Kerri Pakulski is excited about beginning the fourth grade tomorrow at Essex Elementary School.
That's a big change from the fear she felt a few years ago before the first day of the first grade.
"I was scared, I was nervous," Kerri, now 8, remembers. "I think I was crying, I don't remember."
Indeed she did cry, confirms her mother, Jackie Pakulski, president of the Essex Elementary PTA. And she kept on crying when she got to school, says Laura Hudson, the school guidance counselor -- a pattern of behavior that continued for several weeks.
Kerri was suffering from a relatively mild case of what psychologists and counselors call school phobia -- an irrational fear and anxiety about going to school.
School phobia affects about 1 percent of children, estimates Cynthia Last, director of the Child and Adolescent Anxiety Disorder Clinic at Nova University in Coral Springs, Fla., and a recognized authority on the subject of school phobia.
School phobia is most common with young children, but "it can strike at any age and in any population," said Peggy Bagwell, a counselor at Woodbridge Elementary School in Baltimore County. "Many times you'll find that the children more prone to school phobia have higher academic standards for themselves. The school phobic is usually the real conscientious kid who wants to do well."
Although this is not a new problem, scientific examination of it is "still in its infancy," said Dr. Last, who is involved in research comparing behavioral therapy and medication in children with extreme levels of school phobia. "We still have a long way to go on this."
But, she said, the problem can be treated successfully in 80 percent of the cases. The bottom line is that parents should not give in to a child's plea to be allowed to stay home.
"The general rule of thumb is, I don't care if you have to hire a tow truck to take them, but get those kids to school," said James McGee, director of psychology at Sheppard and Enoch Pratt Hospital.
"It's important not to let them stay home because they're crying," said Michael Oidick, psychologist for Baltimore City schools. "That reinforces their negative behavior, and that's the last thing you want to do."
For Kerri, the problems started the summer before the first grade. Mrs. Pakulski remembers, "Kerri would ask a lot of questions. 'Is the work hard?' 'What happens if I get bad grades?' 'What kind of homework will I have?' 'Suppose I have to go to the bathroom?'
"The questions would come out of the blue, unrelated to what we were talking about, so I knew this was always on her mind. The way she was acting, I thought, 'Is this child ever going to be able to go to school?' "
As she became familiar with the school routine and more confident about her ability to do the work, "the butterflies in my stomach went away," Kerri says, and the tears subsided. By the end of September she would leave for school every morning without complaint.
Sometimes, though, the problem can be more long-lasting.
"Every morning last year when I woke up I said I had a bellyache," said Tammie Wingrove, who is beginning second grade at Gunpowder Elementary School. "It was because my teacher liked to holler. The worst bellyaches were on report card day."
"From Sunday night to Friday morning, we'd have stomach aches, we'd have headaches, we'd have a hurt elbow, we'd have sore throats," said Joan Wingrove, Tammie's mother. But she only let Tammie stay home from school if she had a fever, and conferences with her teacher convinced her that she was doing the right thing. "I found out that when Tammie arrived at school, she was fine. It was just getting her there that was the problem."
The term "school phobia" was coined in the 1940s. It should not be confused with school avoidance or school refusal syndrome, which relates to truancy, usually in teen-agers. School refusal syndrome is a behavioral problem, while school phobia is an emotional problem.
Treating school phobia sometimes can be as simple as a single meeting between a parent and teacher or school counselor. Just making the parent aware of the underlying emotions being experienced by the child and the importance of not reinforcing the negative behavior can solve the problem.
But many school systems, Dr. Last said, are not set up to detect school phobics, and cases may be mislabeled and mishandled. That can lead to trouble in later life.
Dr. McGee agrees. "It can be a very serious problem," he said. "There are people who launch their careers as psychiatric
patients with school phobia. Sometimes we see adults with serious psychological problems that started as school phobia and was mishandled. Something that could have been worked with became something more serious."
Typically, Dr. McGee said, school phobia is a combination of three factors: the child's fear of school, the child's anxiety about separating from the parent, and the parent's anxiety about being separated from the child, which the child usually can sense.