Jennai Cox reports on a new guide which may help children who are afraid of school. School phobia among children is reaching epidemic levels because larger classes and cuts in support staff have left teachers too busy to recognise early warning signs, according to the Centre for Children's Counselling and Educational Support.
Thousands of children who make excuses about not wanting to go to school could be developing anxiety problems which take years to cure and often recur in adult life, the organisation says. Pip Grucock, a psychotherapist who set up the centre two years ago, receives 50 calls for help a week and believes up to 140,000 schoolchildren in Britain could be suffering.
The CCCES has issued a booklet to help teachers recognise symptoms and is urging everyone working in education to be vigilant about what can prove to be a traumatic and damaging experience.
"One young woman who wasn't treated as a child ended up totally incapable of holding down a job," Mrs Grucock says. "Some children are so badly affected they commit suicide."
School phobia is hard to detect, although persistent complaints about minor ailments such as headaches - sometimes used as a way of skipping lessons - may be an early indication.
"All children are anxious about something at some time," MrsGrucock says. "Because there are no classic warning signs, theproblem can bubble on for years."
School-phobic pupils are often academically able and may not seem to be having problems in class. Between the ages of 12 and 15 they tend to keep their heads down and lapses in concentration may not show in their work.
Parents often try to force the child back to school, which makes matters worse, says Mrs Grucock. "The child feels more and more isolated as his attendance at school is seen as more important than his well-being."
Bed-wetting or obsessive worry about uniform, using the toilet or eating in public could indicate that a child has progressed to what the CCCES describes as stage two of the phobia.
"Children can actually be physically sick just at the thought of school, " says Mrs Grucock. Stage two sufferers often give up after-school social activities such as sport or Brownies in order to avoid contact with other children.
"One of the most important things to look out for is how the child reacts out of school. They tend to stay at home, close to mummy."
Because of ignorance about the problem, most school-phobic children seem to suddenly arrive at stage three, when the child has to be literally dragged school.
School phobia, first identified by psychologists in 1941, is sometimes found to be a result of an already anxious child feeling cut off from safety. Sufferers are often conscientious children who feel they should be able to cope alone, making the problem worse.
Research published in 1981 found that a third of 100 school phobic suffers who spent seven months in a psychiatric unit later developed neuroses and another third did not develop normally.
School phobia usually masks more deep-rooted problems which the child either finds difficult to express or has not defined for themselves, Mrs Grucock says.
Skilled counselling is needed. Mrs Grucock emphasises gaining the child's confidence without judging.
"The first thing I say is: 'I am not here to get you back to school. I am here to make you happy again'. In time, they almost always return to school. "
Teachers and parents can help by seeing the child's point of view and refraining from using threats, which make the child more anxious. Extreme patience is needed in the recovery period, which can take months or years. Having a safe place at school where the child can go often helps.
More counsellors trained to treat school-phobic children are needed, Mrs Grucock says. She fears the problem will increase. "The national curriculum and larger classes mean teachers have no time to look out for these things, " she says. "All the rescue packages are being removed."
The number of schoolchildren with behavioural difficulties is increasing and teachers are more aware of emotional disorders, says Sue Nicholson, assistant secretary of the National Association of Head Teachers. But as they are losing extra support, the situation could deteriorate. "Psychologists used to visit schools and chat to teachers about the children," Ms Nicholson says. "But now they tend to visit less often and concentrate on those with obvious difficulties."
Margaret Morrissey of the National Confederation of Parent-Teachers Associations says school phobia has only recently surfaced as a problem. "There is a danger of these children being seen as disruptive and naughty, when really school phobia is an illness. It can be a terrible strain for parents."
Recognising And Dealing With Phobia: a guide for professionals by Pip Grocock is available at Pounds 1.50 from CCCES, Centre House, 14 Basil Avenue, Armthorpe, Doncaster, South Yorkshire DN3 2AT. Helpline: 01302 833596