Merck Manual

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School Problems in Adolescents


Sharon Levy

, MD, MPH, Harvard Medical School

Last full review/revision Sep 2020| Content last modified Sep 2020
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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

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—see Bullying) 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 attempt to understand and address the reason 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 in 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, graduate equivalent degrees (GED), and alternative programs.


School problems during the adolescent years may result from a combination of

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.

Attention-deficit/hyperactivity disorder (ADHD) and learning disorders, which typically begin earlier in childhood, may continue to cause school problems for adolescents.

Diagnosis and Treatment

In general, adolescents with significant school problems should undergo a complete learning evaluation and a mental health evaluation. A professional counselor may be needed to help support school participation.

Specific problems are treated as needed, and general support and encouragement are provided. Changes in the learning environment and sometimes drug therapy can also be of great help to struggling adolescents. The federal Individuals with Disabilities Education Act (IDEA) requires that schools evaluate and provide appropriate services for students with learning disabilities and others who are not living up to their academic potential by providing individualized education plans (IEPs).

More Information

The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
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