Is there such a thing as school phobia?
http://news.bbc.co.uk/2/hi/uk_news/magazine/8367283.stm
By Finlo Rohrer
BBC News Magazine
A school is being asked to apologise to the family of a boy it prosecuted for truancy. The boy was diagnosed as having "school phobia", but what exactly is that?
Most adults can remember days when they vehemently didn't want to go to school.
There would be protestations of illness, and of the danger of passing on an unpleasant disease, before the eventual acceptance that the journey into school was inevitable.
So many might react with scepticism to the idea that there is such a thing as "school phobia".
Any attempts to get them to school... can lead to quite extreme behaviour - temper tantrums, screaming, kicking. It is very distressing for the adults
Nigel Blagg
School phobia boy granted apology
But, says Nigel Blagg, author of School Phobia and Its Treatment, it is a condition that has been recognised since the 1960s.
"They will experience extreme anxiety. They are off school, typically with their parents' knowledge and approval. And they often have symptoms like tummy aches, head aches and nausea. Some of them suffer severely with depression.
"Any attempts to get them to school, when they are at their worst can lead to quite extreme behaviour - temper tantrums, screaming, kicking. It is very distressing for the adults."
The sceptics might of course want to bracket these children as truants, but, says Mr Blagg, a former local authority educational psychologist who now runs a private practice, they are quite distinct in background and behaviour.
"They are typically well behaved, socially conforming who are usually doing quite well. Normally they come from caring families.
"The truant group are the ones who [miss] school because they want to… often involved in delinquent behaviour."
Separation anxiety
It is thought the worst ages for school phobia are five to six and 11-14, says Mr Blagg. There are no precise numbers for how many children suffer the condition, but he notes one estimate is that 1% of children will have it at one point during their school careers.
A day at school is not every child's idea of fun
But the diagnosis is not without controversy, and even the term is subject to dispute, says Mr Blagg.
"In the psychological world the preferred term these days is school refusal. [But] school refusal doesn't convey the extreme distress, anxiety and panic, the physical symptoms that these children experience or the fact that it isn't a volitional state."
There is a recognition among psychologists and other education professionals that school phobia/school refusal covers a range of different problems.
Some of the younger sufferers can be diagnosed as having "separation anxiety", leaving them distressed at parting from their parents at the school gate. But some psychologists say this is more about refusal, not phobia - a true school phobic will experience a reaction even if their parents are present.
"Other children could be classified as having a social phobia to do with performance aspects of school - reading out loud or changing for PE," says Mr Blagg.
Other children might be off sick for a prolonged period, fall behind with work and fall out of a routine. Some might simply have changed school and lost friends they relied on to feel secure at school. Still others may have had a single distressing experience.
Indulging children?
"More typically what you have is an accumulation of stresses to do with home and school that add up over time and cause the child to be anxious," says Mr Blagg.
PHOBIA OR REFUSAL?
School phobia - irrational fear of school or the school situation
School refusal - Refusal on the part of a child to attend school
Refusal to go to school may be caused by a school phobia but most school refusals due to separation anxiety
In a true school phobia a child will show the phobic reaction even if his or her parents are present
Source: Penguin Dictionary of Psychology
"The avoidance leads to greater problems. They fall behind with school work. They worry what friends will say. The longer they are out the worse the problems get. If they are told they don't have to go they feel fine and the symptoms disappear."
Not only is there disagreement over the name for the condition, but also how to treat it, and whether it exists at all.
Sociologist Prof Frank Furedi, author of Wasted: Why Education Isn't Educating, is not convinced.
"You take an understandable anxiety about going to school and turn it into a disease… Children will internalise it and play the role that's been assigned to them.
"It cultivates the idea that these [exaggerated medically diagnosable] anxieties are normal. You do begin to encourage children to think in these terms."
But even if you do accept that school phobia exists, there can still be disagreement over the best approach to tackling it.
Mr Blagg insists that while educational psychologists, teachers and parents must be sensitive to the child's needs, they must recognise that confrontation and getting the child back to school is necessary.
Stay at home
"They need that very firm handling and confronting them and getting them back to school. You might have to take them to school and escort them [in]."
For those who have been away schools should assign tutors, help them catch up and offer them quiet space to be in while they are adjusting.
Would you help an arachnophobe by plonking a spider in their hand?
But there are some advocates of home schooling who believe that rather than being a psychological aberration requiring a cure, the symptoms of school phobia may simply indicate that the child is best educated away from the school, at home.
Ann Newstead, a spokesperson for the home tuition charity Education Otherwise, says school phobia is a "very real condition".
"I see a lot of families where they are in that situation - you only have to meet the children and families to see that it's not a made up condition. It's genuine. Not sending your child to school is something parents can be prosecuted for. You don't risk prosecution lightly."
"You wouldn't dream of forcing an adult to engage in an environment that wasn't beneficial to them. So why do we think it's ok to treat children in this way?"
But aren't children more malleable? Doesn't keeping them back from school indulge their fear rather than tackle the problem?
"I agree with the tackling but not the forcing of it. That's like treating someone who is scared of spiders by putting a spider in their hand. You tackle these things gradually, help someone to overcome a phobia and home education is a way of doing that."
More generally, many schools seek to make some of the changes for children less stressful, for example working on acclimatisation for children moving up to secondary school.
But Prof Furedi does not believe that such a sensitive treatment is necessarily always helpful.
"Kids going from primary school to secondary school often get transitional counselling.
"If you tell them enough times this is an extremely difficult, painful step, you make the kids more anxious."
. It has tricked me many times in my life, as soon as I thought I had one fear under control, it comes up with something new.