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David Baxter

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When a Child Refuses To Go to School
March 20, 2007
By Michael Craig Miller, M.D.
Harvard Medical School

Separation anxiety is normal for a child. During the second half of their first year, children realize that their parents leave them from time to time. That's why they become uncomfortable around strangers. This discomfort, which usually peaks around age two, lasts until first or second grade.

But some children experience separation anxiety well past age 7. They may avoid sleep-overs with friends. Nightmares may drive them to climb into bed with their parents. They may worry about being kidnapped. Or they have persistent unreasonable fears that their parents will be harmed or killed. They cry, cling, throw tantrums, or get physical symptoms.

But the most difficult sign of separation anxiety may be when a child refuses to go to school.

Signs of "School Refusal"
This problem is quite painful for everyone in the family. Children who fear school may:

  • Take forever to leave the house
  • Cling, cry or dawdle while dressing, and then miss the school bus
  • Look for ways to leave school before the end of the school day
  • Complain of a headache or tummy ache during the week, which goes away on weekends
  • Become more anxious Sunday night, especially when it is the last day of a vacation
  • May show more symptoms after an illness, an accident, or death in the family
Many Possible Causes
Refusal to go to school isn't always a sign of separation anxiety. It has many possible causes:

  • The child may have a fear of most social situations, not just school.
  • Particular conditions at school might be making it a scary place for the child. For example, the school may be more impersonal or authoritarian than the child can easily tolerate.
  • He or she may have difficulty adjusting to rules made outside the family.
  • The child may be afraid of the teacher. For example, the teacher may shame students who make mistakes or are mischievous.
  • The child may be the victim of a bully.
On the other hand, the problem might not be at school at all. The child may be suffering from anxiety or depression that requires attention.

How To Help
Parents can help head off school refusal by getting their preschool children used to the idea of school. This can help the child feel less anxious about going to school. Here are some suggestions:

  • Take your child on trips.
  • Arrange brief, practice separations, leaving him or her with another trustworthy adult.
  • Involve your child in shopping for school supplies; finding a special item your child can bring to school can give him or her a comforting emotional link to you.
  • Tell your child about the first day of school in a straightforward way, so your child knows what to expect. For example, explain where he is going and who will pick him up and bring him home.
  • Arrive early at school to help your child settle in.
  • Walk around the school with your child, so he or she can become familiar with the environment.
  • Arrange to meet other children in the class so the setting feels more familiar to your child.
  • Try a system of small rewards or prizes for school attendance to motivate your child.
  • Always say goodbye to your child. Resist the temptation to sneak away. Scooting out the door while your child is distracted can undermine his or her trust and make matters worse the next day.
  • Try to control your own anxiety. The less anxious you appear, the sooner your child's distress will pass. The trick is to remain matter-of-fact, calm, and firm, even if your child is screaming when you leave. Teachers usually have experience with this problem and know that most children stop crying soon after the parent leaves.
  • Consider meeting with teachers and other school staff when your child is in pre-school and kindergarten to develop a strategy to work out a school refusal problem.
  • Consult with teachers and school nurses about any physical symptoms your child is complaining of.
If school refusal persists, there may be something other than separation anxiety going on that needs treatment, such as an anxiety disorder or depression. Have your child evaluated by a mental health professional to minimize your child's absence from school. If your child is being bullied, it is best to make the school aware so they can deal with it, but you or a therapist can also help teach your child more effective ways to respond to a child that is causing trouble.

Moving Forward, Growing Up
Although it may seem compassionate, letting a child stay home from school only makes it more difficult for the child to go the next day. Remind yourself that staying home can never be a satisfying choice for your child. The real satisfaction will come when he or she works through the anxiety and has met the challenge of separating successfully.
 

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