Question: My tween has been repeatedly refusing to go to school. Could she have a school phobia?
Answer: She may not necessarily have a "school phobia," but she's probably experiencing something worth investigating further.
In the mental health community, there's debate over what exactly constitutes a "school phobia." This term is not in the manual used to diagnose mental disorders (the Diagnostic and Statistical Manual of Mental Disorders IV-TR). Many psychologists instead use the broader term of "school refusal," although this too has no formal diagnosis.
Children with school refusal typically have long absences from school with the parents' consent (as opposed to truancy), become highly agitated when told they have to go to school, and may develop headaches or stomachaches when in school or approaching school. As many as 5% of school-aged children have some degree of school refusal and it seems to occur equally often in boys and girls. The peak age of onset of school refusal falls smack in the tween years, with the average age being 10.3 years.
School refusal can occur for a variety of reasons. For one, the child may have a mood disorder (depression or bipolar disorder). He or she may also or instead have an anxiety disorder. The most common anxiety disorders related to school refusal are separation anxiety disorder, social phobia and a specific phobia related to school (such as crowds, exams or school in general). Of course, children who refuse to attend school may not have any disorder at all. Their refusal may instead be caused by a specific situation, such as wanting to avoid contact with a bullying or relationally aggressive peer, finding a new classroom intimidating, poor preparation for an upcoming test or simply finding home to be fun and enjoyable. Learning disorders should also be considered in cases of school refusal, in case the child is staying home as a way of hiding his academic struggles.
All in all, there are so many causes for school refusal that your tween may not have "school phobia," per se. Nonetheless, her refusal likely indicates that something is going on. Therefore if your tween is consistently refusing to attend school and becomes highly upset when school comes up, a talk with your school's mental health professional may be in order.
Bernstein, Bettina, DO. Anxiety Disorder, Separation Anxiety and School Refusal. Accessed July 27, 2010:
Phares, PhD, Vicky. Understanding Abnormal Child Psychology, Second Edition. 2008. Hoboken, NJ: John Wiley & Sons.
Prabhuswamy, Mukesh, Srinath, Shoba, Girimaji, and Seshadri, Shekhar. "Outcome of Children with School Refusal." Indian Journal of Pediatrics. 2007: 74, 375-379.