August 7, 2006
A University of Michigan Health Minute update on important health issues.
"Mom, don't make me go back to school!"
U-M child psychologist offers tips for dealing with children's anxieties and fears - before the school year starts
ANN ARBOR, MI – The countdown to the start of the school year has begun. And while most kids aren’t exactly looking forward to it, some kids are truly dreading the return to the classroom.
Anxiety over making new friends, being in a new school, facing bullies, feeling “uncool” or coping with academic pressure can make even a well-adjusted child anxious. And that anxiety or fear can build up in a child’s mind, leading them to act on it in many ways — from tummy aches and sleep problems to out-and-out refusal to go to school — says a University of Michigan Health System child psychologist.
Fortunately, there’s still time to do something about it. Parents can start now, in the summer, to help kids face their fears and calm their worries, says Michelle Kees, Ph.D.
Most kids can overcome their fears with the help of a parent, she says. But for children who show signs of anxiety over a longer period, or intense fears, parents shouldn’t hesitate to seek professional help from someone trained to help children and teens with anxiety problems and other mental health issues. As many as 5 percent of children have expressed some sort of prolonged “school refusal,” experts estimate.
Fear of school can also have its roots in other situations — such as stressful home events, learning problems or bullying — that need prompt attention. And serious untreated anxiety in childhood can put a child at risk for problems later in life.
“Going back to school can be a very exciting time for children, or it can be a time of great anxiety, apprehension and uncertainty,” says Kees, a clinical assistant professor of psychiatry, who treats children with anxiety disorders through the U-M Child & Adolescent Psychiatry clinic. “With any change that we experience in our lives, natural emotions such as anxiety can emerge. For children, this becomes more pronounced because every year they have this new experience of returning to school or starting at a new school.”
If kids and parents don’t deal with the anxiety and its causes, Kees says, “it can get out of control very easily. Often times, it’s a vicious cycle where a child will feel anxious about going to school, the parent will feel badly for the child, and allow them to stay home. The next day, it becomes even more difficult for that child to go to school.”
So, no matter what, parents shouldn’t let anxiety keep kids away from school, she says. Talk to school counselors and teachers, and mental health professionals if need be, to figure out what might be done. And most important of all, work hard to talk openly with your child about what’s worrying them, and how they might deal with it.
Depending on your child’s age, different things might be causing them to worry, and different techniques might be able to ease their back-to-school fears, Kees explains. She offers this advice:
Kindergarten and elementary school children
Parents of young kids often have a lump in their throat as they send their child off for the first day of kindergarten or first grade. Kids can pick up on that nervousness, says Kees, making their own worries even more intense. Months of buildup to the start of school, talking about it as a big event in the child’s young life, can also make a child anxious.
“Young kids who are anxious might avoid talking about going to school, or about school supplies, or about going to get their new school supplies,” says Kees. “Parents should begin early by opening a line of communication even with young children about school experiences and expectations, and about a child’s thoughts and feelings about school. Help children connect with their school by visiting it before school starts, especially if it’s a school they haven’t attended before.”
Shopping together for school supplies, and using the shopping trip as a time to talk about what to expect at school, can be a healthy way to keep a child talking. Parents should also try to connect their child with future classmates. “If a child knows someone who is going to be in the same classroom, that can greatly reduce their apprehension and fear of the unknown,” says Kees.
What if the first week of school arrives and a child still doesn’t want to go to school? He or she might not say it directly, but rather claim to have a tummy ache, a sore throat or a headache that quickly disappears once it’s decided to keep him or her home from school. Kids might hide when it’s time to get ready to go to school, or throw temper tantrums. Anxiety can also cause a child to have trouble sleeping or have nightmares while they’re sleeping. Little ones especially may become very clingy, and not want to leave a parent’s side – especially if they aren’t used to being away from parents during the day.
All of these signs of anxiety may end soon after the start of school. But if they continue for several weeks, Kees recommends that parents talk to a school professional or mental health counselor.
Middle school children
Making the transition from a small elementary school to a bigger middle school with different classes and more difficult work can be a big hurdle for some pre-teens. This age also comes with the added issue of meeting new children and facing social pressures about clothes, appearance and other things.
“For parents, recognizing anxiety in middle-school children can sometimes be difficult. This is the age when friends start to become more important than parents in a child’s view, and they may not share their feelings with you,” says Kees. “Possible indicators include coming up with excuses for not riding the bus or staying at planned school activities, or any behavior that involves avoiding going to school.”
Children who withdraw from friends or family, seem sad or less energetic, or just “aren’t themselves” may be experiencing issues about going to school or something more serious such as depression.
“If parents notice a dramatic change in their child’s attitude about school, their level of enjoyment or interest, as well as their performance, this is a red flag that something might be going on that should be addressed,” Kees explains. Parents can start by talking with their child’s teacher or school counselor, and perhaps seek advice from a mental health professional in the community.
High school students
By the time they reach high school, kids face a growing amount of responsibility at school, including pressure to fit in, and to do well academically in order to prepare for college or technical school. This is also the time of a young person’s life when they develop their own identity and the self-confidence needed to be independent.
Starting high school comes with a whole range of anxieties, says Kees. “The fear of starting high school and thinking, ‘Where do I fit in, what will people think of me, and will there be peer pressure to do things I don’t want to do,’ can be quite overwhelming as a freshman, or even later,” she says.
Teens tend to talk with their friends rather than their parents when something is bothering them, says Kees, and if their parents ask if something’s wrong, they may deny it. But parents can try to keep the lines of communication open by talking to teens about their friends, about their interests and activities, and anything else that might help a teen “open up” and say if something’s on their mind. Teens with anxiety issues may also have frequent headaches, dizziness, nausea and muscle aches that don’t seem to have any cause, or may have trouble sleeping.
Anxiety and depression can go hand-in-hand in teens, and the late teen years are a peak time for depression to begin. Parents should keep an eye out for major changes in their teen’s behavior and attitudes, loss of interest in things that once held their attention, large drops in their grades, aggression or irritability, or withdrawal from friends and family. These kinds of signs can signal a more serious problem that will need professional help to address.
When anxiety about school “masks” something else
Kids of any age who don’t want to go to school, or avoid it, may be doing so because of a specific issue beyond general anxiety, worry or depression, Kees notes.
“Children who are bullied or teased often become anxious about going to school, and if the problem is not addressed, the anxiety will continue along with a host of other problems,” she says. “Similarly, children who are avoiding school may be doing so because school is hard for them — school anxiety many times emerges just before a child is diagnosed with a learning difficulty.”
The bottom line, she says, is for parents to reach out to their kids and talk honestly about what’s going on. And, if problems persist, reach out for help — through the school, the child’s doctor or nurse, or a mental health professional.
Find out more on the web at:
KidsHealth: Back to School
American Academy of Child & Adolescent Psychiatry: Children who won’t go to school
National Association for the Education of Young Children: Helping Young Children Start School
Written by Kara Gavin
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