School phobia or “anxious school refusal” refers to the irrational fear of going to school. Being able to have multiple causes, this anxiety disorder remains difficult to measure in France where only absenteeism rates are monitored. Inserm researchers have therefore investigated the subject to try to better decipher school phobia in France.
State of play of school phobia in France
By school phobia or “anxious school refusal”, we mean an irrational fear of school. It results in the child or the adolescent by a sharp emotional distress, a physical and psychic incapacity as well as a refusal to go to his school. Far from being trivial, this state constitutes a real severe anxiety disorder which requires psychological monitoring. Because school phobia can lead to a blockage and lead to deschooling and isolation of the student who suffers from it.
Can have multiple causes, school phobia affects between 1 and 2% of students from kindergarten to high school in many countries. In France, it nevertheless remains difficult to measure because only absenteeism rates are quantified. However, absenteeism includes both skipping school, the eviction of the student from his establishment, the withdrawal decided by the parents and the anxious school refusal. This shows how school phobia is poorly identified in our territory and most certainly underestimated, for lack of sufficiently precise indicators.
To know ! Absenteeism is measured on the basis of four unjustified half-days of absence per month.
In this context, Inserm researchers set up a survey in 2018 to try to better decipher school phobia in France. The goal? To examine the profiles and the future of children aged 5 to 20 suffering from school phobia. Among the 2,000 questionnaires collected, 1,328 cases met the definition of “anxious school refusal”. But only 729 files presenting absenteeism data over three years were finally studied by the researchers.
School phobia: a multifaceted disorder
This survey shows that in primary school, absences are often linked to symptoms (stomach aches, headaches) or to a medical problem (rare or chronic) which worsens during the period of school refusal. The return to school generally takes place following two years of follow-up.
In college, school refusal tends to manifest itself around the age of 11–12, in connection with various disorders (depression, social phobia), existential questions or an embarrassing school environment.. While some students manage to gradually recover with regular support, many see their condition deteriorate. They sometimes end up dropping out of school completely despite substantial medical follow-up (psychotherapy, hospitalizations, drug treatments)…
In high school, although differences are better accepted, the first depressive episodes appear. Pupils find themselves confronted with new sources of anxiety such as the choice of their orientation. Since 2020, the continuous assessment system also maintains constant pressure on future graduates throughout the year.
Furthermore, this survey reveals that of the 1,328 students suffering from academic refusal anxiety, almost half were victims of harassment, insults or threats. This is without taking into account other factors such as learning difficulties (dyslexia, dysgraphia), handicap, precocity, or autistic disorders which can lead the students pointed out to develop a school phobia.
A problem with serious consequences
School phobia is not without consequences for the student who suffers from it. Chronic absenteeism may indeed compromise his academic success and eventually generate financial problems or mental fragility.
The consequences of this disorder can also be heavy for those around the child. Forced to adapt their schedules, parents resort to expensive and unreimbursed care. In addition to the mental burden and the feeling of guilt that can overwhelm them, parents often find themselves confronted with therapeutic wandering, due to a lack of information from educational staff and practitioners.
It is therefore crucial to raise the awareness of all educational actors in order to be able to spot signs of school phobia in children as early as possible. : small ailments before going to school, change in behavior, less good attendance in class, isolation in the playground, frequent visits to the infirmary, etc. The objective: to avoid diagnoses that are too late and to stop the school absenteeism. The role of relatives is essential in this identification as well as in the preparation of the child for the gradual return to school. This will involve securing the child psychologically through a healthy lifestyle, maintaining the link with his establishment and personalized arrangements for his return to class.
Déborah L., Doctor of Pharmacy
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