Should they stay home from school?



This time of year, after the holidays are over and people return to their normal routines, some children adamantly want to stay home and not go back to school. This phenomenon can be a component of separation anxiety, said Karyn Horowitz, MD, director of outpatient services at Bradley Hospital (www.bradleyhospital.org).

Horowitz explains that any extended time away from school - vacation, a prolonged illness, or even a long weekend - can make it very hard for an anxious child to want to return to school, especially if she's also having peer problems, or not doing well academically.

"It's common this time of year to see kids who are already separation-anxious start to fend off having to go back to school by complaining of illness. They get used to the comforts of home and feel anxious about the thought of returning to school," she says.

These complaints, like an upset stomach or a headache may prompt a child to ask to stay home sick, or if at school, visit the school nurse. And typically, being sent home will cause the child to feel physically better in the short-term, but will lead to persistent somatic complaints and worsening anxiety in the long-term.

If a child develops a pattern of somatic complaints, Horowitz advises that he needs to go to school unless he's sick enough to warrant a trip to the pediatrician (has a fever or other symptoms of a medical problem).

"The parent should then decide with the pediatrician whether the child should go to school," she says.

Other symptoms that a child may feel separation anxiety may include difficulties or regression at bedtime. For example, a child may have trouble falling asleep, need a nightlight, more bedtime stories, or come to the parent's bedroom.

"What's difficult about an anxious child is that your natural parenting instincts are not effective. When kids are anxious, talking to them about their worries actually makes their worries bigger, not smaller, so it's actually better not to engage kids in discussion about their worries," says Horowitz.

Parents should know that that once their child goes to school, they'll feel better, and the parent and school can help by having the child check in with a friendly face, like a teacher or friend, once they get to school to help mitigate their anxiety. Also, any skills or techniques the child can learn to help them to manage their own anxiety can be helpful (such as relaxation techniques).

"It's like a snowball effect," says Horowitz, "the longer a child avoids her fear, the more fear she has and the longer she avoids the situation, the bigger the snowball gets, so she should get to school as soon as possible."

Horowitz notes that many parents may feel "mean" for sending their child to school, but if they talk to their child's school nurse or teacher, it's likely the report will be that their child looks great by the end of the day.