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School phobias in children have attracted much psychiatric interest during the past two decades (1), (2), (3), (6), (7), (8), (10), (11), (12), (14), (15). In some cases the onset of the phobia coincides with the start of school, which therefore appears to be the precipitating traumatic event. However, closer investigation reveals that a chronic phobic state already existed and was brought to crisis only when separation of mother and child was enforced by attendance at school. In other cases, children who have attended school without apparent difficulty for short or even long periods of time suddenly, or after a short initial struggle, develop a full-blown school phobia; often the child himself cannot plausibly relate his phobia to conditions at school. Dynamically this type of school phobia strikingly resembles traumatic neurosis, although trauma and effect seem disproportionate on surface observation. It may occur at any age, but I have encountered it most frequently in children at puberty and in adolescents. Biological changes and instinctual struggles inherent in adolescent development naturally make this age group more vulnerable.
Still other children develop a school phobia at the beginning of a new school year or term, or when faced by a change of school or teacher. In these cases both the child and those about him consider the phobia directly related to the school. However, these children are also chronically phobic and function so precariously that any event that rouses their basic conflict causes an acute exacerbation of the phobia. Because of their transitory character, these phobic states often remain untreated and may develop into permanent, crippling phobias. Brief periods