When Johnny Doesn't Want to Go to School:
Is It Illness or Anxiety?
Could Depression Be a Problem?
For children experiencing symptoms of depression, Dr. Harris advises parents to ask their family physicians to conduct a full physical that includes an aggressive screening of metabolic and thyroid levels to rule out physical problems. "I saw two children in a one-month period whose anxiety-type symptoms - school avoidance extreme fearfulness, lethargy, depression - turned out to be hypothyroidism, or an underactive thyroid gland," she says. "We need to uncover all sources of difficulty to ensure we provide proper care."
with them comes a wide range of pressures from their parents, teachers and peers. While most kids are able to handle these demands, some suffer from extreme anxiety, which should not be ignored.
According to Gina Harris, PhD, clinical child psychologist and clinical neuropsychologist on the staff at Memorial Regional Hospital, Memorial Hospital West and Memorial Hospital Pembroke, there may be many reasons for a child's school-related anxiety. For example, a child may fear being able to meet parents' and teachers' academic expectations, particularly if he or she has a learning disorder or difficulty with attention. Fearing he or she will be measured by unattainable standards, that student may simply refuse to go to school.
There may be many social pressures causing difficulty, too. All children experience peer pressures - from concerns about their physical appearance and choice of clothing to issues such as alcohol, drugs and tobacco. Students who are uneasy about not having the right hairstyle or who are being harassed about smoking may not want to put themselves into situations where others will single them out.
While some parents can be demanding or abusive, laying blame on parents is not always justified. "Many people underestimate the role of peers in a child's development," says Dr. Harris. "Peers take over the primary judgment role and can greatly affect a youngster's self-esteem and mental health." Peer pressure can be particularly devastating to students targeted by bullies.
In fact, says Dr. Harris, the popularity of e-mail and cell-phone text messaging has taken bullying to a whole new level. "With this technology, kids can 'follow' others home and relentlessly taunt and threaten them outside of the school setting," she says. "It can be very distressing to the victim."
Symptoms of Distress
How do you know if your child is experiencing school-related anxiety? The problem can present itself physically and emotionally, as well as on the school report card. Parents should be on the lookout for symptoms that may include some or all of the following:
- Headaches
- Poor grades
- Playing hooky
- Depression
- Panic attacks
- Fearfulness and/or crying
- Stomach aches, nausea and/or vomiting
- Withdrawal from activities, family and friends
"If your child is suffering from issues like these, he or she needs compassion and understanding," says Dr. Harris. "Don't laugh or shrug it off. Explore the problem so that solutions can be gently and effectively found."
Addressing the Situation
Just as every child and situation is unique, so may be the treatment for anxiety. Some children outgrow the problem, while others may require special attention. Parents and teachers may work with a student to find an area of interest or talent - such as music or art - and then place that child into a program that focuses on that area. "We strive to replace a lack of meaning in school with an opportunity for excellence," says Dr. Harris. "It can be easy for some children to be overlooked due to poor school performance, so parents and teachers should take advantage of the many resources available to them."
When these types of efforts are not suitable, some students may require the help of a medical professional. In her private practice, Dr. Harris has treated many children and teenagers who have school-related anxiety. She utilizes a variety of techniques to treat them, including individual and group counseling, hypnosis and a technique called "coping imagery." "We do a lot of role-playing and rehearsing over and over about how the child can respond verbally and emotionally to a given situation. Then, if a big test is coming up or the child should encounter that bully in school, he or she will have the tools to deal with it appropriately."
Getting the child to participate in therapy can sometimes be difficult, Dr. Harris admits. Anxiety can cause some children to withdraw far into themselves, so Dr. Harris will often use extraordinary measures to enable them to make the trip to her office - including encouraging them to play their musical instruments for her, showing off their artwork or bringing their pets with them. "The bottom line is, we'll do all we can to help children who are suffering from anxiety," she says.
If you are concerned about your child's emotional or physical health and would like a referral to a physician, call Joe DiMaggio Children's Hospital Physician Referral Service toll-free at (866) JDCH-DOC. We're available 24 hours a day, 7 days a week.