Q: My daughter, aged 10, does not want to go to school. She complains of stomach aches and nausea if she goes, and often ends up getting sent home early due to illness.
I have tried everything from bribes to threats to get her to go regularly, but she often misses most of the week and then it is difficult for her to catch up. I am unable to do home schooling because I work full time. She is intelligent and does well in the classes she does attend. She denies being bullied.
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A: Your daughter is suffering from a type of anxiety disorder known as school refusal or separation anxiety. It is not the same as truancy where the child, usually an older teenager, misses some classes to have fun with friends.
The anxiety symptoms include physical distress such as dizziness, nausea, stomach aches or palpitations. Such children may worry about the physical safety of loved ones, and want to be as near as possible to them at all times.
Younger children may have trouble falling asleep when not in close proximity to parents. They do not like sleepovers, and they get distressed when sent to an outing such as a summer camp. They usually do not make it past the first day, and the parents are summoned to take them home.
I should point out that mild separation anxiety is normal in children younger than four, for example when being left at a day care. But the child usually settles down soon after the parent has left.
Are you also an anxious person? Studies have shown that children with school phobias often have parents who suffer from panic attacks and anxiety disorders. Sometimes the problem is triggered by an unusual and prolonged separation from a parent during infancy, perhaps because of a hospital stay or early loss of a primary caregiver from death or divorce.
Once you have had a doctor determine that there is no physical cause for her symptoms, you must insist that she goes to school regularly, unless she has an obvious sign of illness such as a fever or rash.
To achieve this, you may have to drive her to school and make sure she gets through the doors. Talk to her teachers, who are probably already aware of the problem, and tell them not to send her home early without first consulting you.
I am glad you are not home schooling her. This would only reinforce the problem behaviour.
Your daughter may need professional help from a psychologist or psychiatrist. Cognitive-behaviour therapy and relaxation techniques have been proven to be helpful.
In severe cases, medications can help, such as the SRIs (serotonin reuptake inhibitors) that are usually used to treat depression. These should be a last resort and only given for a few months in order to get her into an established pattern of going to school regularly.
Window seat problem
Researchers in Holland believe that you have twice the chance of developing deep vein thrombosis if you sit in the window seat of the plane rather than the aisle seat.
They speculate that this might be because it is easier to fall asleep in that seat, and it is also more cramped. You may not wish to disturb other passengers to get out of your seat and walk around as often. Obese passengers were found to have six times the risk.
One alcoholic drink per trip has also been found to help reduce this risk. Drinking water did not seem to make much difference.
Clare Rowson is a retired medical doctor living near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
