School constitutes a large part of an adolescent's existence. Difficulties in almost any area of life often manifest as school problems.

Particular school problems include

• Fear of going to school
• Absenteeism without permission (truancy)
• Dropping out
• Academic underachievement

School problems during the adolescent years may be the result of

• Rebellion and a need for independence (most common)
• Mental health disorders, such as anxiety or depression
• Substance use
• Family conflict

Sometimes, inappropriate academic placement—particularly in adolescents with a learning disability or mild intellectual disability that was not recognized early in life—causes school problems.

Problems that developed earlier in childhood, such as attention-deficit/hyperactivity disorder (ADHD—see Learning and Developmental Disorders: Attention-Deficit/Hyperactivity Disorder) and learning disorders (see Learning and Developmental Disorders: Learning Disorders), may continue to cause school problems for adolescents.

In general, adolescents with significant school problems should undergo educational testing and a mental health evaluation. Specific problems are treated as needed, and general support and encouragement are provided.

Between 1% and 5% of adolescents develop fear of going to school. This fear may be generalized or related to a particular person (a teacher or another student) or event at school (such as physical education class). The adolescent may develop physical symptoms, such as abdominal pain, or may simply refuse to go to school. School personnel and family members should identify the reason, if any, for the fear and encourage the adolescent to attend school.

Adolescents who are repeatedly truant or drop out of school have made a conscious decision to miss school. These adolescents generally have poor academic achievement and have had little success or satisfaction from school-related activities. They often have engaged in high-risk behaviors, such as having unprotected sex, taking drugs, and engaging in violence. Adolescents at risk of dropping out should be made aware of other educational options, such as vocational training and alternative programs. Changes in the learning environment and sometimes drug therapy can also be of great help to struggling adolescents.

Last full review/revision January 2009 by Sharon Levy, MD, MPH