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School Problems in Adolescents


Sharon Levy

, MD, MPH, Harvard Medical School

Reviewed/Revised Jul 2022 | Modified Sep 2022

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

Learning disorders Overview of Learning Disorders Learning disorders are conditions that cause a discrepancy between potential and actual levels of academic performance as predicted by the person’s intellectual abilities. Learning disorders... read more may manifest for the first time as school becomes more demanding, particularly among bright children who previously had been able to accommodate for their areas of weakness.

Particular school problems include

  • Fear of going to school

  • Absenteeism without permission (truancy)

  • Dropping out

  • Academic underachievement (particularly a change in grades or a drop in performance)

Between 1% and 5% of adolescents develop fear of going to school School Avoidance School avoidance occurs in about 5% of all school-aged children and affects girls and boys equally. It usually occurs between the ages of 5 and 11. The cause of school avoidance is often unclear... read more . This fear may be generalized or related to a particular person (a teacher or another student—see also Bullying Bullying Children and adolescents may engage in occasional physical confrontations, but most do not develop a sustained pattern of violent behavior or engage in violent crime. Children and adolescents... read more ) 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 with or felt little satisfaction resulting from participation in 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.

School problems during the adolescent years may be the result of

As adolescents begin to seek more freedom, their desire to do so may clash with their parents' desire to keep them safe. Adolescents rebel in various ways, such as refusing to attend school or drinking alcohol. Adolescents who are anxious or depressed may refuse therapy or stop taking their prescribed drugs. All of these challenging behaviors can cause problems within the family and at school.

Diagnosis of School Problems in Adolescents

  • Learning and mental health evaluations

In general, adolescents with significant school problems should undergo complete learning and mental health evaluations.

Treatment of School Problems in Adolescents

  • Treatment of cause

School problems, especially when related to learning or attention difficulties, should be addressed by clinicians, working together with school personnel and parents. If a learning disorder or intellectual disability is present, appropriate services should be provided through an individualized educational plan (IEP). Environmental changes and sometimes drug therapy can be of great help to struggling students.

NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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