The following school anxiety counseling question comes from an actual ScottCounseling, Ask A Counselor question.  This parenting question and ScottCounseling response may help you parent a child suffering from school anxiety attacks.

Parents Background Information:

My 11 year old son, Tony, started Middle School this year. He has always had some self- esteem problems and confidence issues and afraid of things like windy nights, spiders, etc. When he played baseball he would always step out of the batter’s box because he was afraid he would be hit. He lets anxieties prevent him from doing things that he really wants to do. In the past I have pushed him to try to get over these anxieties but he is not responding to pushing anymore.

Tony’s dad and I divorced when he was 3. My kids and I moved 3 ½ years ago when he was in 3rd grade to blend homes with a man I was engaged to and am now married to. He has 2 sons who are 10 and 9 who live with us about 50% of the time and who Tony likes to play with. For the past 3 1/2 years things have seemed overall very good from that transition with normal bumps here and there as everyone got used to the new family and blended home. Tony also has an older brother (21) and sister (17). We were redistricted when he was going into 5th grade so he had to change schools yet again.

Starting in the spring of 5th grade Tony started getting more and more anxious about middle school (complaining of another change in schools). That same summer he became very upset when his sister moved to college and his brother moved out on his own. Then school started and he had stomach aches and threw up daily at school but would then go right back to class.

Tony gets all A’s and B’s. He is above grade level but very anxious and does have ADD. He has been seeing a psychologist for about 2 years now for anxiety and to help him deal with problems he has with dealing with his father. His father is an alcoholic and steps into Tony’s life for months or even a couple of years at a time and then disappears for months at a time. He did not see or communicate with Tony again until October 2008 when his dad called and apologized and they started seeing each other every other weekend again. His dad did was able to finally reconcile because he admitted himself into a 30 day rehab facility which helped him dry up and have the strength to reunite with his son. Things have been much, much better over the past few months.

Tony is seeing a psychiatrist for medication. He takes Vyvannse, 50 mg, to help him focus. He takes Lexapro 8 ML daily for anxiety. This was at 6 ML at the beginning of the school year but we have been continuing to very, very slowly increase as the year progresses due to evidence of increased anxiety. He has a tic too – sniffs a lot. We believe this is due to the Vyvannse. As the tic has become more frequent, teasing has started increasing which has increased the Anxiety.

September 10th, 2008, Tony fell at school and suffered a concussion. He was playing soccer in the gym at school and he and a friend kicked the ball at the same time and he fell straight backwards and hit his head getting dazed. Cat scans from that did not show anything but tests to release him to full activities did not allow him to resume activities for almost a month. One week later Tony had a panic attack in school (his first). He was rushed to the ER because we did not know what it was at that time.

Oct to Nov 2008 – Occasional panic attacks and vomiting at school but quickly got him back to class.

On December 13, 2008, just days before winter break, Tony suffered a Grand Mal seizure at home (his first and only so far). He does not remember the event but it was very traumatic to him being in the hospital afterwards. He has been to several doctors since then to test him to see what is going on. He has had a clean CAT scan; an EEG – which came back abnormal but they don’t know why yet – something in the peripheral vision area of the brain. He has had 3 MRIs and lots of blood work. There were 3 MRIs because they saw something in his brain but additional MRIs did not help see what it was. They said it really is not something that impacts seizure activity but they want to monitor it – thinks it may just be an irregular shaped bone but they want to rule out tumor so he will have another again in 6 weeks.

Since winter break ended on January 5th, Tony has not been able to attend school all day. He vomits in school, has anxiety attacks – panting, shortness of breath. The school calls to tell me what is going on. The first 2 times I ran to the school to take him home but the second I got him home he was fine, laughing and happy to be home. I no longer go to get him. We try to talk him down and get him back to class. We are only hit or miss successful at this.

The week of January 12th the psychiatrist added .25 mg Clonazepam 1 x at night and 1 x in the morning to Tony’s medications to try to help with the anxiety. It has softened the attacks but they have not stopped. This is supposed to be a very short-term treatment approach. The doctor is also discussing introducing an anti-tick medication (as Tony said that would mean the world to him so kids would stop teasing him due to the tick) but the doctor has been unable to reach Tony’s neurologist to get the OK to give him this medicine. The psychiatrist said he has to understand why the EEG is abnormal before he can administer this medication. The medication for the tick I have heard is controversial but what was once a sniff has grown into a snort during the month of January. The doctor said that the ticks change and can evolve.

Last week my husband and I had a meeting with the school psychiatrist, school guidance counselor, school nurse along with Tony’s  psychologist to discuss strategies. The psychologist wanted the teachers to understand this is anxiety and he needs to be reminded of how brave he is and to encourage him to stay in class. The attendees for the school wanted his input on what they can do to help him because they are frustrated and they don’t know what to do. The psychologist believes Tony is having real anxiety at school and that all of his pains are real but caused by anxiety. He does also think Tony has serious self-esteem issues and problems connecting to others. He and I are very close and he is very close to his older brother and sister.

I purchased relaxation breathing CDs which Tony and I listened to and practice at night. We burned the CD onto his MP3 player so he could take it to school and listen to it at lunch. I also purchased a book called Helping Your Anxious Child. We are starting activities recommended there too.

Despite this issue the school has allowed him to make up all work he misses in class and he continues to retain an A to high B average. The absences are going to start becoming a problem. He happily goes to school and is very happy at home and does his homework without any complaint or problem. He is over all a good kid, empathetic, usually follows rules but he is opinionated and can be mouthy at times. He does not get along well with kids his age because he always wants to tell everyone how to play games or what games will be played. At home when he does this with his younger step brothers we step in and help balance things out but when he is not at home – he does not play well with others. He gets along well with adults and is often the teacher’s pet – often volunteering to help them to gain their affection. He also works very well with special ed. kids who attend the middle school as part of a program to keep disabled kids in school. He even tutors one in math. He likes “helping”. He has even told one of the kids how to handle bullies or being teased (which I found very ironic).

Counseling Questions for ScottCounseling:

In your opinion do you have any other suggestions or ideas for how to help children through this. Are there any support groups out there? I have found none. The school does not even seem to understand what this is or how to treat this which is so odd to me if it is a real condition. Are there statistics out there for how many kids can overcome this vs how many kids have to be placed into “special” schools for kids with emotional disabilities?

ScottCounseling Response:

Dear Parent,

The information that you shared with me is not only well written, but it provides a great deal of valuable information. Let’s take the information that you presented and prioritize your child’s medical condition as it pertains to his school anxiety.

1) Your son’s condition is a medical issue with multiple, but treatable symptoms will require patience from your son, you and the school.
2) Although many of your son’s described conditions listed separately (ADD, Seizure, Concussion, Anxiety) do occur in other children in your child’s age group, the fact that you son has experienced all of these at one time make the situation more complicated.

I have some important questions for you:

1) Is one medical doctor overseeing the treatment of your son and aware of all the symptoms, behaviors and treatment plans (including medication) that your son has undergone?
2) Is the school nurse and school psychologist aware of the same information?. Note: I am very impressed with the fact a meeting took place with outside psychologist and school personnel.
3) Does the school allow your son to come to the school counselor or school nurse when the anxiety begins; before a full panic attack occurs? If not, ask your son’s psychologist to speak with the school counselor to see if time out of class (with the counselor) is appropriate, and your child can be eased back into class after he has had a chance to reduce the anxiety. This would also be a good time to practice his breathing relaxation tapes.

I work with several students every year who have several of the conditions that you have described. I have only worked with a few who have had all that you described with seizure(s).

To answer your questions:

“In your opinion do you have any other suggestions or ideas for how to help children through this. Are there any support groups out there? I have found none. The school does not even seem to understand what this is or how to treat this which is so odd to me if it is a real condition. Are there statistics out there for how many kids can overcome this vs how many kids have to be placed into “special” schools for kids with emotional disabilities?”

1) Yes, some school do have support groups for children who are experiencing anxiety in school. Ask your school counselor(s) if they facilitate this type of group.
2) First and foremost, your son’s condition is a medical condition and the school needs to follow directions or suggestions from the medical doctors and team together when implementing a school plan.
3) 90% of the time (from my experiences), children beginning to experience what your son is going through in 6th grade begin to make improvements as they get closer to 8th grade. The complexities that you described at the dawn of puberty (normal for all 11-14 year old children) will require your patience. Yes! I have seen kids pull through what your child is experiencing.
4) Many states require special assessments in order for children to be placed in emotional/behavioral school-based programs. The school psychologist should be able to tell you about various levels of these programs.

Please continue to work with your medical doctors and updating them as situation change (for better or worse). Ask your doctor from time to time if he/she wants information directly from the school. Some doctors have teacher questionnaires to obtain this information.

You are a great parent! Get back to me if I may be of further assistance.

Scott
ScottCounseling.com

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