Listen to what's making them frightened

Children who are anxious about school need to be taken seriously - and treated gently, says Adi Bloom

Ten children in an average 1,000-pupil comprehensive suffer from school phobia. Up to 100 more experience anxiety about going to school. School phobia can strike at any age and manifests in many way - palpitations, hot flushes, nausea, and even stomach pains, vomiting and diarrhoea.

"Essentially, they are having mini panic attacks," says Nicky Lidbetter, of the National Phobics Society.

But although the symptoms are similar to other phobias, Nicky says children's overwhelming fear of school is not treated as seriously or as sympathetically. And she says telling a school-phobic child to snap out of it is the worst thing you can do. "Shouting will just make them more scared. You need to listen to what's frightening them. Facing up to the thing you're frightened of is difficult and needs to be done in a supportive environment.

"The key is little and often - small stages," she says. For example, instead of expecting school-phobic children to return for an entire day, teachers should ask them to spend a week seeing if they can go as far as the school gates without feeling sick or panicky. They should be reassured and praised for the courage it has taken just to turn up. And they should be helped to succeed. For example, if a child is a slow worker, teachers could give repeated warnings that the lesson is about to end.

The anxiety that causes school phobia can stem from a range of sources. For the very young, it can relate to being separated from parents. It can also be triggered by bereavement, problems at home, or feeling threatened by a new baby in the family. A prolonged absence from school, whether due to illness or a holiday, can also make returning difficult.

In older children, social phobia - a fear of being judged by others - can become particularly associated with school. These children are terrified of being made the centre of attention, so the anticipation of being asked to read aloud in class or being picked for a sports team causes panic and stress.

Marianna Csoti's six-year-old daughter developed school phobia after a bout of croup. During the ambulance ride to hospital, she suffered a severe bout of vomiting and as a result, began to fear illness and dying. Then, climbing on to the school bus one day, she stepped in dog faeces. This made her feel nauseous and she immediately connected being sick on the bus with vomiting in the ambulance. After this, she was afraid to travel on the school bus.

Marianna, a former physics teacher, now advises staff on how to deal with school phobia.

"A child suffering from school phobia is not attention-seeking or spoilt.

School phobia is severe emotional stress. An adult having problems like that would have time off work. I see teachers in schools damaging kids by forcing them."

She believes school-phobic children would benefit from a designated teaching assistant. "People don't see anxious children as having special needs. But they very much do. They're a special-needs peg being forced into a normal peg hole."

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