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Barbara F. Meltz writes the Globe's Child Caring column. She is author of "Put Yourself in Their Shoes, Understanding How Your Children See the World," and a frequent speaker to parent groups. Join her chat on the first and third Monday of the month at noon.
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Monday, September 10, 2007

Sick or not?


"Is my child really sick?" That's often a tough question for parents, especially if there are no obvious symptoms like a fever. The complaint is particularly common at the beginning of the school year, when it's not unreasonable to think your child might have caught a bug from being exposed to oh so many germs. But not feeling well, especially at the beginning of school, can be caused by social and emotional issues, too: feeling left out as friendship groups shift; thinking a teacher doesn't like him; worrying about who he'll sit with at lunch; fearing he'll forget his locker combination. The list can be endless. Any one of these issues is a big deal, and any one of them can surface for any child any year, including in a child who has had perfectly smooth transitions in previous years.

Here's the bottom line: If your child isn't sick in some measurable way like a fever, send him to school. Even if he's miserable, even if she's crying. That may sound pretty harsh.

But here's the issue: By keeping home a child who is nervous or anxious about something -- who may indeed be overwhelmed enough by it to have a very real stomach ache -- the message you send is this: "Yep, everything you're fearful of is true, and then some. I'll keep you home because that's where you're safe. What's going on in school is more than you can handle."

If you're lucky, your child is verbalizing her worry: "My teacher hates me!" Be a respectful, reflective listener ("Boy, that's a terrible feeling, to think a teacher doesn't like you."). Let her sit with your feelings of support and sympathy for a while, hours, maybe even a day. Too often we are too quick to jump in with advice or to try to reassure by dismissing the concern: "Of course she likes you, you're a wonderful boy!" Guess what? The message your child takes from that is, "Mom just doesn't get it." By letting him sit with your support for a bit, he feels that you are an ally. That can make all the difference in the world when, some time later, you try brainstorm with him in a way that enables him to come up with a coping strategy. ("What do you think you can do about this?" )

Whatever you do, don't keep her home, even for just one day and especially not at this tender time of the new school year. It makes it that much harder to return to school the next day, and then you can be well on your way to one of the most difficult issues of childhood, school refusal.

Just a quick word on that. There are three levels of what professionals call school refusal, when kids don't want to go to school: the normal separation issues of a preschooler; the mild school reluctance of a school-age child who now and then says he doesn't want to go to school but, in the end, goes off without too much difficulty; and anxiety that is so intense, it's accompanied by physical illness. That's school phobia, and professionals take it very seriously. Which is why you want to get help from the teacher and/or school as soon as you think you have a problem.

Even at the school refusal stage, you want to probe with your child: "Gee, you really didn't want to go to school this morning. What was that all about?" If he dismisses it, it's probably blown over and you can move on. But if his behavior changes in other ways, or the same thing happens the next day, it's not too soon to consult with the teacher: "Anything going on for John that might have caught your attention?"

As to that original question of, Is he sick or not?, here are some thoughts from a website I like.

Posted by Barbara Meltz at 11:32 AM
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