house can unsettle a child and lead to school refusal.
  • Jealousy of a sibling staying at home can trigger school refusal.  He might believe that his brother gets special treats and are being favored by his mother.
  • When children have no friends they might refuse to go to school
  • Bullies make some children refuse to attend school.
  • Not getting along with teachers or classmates can trigger school refusal.
  • When parents start to worry about school refusal, he starts to believe there is a valid reason for him not attending school.

These are only a couple of reasons a child might mention.

When should I become worried about school refusal?

There are 4 signs of School Phobia which should worry any parent or teacher:

  1. When a child is entirely absent from school.
  2. When a child will attends school, but always leaves sometime during the day before the end of the school day.
  3. When a child goes to school under duress from parents, but goes crying, clinging or throwing tantrums.  This is worrisome if it is still present after an adequate adjustment period of 2 weeks.
  4. When unusual distress is visible to others whilst he is at school.  This distress leads to him begging not to go to school the following day.

Children either internalize or externalize their anxiety about going to school.  The children who internalize their fears become the little worriers who exhibit social anxiety, isolation, depression, fatigue and physical complaints.

The children who externalize their fears, do it by throwing tantrums, showing verbal and physical aggression or show oppositional behavior.

What can be done to help this child?

For children who avoid school because of friends, teachers or anxiety provoking situations can be treated in the following manner:

  • Relaxation training: This will assist the child to lower their levels of anxiousness through different relaxation techniques.
  • Gradual exposure to the school: Gradual exposure to the aspects of schooling that provokes anxiety provides the child to become comfortable one small step at a time.
  • Self-reinforcement: These children need to learn to believe in themselves, they should have multiple experiences of success to boost their self-esteem.

Children who escape school because of uncomfortable peer interaction or poor academic performance, can be helped:

  • Changing negative self-talk: Instead of constantly berating themselves, they should be taught to use self-affirmations.
  • Role play: Parents can role play possible embarrassing situations with their child to show him how to come to a positive ending.
  • Graded exposure: Gradual exposure to tasks involves breaking anxiety provoking tasks into small manageable pieces.  Your child initially only have to greet a classmate, in order to form friendships at a later stage.
  • Social skills training: Knowledge of some basic social skills will help your child to feel empowered and behave appropriately.
  • Problem solving skills: Dealing with conflict effectively can help a child to avoid embarrassment and being the victim of bullies.

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Children who avoid school to get attention from their parents or friends, can be helped through:

  • Parent training: Some parents need to be trained not to reward negative behavior with attention and other rewards.
  • Routines: Children feel secure with a set routine.  Set the routine and do not get derailed or bullied to change it.
  • Use rewards and punishments: Reward your child for attending school without a fuss and punish him for refusing to go to school.

Children who receive tangible reinforcement from outside school for instance, if he gets to stay home for the whole day watching television or playing games instead of attending school can be treated in the following manner:

  • Incentive: Parents should increase the incentive for children to attend school.
  • Punishments: Social and other activities should not be allowed if he did not attend school.
  • Conflict management: Parents can benefit from knowing how to deal effectively with conflict with their child.

What is the difference between school refusal and truancy?

The most important difference between school refusal and truancy is that truancy is secretive and the parents are uninvolved in the absenteeism of their child.  Truancy can be motivated by anger, attention from friends or even unaddressed learning difficulties. School refusal is motivated by anxiety and the parents are informed and involved in the situation.

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Separation anxiety is not only painful to your child, but also painful to the parent.  Most parents will be able to recall some instance where their child was extremely clingy and tearful at the prospect of their mom or dad leaving them somewhere or with someone that suddenly became a baby monster.  The reason why it is so easy for all parents to recall, is because it is a normal part of development in your child’s life.

In the first couple of months of a baby’s life your baby does not differentiate in whose arms she is, the only important thing is that they are loving and meeting her immediate needs.  From
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month 7 to 14
, your baby starts to understand the concept of object permanence.  This means that even when Mommy leaves the room for only a couple of seconds; baby fears that she has disappeared forever.  Children at this age do not have the concept of time which makes it difficult to even leave for a second without tears flowing. During the toddler years , our children usually becomes very anxious at the prospect of us leaving them, but luckily can be easily distracted by activities to stop crying. Usually when you go around the corner of the classroom, she is happily building a puzzle or playing with a friend. Tears usually come again when you pick your child up and they are reminded of the fact that you left them. After the age of 5 years , children usually have bonded securely with their parents and trust them to return when they are dropped off at school or left with a babysitter.

Separation anxiety shows itself in different ways.  You might recognize some of these:

  • Crying and whining
  • Clinging
  • Shyness
  • Silence and unwillingness to talk to other caregivers.

Separation anxiety can be triggered by traumatic events like a sibling’s birth, moving of house, changing of schools or even a simple change in daily routine.

When does normal developmental separation anxiety turn into Separation Anxiety Disorder?

  • When a child still reacts with the same intensity when separated from caregivers, even though she has reached the age (5+) where you would not expect it from her.
  • Her anxiety and crying is excesssive.
  • When she fears that something bad will happen to her parents when she is away from them.
  • When panic symptoms are present, for example heart palpitations, sweating, dizziness, etc.
  • Nightmares are present that are about being separated from her parents.
  • When an older child still have a fear of sleeping alone.
  • When a child becomes worried about being lost, kidnapped or having to go to events without her parents.
  • Physical symptoms in anticipation of separation like headaches and stomach aches are worrisome.
  • School refusal because of not wanting to be separated is an important indicator.

What are the effects of Separation Anxiety Disorder on the development of a child?

Separation Anxiety Disorder can have a serious impact on future relationships of a child.  These children are unwilling to enter into normal settings where friendships and also teacher-child relationships can develop.  Isolation is a very real threat to children and they can become detached from others. Isolation and detachment can lead to related disorders like agoraphobia, panic disorder and school phobia.

What are the risks for your child to develop Separation Anxiety Disorder?

  • A scary event that your child heard of experienced may entrench her fear of being separated fro her parents.
  • Serious or long term separation from parents (parent in military) can contribute to SAD.
  • Significant change in the child’s life for example divorce can pose a risk for developing SAD.
  • Constant and tangible stress in the family.
  • Illness of a parent, sibling or the child self.
  • An extremely close-knit family constitutes a risk factor.
  • Children that are temperamentally fearful and withdrawn or passive and shy stand a higher chance of developing SAD.
  • Insecure caregiver-child attachment can lead to SAD, because the child never learns that they can trust the person who is supposed to care of them.

Treatment options for Separation Anxiety Disorder :

  • Cognitive Behavior Therapy
  • Family Therapy
  • Play Therapy
  • Bibliotherapy and
  • The teaching of relaxation techniques and bio-feedback.

The development of Separation Anxiety Disorder cannot always be prevented, but parents can start early to help their child go through this developmental phase painlessly:

  1. Time separations to be at times when your child’s basic needs are met, for instance after a meal or a nap.
  2. Practice with your child to be separated for short periods from you – let the babysitter sit with her while you leave the room for a couple of minutes at a time.
  3. Stay calm and be consistent in your reactions to your child when she is fearful of you leaving. If you become emotional it will only lead to her mood escalating.
  4. If you promise to be back at a certain time, ALWAYS make sure you keep your promises.  This teaches your child that you are trustworthy.
  5. Try to introduce your child to the babysitter before leaving her for the first time and also make sure that she knows the environment that she will be left in.
  6. It is always good to have a goodbye-ritual.  It can consist of a hug, a kiss and a wave.  Rituals make life predictable and safe.
  7. With older children you must acknowledge their feelings and remind them of their previous successes.
  8. Stories of children being able to overcome their fears of being left alone provides role models for children.
  9. Always plan ahead and prepare your child for the separation.  Surprises upsets children and make them feel vulnerable.