"How do I get my nine-year-old daughter to school? She seems to have tummy aches or headaches constantly, and misses several days of school each week. Any suggestion that she must go and she screams and cries and seems to be genuinely afraid of going to school. What can we do?"

You need to be firm with her. Don't count on the problem going away if you ignore it. She could end up not ever going back.

However, don't be angry with her as her anxiety and distress are real. You need to find out what is troubling her. It could be school phobia ( a fear of school), separation anxiety (fear of leaving you or the home) or agoraphobia (fear of crowds and public places). These are all very real disorders. If it might be the first, check if she is being bullied, teased, embarrassed, or abused at, or on the way to, school. Work closely with the teachers to identify and deal with any problematic situations. Make a doctor appointment for a complete examination. Explain the whole situation to him so he can look for serious illness. If he rules out an illness, then believe what he says. Don't have a lot of expensive tests. Assume that your child is physically well and needs to go to school. Keep assuring her firmly and confidently that she'll be fine (and so will you) once she arrives. If she still claims of physical ailments, you have two options; The first is that you insist that she go to school unless there is clear, measurable, evidence that she is sick, for example having a temperature, obvious diarrhoea and vomiting, etc. Just "feeling unwell" is not enough to miss school, after all, many adults have to go to work with headaches or other symptoms.

The second option is to believe her. Since she says she is too unwell to go to school, then clearly she is too unwell to be up and about the house. If she is sick then she is sick, and so she goes to bed: lights off, curtains closed, no TV, no special snacks. Ignore her and go about your normal daily routine. Make sure that the option of staying home is boring. If she is not sleeping then, ideally she should be doing some school work. Certainly there should be no friends or visitors to entertain her.

Along with this, set up clear incentives (rewards, privileges) for getting to school.

You must be tough and firm, but also calm, about all of this. Be clear that you expect her to be at school, but do not get into a fight with her about it. The goal is for her to want to get back as quickly as possible. Once there, and she discovers that nothing does happen to her or to you while at school, the symptoms of depression and anxiety should rapidly resolve.

If these techniques don't work and you think she may be seriously depressed or anxious, then find professional help by asking your family doctor for a referral.  

The Author:   Do your kids play you up? Then you should really take a look at Dr. Noel Swanson's excellent website, http://www.good-child-guide.com He also has a free newsletter on children's behavior management that is packed with advice.

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Article Posted: September 22, 2005