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School Refusal Help for the Reluctant

Help for the Reluctant

His first month in middle school, Stephen started missing the school bus routinely.

When Jane entered the first grade, she began having painful stomachaches every school morning.

Three-year-old Tyler screamed with anguish whenever his mother left him at preschool.

All these children shared a problem that occurs in many children: They didn't want to go to school. The possible causes range from simple separation anxiety at leaving their parents to serious problems with school, classmates or teacher.

After you've ruled out actual physical ailments, here's how you can deal with the child who doesn't want to go to school.

For All Children

Explain the facts. Whatever age your child, you need to explain why the child must go to school, says David Waller, M.D., pediatrician, child psychiatrist and chief of child and adolescent psychiatry at the University of Texas Southwestern Medical Center and Children's Medical Center in Dallas.

For the preschool child, keep it in simple terms: 'This is a place where people will take care of you and you can play while we are at work' or 'Mommy and Daddy want you to meet new friends, and this is a good place to do it.' But make it clear that you're not angry at your child or punishing her.

For older children, explain that it's a law that they attend school. Dr. Waller recommends that you tell them the consequences of missing school or constantly being tardy. If the child knows he may receive poor grades, get detention or possibly have to repeat a year, he's more likely to climb on that morning bus.

Visit the school. For the child just starting preschool or kindergarten or transferring to a new school, arrange a visit before the first day.

'Spend some time in the classroom with your child,' says Karen Smith, Ph.D., a pediatric psychologist and associate professor of pediatrics in the School of Medicine at the University of Texas Medical Branch in Galveston. 'Talk to the teacher, too, so that your child can see that Mom and Dad like this new person, that she's not someone to be afraid of. You might need to do this more than once for very anxious children,' she says.

Supply a map. Children can worry a great deal about finding their way around a strange place. Draw a map of the school in bright colors for your child and point out places such as the art room, bathroom and lunchroom. Hang the map on the wall of your child's room.

'It's important for your child to become familiar with the physical layout of any new school,' says Leah Klungness, Ph.D., a psychologist in Locust Valley, New York. 'Not being able to find the bathroom can upset a child who is already shaky about new beginnings.'

Tantalize with descriptions. Find out what types of activities your child's preschool or school will have, and describe them to your child. 'Talk to your child about the kinds of things he'll be doing there and the friends he'll make,' suggests Dr. Smith. 'Try to find something of interest that will happen in that setting that might not happen at home.' For example, if your child will learn to fingerpaint at preschool or have recess every day at kindergarten, explain that to him.

Just for Preschoolers

Depart cheerfully. This means no prolonged leave-takings with smothering hugs and kisses and syrupy reassurances. 'Don't tell your child, for example, that he shouldn't be afraid or that nothing bad will happen to him,' says Dr. Waller. 'If a child reads anxiety in a parent, he's bound to think that there must be something to be anxious about.' Give a quick kiss and a hug, tell your child when you will return and leave with a smile on your face--whether or not your child is screaming and beseeching you to come back.

Leave openly. Although it may seem easiest to sneak off while your child is playing quietly, don't do it. ' Whether your child is howling or playing quietly, never just disappear,' says Cathleen A. Rea, Ph.D., a clinical child psychologist at Riverside Regional Medical Center and the Behavioral Medicine Institute in Newport News, Virginia and an assistant professor in the Department of Psychiatry and Behavioral Science at Eastern Virginia Medical School in Norfolk. 'That's traumatic to a child; Mommy or Daddy disappearing is his worst fear. You need to let him know when you're leaving.'

Plant a lipstick kiss. Preschool children may find a lipstick imprint from Mom comforting. 'Cover your lips with lipstick and then kiss your child on her hand or wrist where she can see the lipstick imprint,' suggests Dr. Klungness. 'Lipstick doesn't wash off so easily, so it's a constant reminder of your presence.'

Supply pictures of Mom and Dad. A small photo of his parents tacked into his cubby or locker may be immensely comforting. 'A picture showing you in your office or workplace is particularly helpful,' says Dr. Klungness. 'Looking at that picture, the child sees you in a particular physical environment, and he won't feel as if you've disappeared.'

Arrange for a greeting. It's important that you don't just drop your child off in a crowd of children, says Dr. Rea. ' When you walk into the day care center, you want to have a teacher or aide come over immediately to greet you and your child. She should get down to eye level and help with the transition from parent to day care setting,' she says. At a busy day care center, you may have to make a request in advance, but most caregivers will be happy to cooperate with this greeting arrangement.

Provide a time framework. Very young children often don't have a good sense of time, so telling your child a specific activity you will do together that evening will help her realize that day care isn't forever. ' You could tell her that you'll stop for a snack on the way home, or that you'll read her favorite book while dinner is cooking,' suggests Dr. Rea.

Take Teddy along. It can make day care far less frightening to take along a favorite toy, says Dr. Rea. 'Bringing any special transitional object from home is often comforting to an anxious child,' she says.

Ask about your child's behavior. After a few weeks you may feel that things aren't getting any better. Your child still screams and cries when you leave. But once you're out of sight--unknown to you--he may be playing happily the rest of the day.

'Check with your child's teacher to find out if there's a decrease in the intensity and the duration of the emotional distress your child experiences,' suggests Dr. Smith. If your child adjusts rapidly after you leave, stop worrying.

For Older Children

Talk it out. Talk gently with your child to find out what is bothering him about school, suggests Dr. Klungness. If you can't discover the problem, arrange a conference with the teacher. There could be a bully who has been picking on your child. Other children could be taunting your child because of the style of his clothing. Your child may be anxious because he feels he's not doing well in school.

Or something could have happened that embarrassed your child. Dr. Rea counseled one child who refused to go to school after he dropped his lunch tray in the cafeteria. 'It can be as innocuous as that,' she says.

Think about things at home. A sudden change in your child's schoolgoing behavior can sometimes be traced to events at home. 'Consider if there is something going on at home that might have precipitated your child's refusal to go to school,' advises Dr. Waller. 'Sometimes a child who has experienced a death or illness in the family--or notices her parents' marital problems--feels that she is 'needed' at home and will do what she has to to remain there.'

If there is a problem, don't lie to your child about it, but don't go into great detail either, says Dr. Waller. Explain that it is Mommy and Daddy's job to deal with the problem. Your child should understand that it's her job to go to school and try to do well. Reassure her that you will be honest with her so she doesn't feel she needs to stay home to know what's going on.

Take charge of real problems. While your child needs to know that every school day won't be perfect and that she has to learn to deal with problems, she also needs to know you will help when needed, says Dr. Klungness.

For instance, if your small child is being tormented or hit by other kids on the bus, talk to the bus driver or principal. If your child is having trouble with schoolwork, set aside time when the two of you can work together on problem areas. And if you become convinced that the teacher has taken a dislike to your child or doesn't want to help solve your child's problems, you should arrange a meeting with the principal to consider transferring your child to another class.

Accentuate the positive. For the child with minor problems, acknowledge what your child dislikes about school, but try to identify some things at school that she does like. Remind her of the music lessons she loves or a friend she sees only at school, says Dr. Smith.

Seek guidance. Talk to the school's guidance counselor or nurse and ask if your child can visit the nurse during the day if she suddenly becomes anxious, suggests Dr. Waller. You don't want to encourage frequent visits, but if the anxious child knows she has someone to turn to, it gives her reassurance. 'It's better than coming home early, which would only reinforce the school refusal behavior,' says Dr. Waller.

Give praise to your child. Sometimes the best reward is a big hug and a word of praise from Mom and Dad. Be sure to acknowledge your child's efforts. ' Your child should be complimented every time she stays through the school day or goes to school without protest,' says Dr. Smith.