School Phobia in Students on the Autism Spectrum

At some point in their school career, High-Functioning Autistic (HFA) children are significantly challenged by anxiety. School phobia (known to professionals as school refusal), a complex and extreme form of anxiety about going to school (but not of the school itself as the name suggests), can have many causes and can include related anxiety disorders (e.g., agoraphobia and selective mutism).

Symptoms include:
  • a racing heart
  • fatigue
  • frequent trips to the toilet
  • nausea
  • shaking
  • stomachaches

Young children on the autism spectrum (up to age 7 or 8) with school phobia experience separation anxiety and cannot easily contemplate being parted from their parents, whereas older kids (8 plus) are more likely to have it take the form of social phobia where they are anxious about their performance in school (such as in games or in having to read aloud or answer questions in class).

HFA children with anxieties about going to school may suffer a panic attack if forced which then makes them fear having another panic attack and there is an increasing spiral of worry with which parents often do not know how to deal.

Going to school for the first time is a period of great anxiety for very young kids. Many will be separated from their parents for the first time, or will be separated all day for the first time. This sudden change can make them anxious and they may suffer from separation anxiety. They are also probably unused to having the entire day organized for them and may be very tired by the end of the day – causing further stress and making them feel very vulnerable.

For older children on the spectrum who are not new to the school, who have had a long summer break or have had time off because of illness, returning to school can be quite traumatic. They may no longer feel at home there. Their friendships might have changed. Their teacher and classroom might have changed. They may have got used to being at home and closely looked after by a parent, suddenly feeling insecure when all this attention is removed; and suddenly they are under the scrutiny of their teachers again.

Other children with HFA may have felt unwell on the school bus or in school and associate these places with further illness and symptoms of panic, and so want to avoid them in order to avoid panicky symptoms and panic attacks fearing, for example, vomiting, fainting or having diarrhea. Other kids may have experienced stressful events.

Possible triggers for school phobia include:
  1. Being bullied
  2. Being off school for a long time through illness or because of a holiday
  3. Being unpopular, being chosen last for teams and feeling a physical failure (in games and gymnastics)
  4. Bereavement (of a person or pet)
  5. Fearing panic attacks when traveling to school or while in school
  6. Feeling an academic failure
  7. Feeling threatened by the arrival of a new baby
  8. Having a traumatic experience such as being abused, being raped, having witnessed a tragic event
  9. Moving to a new area and having to start at a new school and make new friends or just changing schools
  10. Not having good friends (or any friends at all)
  11. Problems at home such as a member of the family being very ill
  12. Problems at home such as marital rows, separation and divorce
  13. Starting school for the first time
  14. Violence in the home or any kind of abuse; of the youngster or of another parent

Children with an autism spectrum disorder need to be dealt with differently as compared to kids without the disorder (e.g., teaching them relaxation techniques can actually make them more anxious).

The longer school phobia goes on, the harder it is to treat, so referrals to Child and Adolescent Mental Health Services are usually quite quick to ‘nip it in the bud’. However, if your youngster is severely affected, it is better to ask for a referral (from your youngster’s doctor or head teacher) to the service before you are desperate as it is often overstretched: in reality it can take some time to get an appointment. 

Things you can do yourself as a parent include getting help from your youngster’s school. Teachers need to be aware there is a problem. Sometimes being taught in a special unit in school (if the school has one) may help your youngster feel more secure as it is a more comfortable place and acts as a half-way point between home and school. Some HFA children are so severely affected that they stop going to school. It should be made quite clear to your youngster’s teachers that she is not ‘playing up’ but that her anxiety is very real and she is suffering from it.

At home, life should continue and your youngster should be encouraged to carry on as normal. But she might want to stop going out, especially without you, even to parties that she was quite happy being left at before. Although you need to deal sensitively with her, if she doesn’t absolutely have to miss something, it is best to help her go by going with her for part (or all) of the time so that her world does not shrink altogether. 
It is also helpful to:
  • Encourage your youngster to find things she can enjoy in the school day.
  • Explain that her fears are brought on by thoughts that are not true thoughts; she is reacting to normal things in an extreme way.
  • Find things that your youngster can look forward to each day.
  • Keep to the same routine. 
  • Make her go to bed and get up at the same time every day (even on weekends) so that she has some secure framework to live around.
  • Reassure your youngster. Tell her that she will be fine once she has got over the part she dreads.
  • Tell her she is brave for going to school. Although her friends find it easy, she has a private battle she has to fight every school day.
  • Tell her you are proud of her for being so brave.


•    Anonymous said... Homeschool was the best thing I did for my daughter.
•    Anonymous said... Homeschool!!! Made a world of difference for our son. There is no need to force children into painful, emotionally damaging situations every day.
•    Anonymous said... I am homeschooling my son this year after a horrendous attempt at mainstreaming at a new school last year that just left him feeling horrible about himself and behind academically.
•    Anonymous said... I did homeschool .. Did wonders for his self esteem
•    Anonymous said... I would agree homeschooling sounds like it would just be so so much better for him....
•    Anonymous said... My son was compressing his anxiety all day and then melting down the second he was off the bus. It would happen every single night. Several times a week the school would call be because he was vomiting. After we finally figured out what was going on, we made the decision to homeschool him. It has been the best decision we've made and a huge blessing for our family. He is doing great, light years ahead academically and happy. I wish we'd have started when he was younger and never put him through that at all. 99% of the time, his Aspergers symptoms are gone or under control now.
•    Anonymous said... My sons kindergarten teacher told me he should snap out of it. She immediately learned the extent of my vocabulary.
•    Anonymous said... Same for my son....I homeschooled my son (12) last year. This year he is going to attend a small private school that is very similar to homeschooling with multi age classrooms.
•    Anonymous said... School is a constant struggle for my 16 year old aspie son. He's currently in a special ed autistic class at his high school but he still struggles with not wanting to be there. Last year we dealt with him having thoughts of injuring/killing one of his teachers. He too would hold things in until finally blowing up. I have been told by his IEP team and school counselors that home school would be a horrible idea for him and that because he has an IEP the school would not approve it. I considered online schooling for him but was basically told no. How did you all get around that? We live in Washington state.
•    Anonymous said... they likely say that because they don't want the school to lose funding they get for kids on IEPs, and plus the school has no right to tell you how you educate your child. Since when do schools have to approve homeschooling? Sounds like bullying tactics to me. It is your choice.
•    Anonymous said... This was perfect timing for me..school starts on Tuesday and last year was a constant battle with the school and getting the kids to go. Meltdowns, nightmares, and physical illnesses all year. I have been strongly considering homeschool iand its great to know how well it has worked for others.
•    Anonymous said... We had the experience. We cyber school now and it has changed everything for the better. So grateful for options such as this to help these precious children succeed.
•    Anonymous said... Yup true, I sent my son to homeschool. Better environment for them. No bullying from teacher and friends. when there is no bully, they feel comfortable with the lesson they are in. Now he even able to skip 2 levels....

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