Does your child suffer from school refusal?

Like other phobias such as arachnophobia (fear of spiders) and aviophobia (fear of flying), school refusal, formerly known as “school phobia,” is an irrational and persistent fear that is out of proportion to the actual risk.

Stress and sleep | Children's Health

Sonia Chartier

14 September 2017

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I’m afraid of putting my head underwater, a type of aquaphobia. I know how to swim, I know I can resurface whenever I want to, and I’m perfectly capable of holding my breath. My fear is completely irrational, but just imagining my head underwater puts me into a state of total panic. For starters, I get cold sweats and my heart goes into overdrive.

As a teenager, I always declined invitations to pool parties, given the high chances of having to go underwater. Luckily for me, not dunking my head is something I can easily live with. But other people aren’t so lucky and feel an intense and irrational fear when it comes to hard-to-avoid situations: a fear of elevators, storms, social situations or even going to school.

School refusal

This latter type of phobia tends to emerge in kindergarten, then a little later in 11‑to-14-year-olds, either at the end of elementary school or early in high school. It affects around 1% of children, boys and girls in equal proportions, and makes up around 5% of consultations in pediatric psychiatry.

From a medical standpoint, while the causes of phobias aren’t clearly understood, three possible categories of causes have been identified:

  • Negative experiences: We know that phobias often develop as a result of having a negative experience, trauma, or panic or anxiety attack related to a specific situation.
  • Nature and nurture: There may be a link between our phobia and the phobia or anxiety experienced by a parent. What’s still unclear is whether this is a learned behaviour or a genetic hand-me-down. School refusal could be rooted in the separation anxiety experienced when a child enters kindergarten.
  • Cognitive function might also play a role in the development of specific phobias.
  • Sleep disorders, loss of self-esteem and depression are major risk factors for school refusal.

The factor that triggers a fear of school is sometimes related to a specific condition such as attention deficit disorder (ADD), impaired fine motor skills (such as difficulty holding a pencil), performance anxiety or other conditions. In such cases, children are confronted by the trigger every time they’re at school; they may feel “different,” ridiculed or judged. Their anxiety is so intense that they will use every means at their disposal to avoid that kind of situation. And so they refuse to go to school: some have fits, while others will literally worry themselves sick.

Children react to these anxiety-inducing situations in different ways:

  • An imminent feeling of intense fear, anxiety or panic when having to go to school or merely thinking about going to school. This anxiety increases as the child approaches school.
  • Those who suffer from this or any phobia feel incapable of controlling the fear even though they know it is irrational and out of proportion.
  • They do everything they can to avoid the situation, such as not going to school, clinging to parents (depending on the child’s age), throwing tantrums and so on.
  • Once at school, they have trouble functioning because they are experiencing very real anxiety.
  • The body also shows signs of anxiety: racing heartbeat, sweating, hyperventilation or trouble breathing, nausea, stomachache, headache, etc.

It’s important that parents understand that school refusal is not the child being capricious: it’s serious and needs to be dealt with promptly. Children who don’t learn to control their fear and reactions may eventually adopt destructive behaviours such as drug or alcohol abuse (to escape) or develop mood disorders.

What can be done

The recommended approach for treating school refusal is to speak with the child’s pediatrician and see a psychotherapist who can properly diagnose the problem and teach the child to control the emotions elicited by his or her fear.

While in no way claiming to cure phobias, some natural products can help the body better manage stress created by fear, while improving cognitive function.

Some plants are mild enough for kindergarten-aged children but effective enough for older children, including Flowering Oats (or Avena sativa for those who prefer Latin). It is known to soothe the nervous system in stressful periods and is often used to help with cases of acute anxiety.

Omega-3 plays a role in brain and nervous system development in children up to the age of 12. It supports the brain functions called on at school. A supplement rich in vitamin B also makes it easier to function in periods of stress, while improving concentration.

Combined with cognitive therapy to guide the child’s efforts, these natural health products can only help make the journey easier.

McNamara et al; Am. J. Clin. Nutrition, 2010 & Craig et al. The American Journal of Clinical Nutrition, 2005

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