School Phobias

True childhood phobias are less common than adult phobias. Most childhood fears do not develop into phobias because the fear goes away, usually on its own, within a year. There are some children, however, who do develop true phobias.

One of the most common childhood phobias is school phobia. School phobia is usually defined as an exaggerated and often handicapping fear of attending school. A child with school phobia causes constant turmoil, often arousing guilt, anger and anxiety in everyone.

Most children have shown reluctance to go to school, but have it go away without treatment, as with children first attending school, or moving to a new school. When a child has avoided school for over a week, it's a significant risk of persisting and growing. School phobias are not like school truants, for they stay at home with their parents' knowledge and are often excellent students. Truants avoid both school and home and have other delinquent behavior.

Children who have a school phobia may show their distress in a variety of ways such as temper tantrums, sulking, and fear. Before school, he/she often has a wide variety of physical symptoms such as nausea, vomiting, headaches, diarrhea, stomach ache, and even complaints of sore throat or other illnesses. These usually disappear after the child has permission to stay home. Typically, an emotional storm ensues first before school time, with the child begging or demanding to stay home from school, and resisting any efforts on the parents part to get him to go. Parents will usually unsuccessfully try reassurance, bargaining or force. Some children may even refuse to attend parties, playgrounds or other activities outside home.

School phobias generally occur at one of two stages in a child's development. In the first stage, the children are usually of kindergarten or elementary school age. Onset of the phobia is rapid and some clinicians feel that the child is having anxieties about leaving his/her mother. Others feel that the child is more afraid of school than of leaving their mothers. These phobias are usually mild and quite treatable.

In the second case, the phobias usually occur in children who are in the junior high school grades and up. The onset is usually much slower and the phobia more severe. Older children attribute their fears to many parts of school life: being bullied or teased, undressing in showers, anxiety about school work, fear of fainting in assembly hall, menstruating, etc. Young children may give no reasons at all and just refuse to go.

Most new school phobias arise when there is a change in the school location, and sometimes other major changes such as illness or death in the family, or a move by the whole family. The data suggests that about 1-2 children per 100 each year develop this phobia, 3 per 1000 being severe cases. The frequency appears to be increasing. The peak age is between ages 6 and 10. It appears equally often in boys and girls, and economic levels, but is more often found in the only child or the youngest child.

What can you do to help your child?

Helping a youngster or adolescent with a school phobia means getting the child back to school as quickly as possible. This is true even if the first step is simply going for a ride to look at the school. The individual situations are usually so different that treatment has to be formed around a variety of considerations which we will look at shortly.

The most common mistake that parents and others such as school personnel make is in their communication with the child. The first instinct is to reassure the child that everything will be fine. This reassurance, however, usually increases the child's need for more reassurance. And, in the long run it would also reinforce the fear that there IS something for him/her to be afraid of. It is sometimes helpful and necessary for the school to be involved in helping the child. When seeking therapy for a school phobia, it is helpful that the therapist outlines the steps to be taken, and go over how to handle the tantrums and other aspects of treatment for both the parents and school. Parents may acknowledge briefly that the child is afraid, and at the same time, encourage him/her to try a small step while feeling afraid. Do not focus too much on how the child feels.

When starting a behavioral treatment program, the cooperation of the child is helpful. Treatment is similar to adult treatment, with games and incentives offered to bring the child steadily closer to the fearful situation and to keep him/her there until the anxiety has gone and he no longer wants to escape. This is done in small steps, first with ones that the child is already able to do. Once the first stepping stone is done, the rest will fall into place with practice and patience.

For a situation of mild school refusal, the immediate determination and plan by parents and teacher to outmaneuver and compel attendance in a non-punitive way is critical. An escalation of pressure is used, leading usually to a "showdown", on which the whole method depends. It is also necessary to block escape routes and remove the benefits of avoiding school.

For the school phobic, a wide variety of techniques are used, in addition, to help him get from home to school. Offering very desirable rewards for going to school can be quickly effective for some. However, play, food, praise, pets, candy, hugs, affection, story-telling, hero models, stopwatch and many other aides have been used in helping the child.

Look for the next article, Average Fears in Young Children, to help determine whether your child has school phobia or passing fears.

This article was written by Dr. Richard C. Raynard, whose latest book Panic Free is offering new hope for those suffering from overwhelming and often debilitating panic attacks. For over 30 years he has helped thousands of his patients with the latest refinements in anxiety and panic treatments. Visit http://www.panicdoctor.com for more information about Dr. Raynard.

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