Back to school, Thursday, September 1, is fast approaching. If some students are nervous at the idea of finding their classmates, for others, the month of September is an obstacle course. Impossible to pass the gate of the establishment without a knot in the stomach, migraines, even anxiety attacks.
This refusal to go to class should not be taken lightly. In France, one in five students is concerned about school (PDF document) and “school phobia” affects about 1 to 2% of schoolchildren, representing 5% of child psychiatry consultations, according to data collected by Laelia Benoit, a child psychiatrist and researcher at Yale University (United States). The phenomenon has grown with the Covid-19 crisis. The School Phobia Association (APS) has seen an alarming increase in membership since 2019. “We have welcomed 150 people a week so far since the end of the second incarceration”, notes Odile Mandagaran, the chairman. How do you deal with the problem if your child is in this situation? Franceinfo put the question to various specialists.
What is school phobia?
In psychiatry, school phobia results in a “anxious school refusal”. This term refers to “children who irrationally refuse to go to school and resist with very strong fear or panic reactions when someone tries to force them to do so.” according to the definition of the neuropsychiatrist Julian de Ajuriaguerra in 1974. Usually this condition covers “many expressions such as anxiety, being late for class and partial or complete absenteeism”complete Laelia Benoit and Marie Rose Moro, child psychiatrists at La maison de Solenn, in Paris, and co-authors of School phobia, rediscovering the joy of learning (ed. Vigot, 2020), with Aurélie Harf.
However, it is important to distinguish school phobia from anxiety, which is much more common. The latter concerns young people “stressed before the start of the school year, or because of the fact of changing classes”, specifies Laelia Benoit. “This behavior is common and does not cause lasting discomfort to the child, reassure the child psychiatrist. Two or three weeks after the start of the school year, these students are no longer afraid.”
Together with her colleague Marie Rose Moro, they discovered that the socio-cultural origin of the children was decisive for a proper diagnosis. “We talk a lot more about school phobia in Paris than in Seine-Saint-Denis, where the words school failure and school dropout are more common”, explains Marie Rose Moro, referring to a study conducted by Laelia Benoit in the two areas. She regrets this “two weights, two measures” form.
“If a good student does not go to school, we immediately speak of school phobia, while he is a bad student, no.”Marie Rose Moro, child psychiatrist
What are the causes of school phobia?
They are multiple and also depend on the age of the child. “School phobia is very complexexplains Marie Rose Moro. Either the child cannot consider leaving his home – which happened, for example, after the Covid -, sor he’s weak, depressed, anxious or worried about what’s going on at home.” According to specialists, bullying at school is the most common cause. Half of students with school phobia have been victims of bullying or violence at school, according to an ongoing survey of 2,000 parents of students led by Laelia Benoit.
Certain disorders can also make life at school more difficult in primary and secondary education. This is the case of learning disabilities, called “dys” (dyslexic, dyspraxic, etc.), autism spectrum disorders or attention disorders, with or without hyperactivity. This does not mean that a child exposed to these conditions will necessarily develop a school phobia. But this young one “being out of line, at risk of being pushed aside by other children, being harassed” or having a hard time with their days at school, Laelia Benoit points out.
Finally, fear related to results and achievement, which is more present in high school students, can also lead to school phobia. “In this case, we can recommend that you stop evaluating the teenager for a while”recommends Marie Rose Moro.
“The French school is achievement-oriented and can be very punitive in the way it does things.”Marie Rose Moro, child psychiatrist
What to do to prevent it?
The start of the school year in September is synonymous with change. For anxious children, Marie-Christine Combes Miakinen, Ile-de-France contact person for theSchool Phobia Association, recommends preparing as a family for the start of the school year by buying school supplies together. As a parent you have to “try to control your own fear so as not to add to it”.
Laelia Benoit even recommends getting some sort of “general repetition”. Understand: set an alarm, eat breakfast, pack your school bag, go to school with your parents or siblings. Then the child can do a fun family activity.
Another advice from the child psychiatrist: coordinate with friends and stand at the door half an hour before the start of the lesson. This way, parents of students and children can discuss their holiday and take the time to “retame”. A way of “turning the school into a warmer place where it is nice to meet and hear from each other”emphasizes Laelia Benoit.
What are the signs that can alert you?
Before getting a phobia in school, parents (or teachers) can detect signs of anxiety, such as being late for class, absences, frequent visits to the infirmary, or headaches or stomachaches. “Especially with the little onesemphasizes Laelia Benoit, who find it difficult to say that they are afraid or that they are anxious.”
It is important to monitor the frequency of these symptoms. In case of school phobia, they are repeated on Sunday evening, Monday morning or at the end of the school holidays, a few days before the return to school. In general, peaks are observed after the All Saints and Christmas holidays.
What if your child refuses to go to school?
The first thing to do is to make an appointment with your GP to check that there is no health problem (problem with vision, anemia…). Parents can also request an appointment with the teacher and an assessment with a speech therapist. Once these clues have been ruled out, Laelia Benoit also recommends discussing with the child, “even make suggestions to him, because he may not have understood it himself” where does the problem come from?.
In case of repeated absences or the inability of the pupil to attend school, Marie-Christine Combes Miakinen recommends covering these absences with medical certificates. And to avoid it at all costs.
“It’s like burnout at work. We’re not going to force the adult to go to the executive committee every Monday.”Marie-Christine Combes Miakinen, of the School Phobia Association
You also have to create “a triangle between the education pole, the health pole and the family pole, with the child in the middle”pleads for the referent of the APS. And if the parents find the dialogue with the school difficult, she advises them “to start talking to the education team under the guidance of a chosen parent. You also need to identify who is the ally, the person with whom the current flows best.”
How and by whom do you get help?
Parents can initially use children’s literature or cartoons and animation films. There are also associations that they can be referred to based on the problem their child is facing.
If the fears or the phobia are installed, do not hesitate to consult a child psychiatrist who knows the question well, or a practitioner who offers behavioral therapies such as sophrology, meditation, art therapy… All that can help the child are emotions and express.
However, getting a consultation reimbursed by Social Security or in the public sector can be difficult. In medical psychology centers (CMP), the minimum waiting time is six months, according to a Senate report published in January 2020. Monpsy scheme, refundable up to a limit of eight per year. But not all practitioners have adhered to this system. Finding a child psychiatrist can also be complicated, as 14 departments don’t have one, the Senate report shows.
The need for support is also felt on the part of the parents. “To protect the family unit, it is best to get help” by discussing it yourself or by contacting an association, the chairman of APS, Odile Mandagaran, insists.
“School phobia is a real tsunami that takes the whole family. Everything collapses overnight. Parents feel judged, feel guilty.”Odile Mandagaran, President of the School Phobia Association
What are the possible alternatives if your child no longer wants to go to school?
To find the most suitable solution, you should look: “the child for the pupil”, Marie-Christine Combes Miakinen recalls. And so unitedly think about what suits him best. If the child categorically refuses to continue his education in a classical course, or if he is in too much pain to do so, it is possible to take distance learning at the Cned. The educational support system in the hospital or school (Apadhe) allows for a gradual return to the classroom. But it remains underused. According to Marie Rose Moro, 3 to 4% of school phobia cases end in hospitalization.
There are also alternatives such as the “Healthcare Studies” course (reserved for adolescents and young adults), which allows for full or partial hospitalization while undergoing training. But in the context of psychiatric care, this option is only available in 26 structures in France. Another option is second chance school, a free education for early school leavers aged 16 to 25.
Finally parents can go to specialized private schools. But these solutions represent a significant budget for families. The APS estimates the additional costs at 300 euros per month for households with a child with school phobia.