Mental Health

Reprinted from HeretoHelp media release, August 2004

Heading back to school is tough. It can be hard for everyone — young people and their families — and it’s even harder for British Columbia families already facing adversity…

The Robertsons of Maple Ridge are one such family. Mary and Colin Robertson's 9-nine-year-old daughter, Marie,* who heads into fourth grade this fall, has lived with anxiety problems since age 3 as well as learning disabilities and some long-term medical issues — this, all on top of the regular back-to-school stress. The result can be exhausting and even traumatic without a game plan.

Marie began to first show symptoms of anxiety at a very young age which were aggravated when she started pre-school. "We were really fortunate there were supports to help us out back then," says Mary Robertson. "The preschool teacher was very accommodating in helping set up what's called a gradual entry program for Marie where, for example, I would initially stay in the class for part of the time and there was a classroom aide who was brought in to help her too."

The Robertsons and the school did gradual entry again for the second year of preschool and again when starting kindergarten to ensure any anxiety triggered by going back to school did not result in school refusal. According to the Anxiety Disorders Association of America, 2-5% of school-aged children refuse to attend school due to anxiety.

Starting first grade was tough because the new academic demands were stressful enough without also having to cope with learning disabilities which had also entered the mix. "Marie was so anxious she behaved so unusually including pulling away from me, curling up in a fetal position crying, and even lashing out despite being a very gentle and loving child," says Mary. "I recognized she was experiencing severe anxiety symptoms, but we could have just as easily missed it. There's so much going on at this time of year with all the normal and temporary anxieties that it can be really easy to miss the kinds we were facing with Marie that required intervention."

Again, with the support of the school, the Robertsons were able to address the concerns and set up a plan of action. Their plan included those successful gradual entry strategies from pre-school. They also set up a reward program of gold stars for attending school. "The stars got us on the right track, for sure," remembers Colin. "Marie was reluctant at first. She is a really bright child and questioned how they would help, but she soon figured out what the stars represented – that Mom and Dad were behind her with love, support and lots of praise to encourage healthy coping behaviours."

"The praise approach can work wonders", says Dr. Sarah Newth, Director of Programs with the Anxiety Disorders Association of BC and project manager with the BC Partners for Mental Health and Addictions Information. "Kids need encouragement from their parents, especially when trying difficult tasks or when the results of their efforts aren't immediate. The research shows that meaningful rewards like getting to spend special time doing fun things with their parents can be a very powerful motivator."

"None of this would have been possible without the school's support," says Mary. "When Marie told a trusted teacher that she ‘felt like a building falling down,' we started more planning with the teachers." For example, the Robertsons were able to set up a modified program for math, a particularly stressful subject for a lot of kids, and especially for Marie. This proactive approach and cooperation allowed their daughter to stay in school and move ahead in the face of these challenges. The Robertsons' active involvement with the school and with school activities is the right move for Marie's future success, according to Health Canada. School-aged children whose parents are actively involved in school-related activities tend to have better academic performance. Kids with parents who are not actively involved are seven times more likely to repeat a grade.

Today, the challenges still exist, but Marie is managing school and coping well with her mental health and neurophysiological problems. She feels more confident, is doing well in her work, and has even adopted a favourite subject: grammar. There are still occasional triggers that require problem-solving. For example, the family switched to a new school and, to deal with the change and uncertainty, visited the school and teachers ahead of time to help Marie adjust. Another example is the school arranging for Marie to be assigned to a familiar teacher as she transitioned to a new grade.

"Our approach is to tackle problems in manageable chunks," says Colin. "It's also important to provide emotional support and encouragement for our daughter as she tries new things and enters feared situations."

"If I had any tips to share with other parents, it's to remember to make your child's problems seem less scary by sharing your own problems," says Mary. "Sharing my own experiences with worry and anxiety has really helped Marie. It's also made her feel more comfortable sharing her concerns with us because she knows we'll listen."

The Robertsons reward themselves with a fun-filled vacation the week before the Labour Day weekend each year so that everyone is refreshed and ready to tackle the challenges and excitement of a new school year.

Common fears behind school refusal:

• Separation anxiety (leaving parents, caregivers, family)

• Worry about academic performance

• Riding on the bus

• Eating in the cafeteria

• Being alone at lunch or recess

• Using the school bathroom

• Being called on in class

• Changing for gym class

• Participating in gym class

• Fear of interactions with other children

• Fear of teachers or school staff

• Fear of being laughed at

• Fear of being of being bullied

_{Adapted from materials from the Anxiety Disorders Association of America}

* pseudonym