Managing School Anxiety

Patient Expert

As summer comes to a close, many children are likely to experience a case of the jitters about the upcoming school year. Nervousness and anxiety are normal, and most children find something to look forward to about starting school. But some experience persistent and excessive anxiety that interferes with their academic, behavioral, emotional, and social development. These symptoms may point to an anxiety disorder. If the idea of returning to school or starting a new school brings out severe anxiety symptoms in your child, rest assured that although anxiety disorders are serious, they are also treatable.

_Refusing to Attend School _

"School refusal" describes the disorder of a child who refuses to go to school on a regular basis or has problems staying in school. A parent should be concerned if a child regularly complains about feeling sick on school days or asks to stay home from school with minor physical complaints, such as stomachaches or headaches that are not related to a physical illness.

Children with school refusal may complain of physical symptoms shortly before it is time to leave for school or repeatedly ask to visit the school nurse. If the child is allowed to stay home, the symptoms quickly disappear, only to reappear the next morning. In some cases a child may refuse to leave the house.

Common physical symptoms include headaches, stomachaches, nausea, or diarrhea. But tantrums, inflexibility, separation anxiety, avoidance, defiance may show up, too.

Reasons for school refusal
Starting school, moving, and other stressful life events may trigger the onset of school refusal. Often a symptom of a deeper problem, anxiety-based school refusal affects 2 to 5 percent of school-age children. It commonly takes place between the ages of five and six and between ten and eleven, and at times of transition, such as entering middle and high school.

Children who suffer from school refusal tend to have average or above-average intelligence. But they may develop serious educational or social problems if their fears and anxiety keep them away from school and friends for any length of time.

What Parents Can Do
Keep your children in school. Missing school reinforces anxiety rather than alleviating it. Read on for tips to help your child develop coping strategies for school anxieties and other stressful situations.

  • Expose children to school in small degrees, increasing exposure slowly over time. Eventually this will help them realize there is nothing to fear and that nothing bad will happen.
  • Talk with your child about feelings and fears, which helps reduce them.
  • Emphasize the positive aspects of going to school: being with friends, learning a favorite subject, and playing at recess.
  • Arrange an informal meeting with your child's teacher away from the classroom.
  • Meet with the school guidance counselor for extra support and direction.
  • Try self-help methods with your child**.** In addition to a therapist's recommendations, a good self-help book will provide relaxation techniques. Be open to new ideas so that your child is, too.
  • Encourage hobbies and interests. Fun is relaxation, and hobbies are good distractions that help build self-confidence.
  • Help your child establish a support system**.** A variety of people should be in your child's life-other children as well as family members or teachers who are willing to talk with your child should the occasion arise.
  • Learn about your child's anxiety disorder and treatment options**.** For more information about school refusal and children's anxiety disorders, click on the resources listed below.

Getting Help

The Anxiety Disorders Association of America provides information and checklists for parents to find professional help for their children, or to find a therapist who treats anxiety disorders in your area.

Treatment options
Along with different types of talk and play therapy, the use of medication is one of many treatment options available to manage the symptoms of anxiety disorders. Click here for answers to frequently asked questions about treating anxiety disorders in children with medication.

More Resources

Check out these articles for more information on back to school anxiety.

_PLEASE NOTE: The Anxiety Disorders Association of America (ADAA) does not endorse or promote any specific medications or treatments. _