Separation Anxiety

Adapted from an article by Kelly Monk, R.N. and Cathie Kalas, R.N., "Childhood Anxieties Can Be Linked to School Refusal."

Sarah refused to ride the school bus when she entered first grade.

During the first month of school, Adam complained of painful headaches almost daily.

When Rachel began pre-school, she sobbed each morning when her mother dropped her off.

These three children are displaying symptoms of anxiety that can eventually lead to school refusal.  Anxiety related school refusal, also known as school phobia, affects one percent of school aged children.  Not only does formal education foster academics, it also promotes the development of crucial social skills.  If a child is having difficulty attending school due to anxiety, it may potentially prevent him or her from developing appropriate social skills.

Characteristics of school phobia can include reluctance to attend school, physical complaints on school days, or excessive emotional distress when anticipating going to school.  When school phobic children do manage to get to school, they frequently visit the nurse's office and often request to call home.  Stressors can trigger school refusal, including transferring to a new school, parental divorce, a parent returning to work or a new sibling in the family.  Some children present with an onset of school refusal after an illness, injury or vacation that causes them to miss school for a period of time.

Many children and adolescents with school anxiety have other underlying problems which may be producing school refusal.  For example, a child may be anxious about separating from his parents or a child may be too shy and refuse to participate in class.  These anxiety problems need to be treated for the child to be able to return to school.  And, if early intervention does not occur, ongoing school refusal can become a school crisis.