School Anxiety in Children

6 Year Old Children

I don’t want to go to school!

The dreaded exclamation from our pre-school and school-aged children.  An age-old complaint, though one must question whether or not this school resistance and refusal is on the rise.  With the implementation of the Common Core curriculum in many of our schools, the enactment of universal academic standards of performance, as well as the invasion of social media on the social development of our children, not all kids can handle this pressure.  Many children develop somatic complaints associated with going to school.  Common complaints include stomach ache, headache, generalized aches and pains, and/or trouble sleeping.  But how do you know whether your child’s complaints are age appropriate or something to genuinely be concerned about?

Is this a temporary behavior…or something else?

Separation anxiety is part of a normal developmental process in infants and toddlers until approximately age 3-4 years.  At this age, children may be clingy to a parent when real or perceived separation occurs; for example, drop off at daycare, when mom or dad leave for work, or when both parents leave for a date night.  This type of behavior is transient, may occur one day and not the next, or it may persist for several days.  Often children who experience developmentally appropriate separation anxiety recover quickly once the separation actually occurs. During these situations, parents should not sneak out and rather offer a quick and confident good-bye.

Preschool and elementary-age children often ask for repeated reassurance, talk about a fear of school, request parents to stay with them during the school day, and may cry at drop-off.  Elementary school children may experience physiological symptoms, in addition to sleep disruption, increased worry, and complete refusal to ride the school bus or walk into school.  This is often transient and reversed with efforts to enhance confidence.

Older children may develop physiological aches and pains.  It is important to listen to your child and have these symptoms evaluated by the pediatrician.  It is also important that once a clean bill of health is received, that parents not perpetuate the behavior.  By law, unless a child is homeschooled, children must attend school.  Talk to your child.  Let him or her know this is the “rule.”  In the context of doing so, it is also important to try to ascertain where the fear is coming from.  Is there a bully on the bus? Is it too chaotic during gym class or recess? Is he afraid he will not have anyone to sit with during lunch?  Social situations may trigger increased anxiety and school refusal.  Fear of public speaking may also trigger this behavior.

What can I do to facilitate at healthy transition?

Empower your child to manage these uncomfortable feelings versus enabling him to avoid them.  Allowing your child’s anxiety to prevent him from engaging in an activity may reinforce his helplessness.  Conversely, forcing a child into an anxiety provoking situation angrily may exacerbate the anxiety.  This strategy may backfire altogether and the child may completely refuse to comply. Instead, let your child acclimate himself to the situation.  Arrive early to the activity.  Role-model assertiveness and confidence for your child.  Introduce your child to the teacher or coach ahead of time.  Reassure him that you will be home at bus drop off/preschool pick-up/practice end.  It is important to emphasize he can handle it.  You can help at home by normalizing your child’s feelings.  You can share your own experience of anxiety as long as you talk about how you overcame your anxiety.  You may also role-play anxiety-provoking situations.  For young children, you can use dolls or stuffed animals to facilitate this process.  This will teach him to assert himself and increase his confidence when faced with real-life situations.  Help your child identify situations in which he was scared or nervous in the past though tolerated these emotions successfully and actually enjoyed himself.  Distraction can be a powerful tool to teach to your child.

When possible, encourage your child to face his fears and remember that anxiety is not inherently harmful.  Remind your child of situations when the worst did not happen.  A desire to protect your child is natural.  With the best of intentions, parents sometimes see a shy or sensitive child as vulnerable and in need of protection.  If a child becomes upset at school, or refuses to get on the bus or go into the school building, sometimes parents will ‘rescue’ the child in effort to reduce emotional stress.  Regardless of what is driving the parents’ behavior, it is important to teach your child independence and self-confidence.  While it may not be immediately detrimental to your child to miss one day of preschool or to drive your child to school every day, this can be detrimental when a child is older and faced with an anxiety provoking situation and is unable to cope.  Emotionally managing our emotions does not occur without support.  When children are taught effective communication strategies, effective coping strategies, and given confidence to do so, they are often able to overcome stressful and challenging situations.  You can set the example.

Lastly, reward your child for positive behavior.  Positive reinforcement is key.  If your child is having difficulty with school anxiety, sticker charts work wonders.  If the child is able to go to school without the clinging behavior or refusal, he earns a sticker.  At the end of a week of earning stickers every day, take you child on a special outing (ie; to ride the carousel at the mall) or for a special treat.

When is it more than developmentally appropriate anxiety?

School anxiety is not a diagnosable disorder; however, kids with anxiety disorders often try to avoid school because it is the place they feel most overwhelmed.  School anxiety can be a symptom of an underlying anxiety disorder, such as separation anxiety disorder, social phobia, or generalized anxiety disorder.  This may appear as oppositional behavior at first; however, if it is persistent and pervasive, this type of anxiety suggests there is something that is truly scary to the child.  When anxiety is untreated, it can lead to depression.

If your child is not responding to efforts at home to reduce anxiety, it may be useful to seek the support from your child’s teacher.  For school bus anxiety, you may wish to follow the same routine each morning and afternoon.  For example, identifying a point person to meet your child’s bus at the start of the school day and escort him to his classroom (the same individual each day, if possible, for continuity).  For tearfulness or increased anxiety during the school day, ask the teacher to give the child an important task at school (help hand out papers or distribute basketballs in gym class).   There may be a disconnect between the teacher and your child.  Ask for support from a school administrator if needed to promote a positive emotional experience.  Consider barriers to learning, such as speech/language delay, reading or writing difficulty, or processing barriers.

If your child is experiencing pervasive disruption in sleep or appetite, increased isolation, decreased enjoyment, or persistent fear, seek the support of your pediatrician.  This may be a temporary issue that requires reassurance, education, and support.  It may also be something that requires more structured support provided by a licensed mental health provider, such as a social worker or psychologist.  As many as 10% of school-age children suffer from an anxiety disorder.  Cognitive Behavioral Therapy (CBT) is the mainstay of treatment for many anxiety disorders with focus on cognitive restructuring, relaxation, and improved coping.  In some cases, psychotherapeutic medication may be indicated.  This is often recommended when symptoms cause significant impairment in functioning.

In summary, anxiety is a common reaction to school.  Most often, school anxiety is reversible with the implementation of additional supports.  While the school curriculum may be predetermined, empowering our children to be confident and to learn to cope with anxiety-provoking situations is something we can do to help to promote a healthy educational experience for our children.

Resources:

The Child Anxiety Network: www.childanxiety.net
New York University Child Study Center: www.aboutourkids.org
Anxiety Disorders Association of America: www.adaa.org
The Center for Mental Health Services: www.mentalhealth.org

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