SEPARATION ANXIETY, SCHOOL REFUSAL AND TRANSITION TO SCHOOL

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Refusal to go to school has gotten more attention recently, because it became a common problem in child psychology. Research shows that it affects more children than earlier. The percentage of children suffering from this problem is estimated to be around 1-2% of school aged children. What is even worse, psychologists think that this problem is likely to peak at transition points (between 5-6 years and 11-13 years).

Even though most children still get excited and are willing to go to school, there is still a certain number of them who have fear of starting this new path. Therefore, they refuse to go. When this happens, we need to ask ourselves what is the reason of such behavior.

 Since separation anxiety isn’t always the reason for children to refuse to go to school, we need to look over all the possible reasons. First, we need to make sure that the child isn’t bullied. Then, we need to make sure that the child doesn’t have problems with getting along with peers or teachers. Last, we need to check if the child has problems with understanding the classes.


If all we mentioned so far is under control, it’s likely that the child has separation anxiety.

The symptom of this disorder is avoidance, that can be shown as avoidance of school, contacting with others or sleeping alone (without child’s caregiver). In the case of this disorder, anxiety  is excessive and developmentally inappropriate

This term is very important because it helps us understand that our child really has a disorder. Although refusing to go to school might seem manipulative to the parents, it is definitely not. It’s understandable that parents sometimes think that way, because it is a normal stage for a child to have separation anxiety. But, it is normal to have it until somewhere around age 2 and it is definitely not normal for school aged children. School refusal after age 2 is a significant problem related to mental health issues, especially separation anxiety, that should be treated. 

Symptoms of Separation Anxiety Disorder

Separation anxiety disorder shows itself in physical, cognitive and behavioral ways. Therefore, according to DSM-5, symptoms of separation anxiety disorder are:

A. Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following:

  1. Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures.
  2. Persistent and excessive worry about losing major attachment figures or about possible harm to them, such as: illness, injury, disasters, or death.
  3. A persistent and excessive worry about experiencing an untoward event (e.g., getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure.
  4. Reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation.
  5. Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings.
  6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure.
  7. Repeated nightmares involving the theme of separation.
  8. Repeated complaints of physical symptoms (e.g., headaches, stomachaches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated.

B. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents.

C. The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning.

There are different causes for separation anxiety in children. Such as: losing a loved one, moving to another neighborhood, changing the school, parental divorce, an illness of a child or a relative, etc.  Parental overprotection and intrusiveness may also be associated with it. 

How to Help Children with Separation Anxiety

  • Show your care and love. Children who receive attention and love learn faster than others who must learn the hard way, without enough attention and affection.
  • Do not tease the children ( e.g., ‘You’re very silly to cry about it’), or do not show your anger ( e.g., ‘I am getting crazy when you do something like this’). Instead of these, prepare the child for separation. Make him or her sure about that you’ll get him or her back when the classes end. In the other words, take their problems seriously. Explain the situation with patience, confidence and understanding (e.g., as ‘I know that it is hard for you to separate now but I’ll definitely come back here to get you after school.’).
  • It is important to schedule sleeping and meal time, because separation anxiety is more likely to happen when the child is sleepy, or hungry.
  • Maintain control over your own anxieties. Children can understand your anxiety while leaving, and it is a distressing signal for the child.
  • Check out if you have some inappropriate anxious thoughts, because children learn many things by observing the parents.
  • Write daily positive and supportive lunch-box notes.
  • Tell your child when you’re leaving and when you’ll be back, and do your best to keep your promises.
  • If necessary, take professional help. Cognitive-behavioral therapy is a good choice for that. Through a variety of techniques, children learn strategies to manage their worrisome feelings and thoughts, as well as the ways to cope with them.
  • Make the home boring during school hours such as no TV and internet use.
  • Get someone other to drop your child at school. This is because it is usually easier for the child to leave at home rather than at school.
  • Reward your child for going to school. Make sure that your child knows what this reward is for.
  • Talk to teachers and school principal to get help and support.
  • Don’t physically force or emotionally blackmail your child to go to school. This may cause a bigger trauma.
  • Last, if your child is still unable to go to school, home tutoring, or online classes may be a good chance for him or her to get education until he or she feels ready to go to school.

References

Weatherall, J. (2014). Separation Anxiety Disorder: School refusal. Retrieved from https://www.heretohelp.bc.ca/infosheet/separation-anxiety-disorder-school-refusal

The Center for Treatment of Anxiety and Mood Disorders (Aug 15, 2019). Separation Anxiety and School Refusal. Retrieved from https://centerforanxietydisorders.com/separation-anxiety-and-school-refusal/

Hurley, K. (Aug 6, 2019). Separation Anxiety in Children: How to Help your Child with Separation Anxiety Disorder. Retrieved from https://www.psycom.net/separation-anxiety-disorder-children/

Swanson, W. S. (Nov 21, 2015). How to Ease Your Child’s Separation Anxiety. Retrieved from https://www.healthychildren.org/English/ages-stages/toddler/Pages/Soothing-Your-Childs-Separation-Anxiety.aspx

Psychology Today. Separation Anxiety. Retrieved from https://www.psychologytoday.com/intl/conditions/separation-anxiety

Hurley, K. (Oct 25, 2017). How to Help a Child Overcome School Refusal. Retrieved from https://www.psychologytoday.com/intl/blog/worry-free-kids/201710/how-help-child-overcome-school-refusal

Theschoolrun.com. Coping with School Refusal. https://www.theschoolrun.com/coping-with-school-refusal

Raisingchildren.net.au. (Apr 8, 2019). School refusal: Children 5-8 years. Retrieved from https://raisingchildren.net.au/school-age/school-learning/school-refusal/school-refusal

Kearney, C. A. (2008). School absenteeism and school refusal behavior in youth: A contemporary review. Clinical Psychology Review, 28, 451–471.

Pellegrini, D. W. (2007). School non-attendance: Definitions, meanings, responses, interventions. Educational Psychology in Practice, 23, 63–77.

Nuttall, C., & Woods, K. (2013). Effective intervention for school refusal behaviour. Educational Psychology in Practice, 29(4), 347–366.

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