School Phobia: differentiations
(4-3-06)

School Phobia vs. Reality Based Apprehension

Reality based fears reflect

Real threat
Reasonable degree of fear

Reality based fears can be decreased with:

1. knowledge

2. skill training

School Phobia vs. Truancy

Children showing school phobia:

  1. Linger at home with parents' knowledge and/or consent

  2. earn average or better grades

  3. profess to like school

  4. bluntly refuse to go to school

  5. show more somatic signs of anxiety: abdominal pain, nausea, vomiting, disturbances of eating and sleeping.

  6. tend to come from stable homes with no history of parental absence.

Truancy: differs from school phobia on all of the above

Truancy is a symptom of conduct problems.

 

Subtypes of School Phobia: Two patterns of school phobia have been proposed, based on characteristics of the episode and the child's family. Type 1 has been described as showing a more positive course (more likely to show spontaneous remission) and a more positive prognosis (good responses to treatment are often shown).

Type I School Phobia ("Acute", "Neurotic", "Neurotic Crisis")

(1) Young (</= 10 years of age)

2. First episode

3. Monday onset, often following minor illness preceeding week

4. Acute onset

5. Expressed concern about death

6. Child thinks Mom may be ill

7. Good communication between parents

8. Mom and Dad well-adjusted

9. Father involved in home and housework

10. Parents easy for school/counselor to work with

Clear presence of 6 characteristics out of 2-10 sufficient for classification.

 

Type II ("Chronic", "Characterological")

(1) Older (>/= 10 years of age)

2. 2nd, 3rd, etc. episode

3. No Monday onset pattern

4. Incipient onset

5. No death theme

6. Mom's health not an issue

7. Poor communication between parents

8. Mental health problems in parents: Mom may have anxiety probems or history of same; Dad may have substance abuse or criminal problems or history of same.

9. Dad shows little interest/involvement in family, home, housework

10. Parents difficult for school/counselor to work with

Clear presence of 6 characteristics out of 2-10 sufficient for classification.