When your child feels too anxious to go to school

When your child feels too anxious to go to school

The cost of school anxiety

Having a child too anxious to go to school can be crippling, both for a child’s academic and social development and for the family as a whole. Parents often feel powerless and may have to take time off work. It is sometimes referred to as school phobia or school anxiety. Often, it is related to social anxiety. Things can quickly spiral out of control, and if you feel you are already at this stage, please seek help from your GP. The GP may refer you to your local CAMH (Child and Adolescent Mental Health) Service, or to an independent clinical psychologist near where you live. You can also find a clinical psychologist at the Association of Child Psychologists in Private Practice (AChiPPP).

Why might a child stop going to school?

There could be one reason, or multiple reasons for making your child too anxious to go to school. In my experience these may include:

  • Becoming overwhelmed or stressed by academic, social or sensory demands.
  • Separation anxiety (fear of leaving/separating from trusted caregivers), meaning that children desperately want to stay home.
  • Bullying, teasing, or conflict with others.
  • Fear about changes to the school routine, such as sports day or a school trip.

Here are some particular issues to be aware of:

1. Physical symptoms are real.

The fight or flight response triggers powerful bodily changes. For example, our muscles tense up (ready to run or fight). The heart rate speeds up (helping to circulate oxygen around the body). Digestion stops so blood can divert to the limbs (causing nausea or “butterflies” in the tummy). It can be very scary for a child. If school, for some reason, triggers fight or flight, then a child can experience all these physical symptoms and more.

2. Special educational needs.

Consider whether your child may have any unmet educational, social or emotional needs. This is a common factor which can make a child too anxious to go to school. For example, might your child have a condition such as dyslexia which is affecting his ability to keep up academically, and his overall confidence? Could he have an underlying neurological difference which is affecting friendships, and causing his nervous system to be overwhelmed by the sensory environment, such as autism?

3. Transitions as flashpoints.

Transitions from one school year to the next, and of course starting a new school, can be major flashpoints. If your child has a tendency to be anxious, it will be crucial to alert the school in advance and ensure they have a transition plan in place. Staff will monitor your child’s process.

Difficulties can sneak in very quickly. One day, a child might complain of a tummy ache or feeling sick, and within a few days, this could escalate. It may also manifest itself as a long-term problem that ebbs and flows. For example, a child may be more anxious about school at certain times of the school year but relatively settled at other times.

How to take action with a child too anxious to go to school

When your child feels too anxious to go to school, the worst thing that could be done is to force them, without any accompanying understanding. However, avoiding school can be a very slippery slope and should not be encouraged. I recommend these measures:

Deepen understanding

  • Read my post about anxiety, to ensure you understand the basics.
  • Once you have a sound understanding of the science of anxiety, ensure key school staff do too. For primary school children, Brighter Futures, the book I co-wrote, is highly recommended. It will help to teach staff to feel empowered as it provides a step-by-step guide to working with anxiety in children.

Teamwork

  • Excellent communication between parents and school staff .

This is the single most important factor, determining whether children will successfully reintegrate into school. This is more difficult when a child is in high school, so parents will need to identify a single member of staff within the school who can provide empathy and consistent practical support. This might be the SENCO/SENDCO, Head of Year, or Head of Pastoral Care.

  • Work together to create a clear and consistent plan. Older children – especially secondary school age – need to be part of the process. The plan might include, for example:
    • A named member of staff consistently greeting the child in reception each morning and parents “handing over” the child. Pay particular attention to other “transition times” during school days, such as moving from one lesson to another. These can be noisy and overwhelming for some children. Some may need adult support at such times until they can build their coping skills.
    • Your child having a quiet space to go to temporarily, instead of certain “trigger” lessons (for example, PE).
    • Weekly mentoring sessions with a member of staff to discuss issues as they arise, monitor progress and prevent crises.
    • Regular time out of the classroom to calm the nervous system.
    • A safe place to go at break and lunchtimes, with calming activities and staff support.
    • A buddy system to support the child with developing friendship skills.
    • A part-time timetable (for example, coming in late and leaving school early, until the anxiety reduces).
    • Regular communication both ways between home and school (emails or a communications book).
  • Look at the root causes. There is no point in developing a detailed action plan without addressing the root cause, such as bullying.

A scientific approach

  • Nurture must be increased.

When a child has heightened periods of anxiety the nervous system is strained and requires “downtime” to recover. This must happen both at school and at home. Your child’s school may have a nurture room which he can access once or more each day. He needs support from an experienced member of staff. He may go to the nurture room to receive help with symptoms of panic. For example, a staff member could help him slow and deepen his breathing. Ideally, your child will also have access to the nurture room as a preventative measure. He may go there to engage in a soothing activity, such as mindful colouring, which will give his overworked nervous system a break. At home, try extra cuddles, chats or special parent and child time.

  • Approach the problem from two directions.

Firstly, your child needs to be helped and “skilled up”. He needs to learn how to manage overwhelming emotions and thoughts. There are many resources you may find helpful, particularly those based on CBT (cognitive behavioural therapy). Highly recommended books include: Think Good, Feel Good by Paul Stallard, and for younger children, The Huge Bag of Worries by Virginia Ironside. Many children need one-to-one support from a clinical psychologist or similar professional. You can find out more about the role of a clinical psychologist on this page.

  • Focus on graded exposure.

Graded exposure is one of the central strategies used in cognitive behavioural therapy for anxiety. It is an evidence-based approach. It involves very slowly (at the child’s pace) exposing the child to what he fears, in a planned and calculated way. You can read more about it here. The most important thing to know is that “flooding” doesn’t work. Flooding is forcing a child to face a huge fear all at once. Imagine a child with a fear of spiders. Flooding is putting a tarantula on the child’s hand. Graded exposure is working step by step, starting with looking at pictures and videos of spiders, then touching a tiny dead spider, followed by a tiny real spider, and so on.

  • Avoid avoidance.

Avoidance fuels anxiety and keeps it alive.  If children continue to avoid situations they feel worried about, they never give themselves the opportunity to prove that they can cope. When they face fear gradually, they get a sense of accomplishment that will help them not to avoid next time.

  • Reduce demands in your child’s life.

Take action immediately to reduce the load. This will give your child’s nervous system the best chance of coping with the anxiety of school. You may need to ask for your school to be excused from homework or from certain lessons for a while. Perhaps the playground is the most demanding aspect of the school day, and an alternative can be found. Reduce extra-curricular activities if your child is exhausted and stressed. Try to understand whether your child’s senses are becoming overwhelmed. For example, are some classes causing anxiety because they are too noisy? If so, what can the school do about this?

Review your current strategy

If you have worked on all the suggestions above, and your child is still refusing to go to school or struggling with significant anxiety or panic attacks, then alternative options may need to be considered.

  • Consider whether a different school might be better suited to your child. When a child is unhappy and anxious, it is tempting to imagine that moving to a different school will be the magic answer. All too often, I have witnessed that this may not be the case, and problems soon start to show themselves again. Occasionally, however, there may be a school which can meet your child’s needs better than the existing school because it may:
    • Be smaller, and therefore less overwhelming for your child.
    • Place a stronger emphasis on nurture, and be better placed to help your child feel safe at school.
    • Have access to greater resources, including higher ratios of staff, or staff with more experience in anxiety disorders.
  • Home-schooling is not an option for most working families but is something many parents of anxious children consider. Needless to say, it is a huge step. Some of the pros and cons of home-schooling are considered in this article.
  • I cannot emphasize enough, how important it is to seek professional help (whether through the NHS or privately) if your child’s school anxiety is at risk of spiralling out of control. Clinical psychologists in particular at experts in understanding and treating anxiety.

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