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Help Your Child Overcome a Fear of School

Help Your Child Overcome a Fear of School
You've heard it before. You may have even tried it before, when you were young. The mysterious stomachache, headache or nausea that seems to creep up on your child, suspiciously right before he or she has to hop on the school bus. You start to feel bad, and agree to let your child stay home sick, only to see just a few hours later the "symptoms" start to disappear.

Yes, your son or daughter may have pulled a fast one on you and just wanted a day off. But in 1 to 5 percent of all school-age children, the cause of such behavior is an anxiety disorder known as school refusal, formerly coined "school phobia" back in the 1940s. School refusal is much more than a child simply wanting a "mental health day" from the classroom, and recognizing the signs and symptoms early will help parents to help their children overcome their fears.

School refusal is, in the simplest terms, a fear of going to school. The disorder, however, is anything but simple, and can be a very stressful time for children, teachers and parents involved. While school refusal can affect children of any age, it is most common in children between the ages of 5 and 7 and in 10- and 11-year-olds.

Danielle S. Dimieri of Bristol is a licensed independent clinical social worker, a certified case manager, and a certified advanced social work case manager whose specialty is children. She spends her time helping parents and children cope with many issues, including school refusal.

"It's a sad thing and parent-teacher intervention is very important," Ms. Dimieri says of recognizing the signs of school refusal.

It is important, she says, to understand the difference between truancy and school refusal. A child suffering from school refusal is unreasonably scared to go to school. The child might pretend to be sick or simply say that he or she does not want to go to school. The child usually wants to stay home because he or she feels safe there.

"Refusal is characterized by severe emotional distress about attending school," Ms. Dimieri explains. "This includes anxiety, temper tantrums and depression."

In cases of school refusal, the parents are aware of the child's absence from school and have given permission for the child to stay home. There is an absence of juvenile delinquency, and during the school hours, the child stays at home in the safe and secure environment. The child will express the willingness to complete school work, but will do so at home.

Truancy, on the other hand, is marked by a lack of anxiety in the child. They are not afraid of going to school, they are simply not interested in attending. The child will try to conceal the absence from the parents. There is also frequent antisocial and delinquent behavior that is sometimes accompanied by disruptive acts, lying, stealing and hanging around with antisocial peers. During school hours, the child does not stay at home, but goes out somewhere. There is a lack of interest in schoolwork and a lack of willingness to conform to academic and behavioral expectations.

"School refusal is a problem that is stressful for the kids, their families and even their teachers," Ms. Dimieri says. "If not treated properly, it could have long-term effects on social and academic development. That's why it's so important to identify it early."

The signs and symptoms of school refusal are as physical as they are emotional. According to Ms. Dimieri, children usually present with anxiety symptoms and mood disorders, and it is usually a very gradual process. There is usually fearfulness, panic, crying, temper tantrums and threats of self harm. These symptoms will generally improve if the child is allowed to stay home.

Some of the physical symptoms include dizziness, headaches, diaphoresis (perspiration), trembling, shakiness, heart palpitations and chest pain, abdominal pains, nausea, muscle and joint pains and vomiting.

Signs of school refusal are commonly seen after the child has been home for awhile, such as after summer vacation or school breaks, weekends or stressful events. The more often the child is allowed to stay home, the worse the problem generally becomes.

The fears that a child with school refusal has are very real. They could be provoked by a number of things, including the overall school environment, tests, bathrooms, cafeterias or problems with classmates or teachers. The fear could come from a separation anxiety or as an attention-seeking tactic.

Once school refusal is recognized, it is important that treatment and management are a collaborative effort, says Ms. Dimieri. The child, parents, teachers and guidance counselors should all be involved. Additionally, it is important to involve the family physician in the beginning of the assessment, in order to rule out any possible underlying medical causes of the symptoms.
Fortunately, school refusal is maintainable. Some of the treatments for the disorder include educational support therapy, cognitive behavioral therapy, parent-teacher intervention and, usually as a last resort, psychopharmacology.

It is imperative that parents watch for signs of school refusal, especially around this tine of year, as the beginning of the school season looms ahead. The effects of school refusal are long-term and can include academic underachievement, employment difficulties, increased risk of psychiatric difficulties and emotional problems, such as anxiety, when they get older. Treatment helps both the child and the parents understand that there really is nothing to be afraid of.



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