School Anxiety, Phobia & Panic Attacks

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.
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 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.
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.
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.
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.
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:
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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