"How do I get my nine-year-old daughter to school? She seems to have tummy aches or headaches constantly, and misses several days of school each week. Any suggestion that she must go and she screams and cries and seems to be genuinely afraid of going to school. What can we do?"

You need to be firm with her. Don't count on the problem going away if you ignore it. She could end up not ever going back.

However, don't be angry with her as her anxiety and distress are real.

You need to find out what is troubling her. It could be school phobia ( a fear of school), separation anxiety (fear of leaving you or the home) or agoraphobia (fear of crowds and public places). These are all very real disorders.

If someone is bullying, teasing, embarrassing, or abusing her, then it could be the first diagnosis. Talk to her teachers to find out what they know and to inform them of your experiences with your daughter.

Take her to the doctor for a complete physical examination. Tell the doctor the whole story and ask him to rule out any serious illnesses.

If he rules out an illness, then believe what he says. Don't have a lot of expensive tests. Assume that your child is physically well and needs to go to school. Keep assuring her firmly and confidently that she'll be fine (and so will you) once she arrives. If she still claims of physical ailments, you have two options;

First, get her to school unless you determine that she truly is sick. In that case she would be running a fever, or have nausea and/ or diarrhea, etc. If she just tells you she doesn't feel well, that isn't enough to let her stay home. Adults often go to work with uncomfortable symptoms.

The second option is to believe her. Since she says she is too unwell to go to school, then clearly she is too unwell to be up and about the house. If she is sick then she is sick, and so she goes to bed: lights off, curtains closed, no TV, no special snacks. Ignore her and go about your normal daily routine. Make sure that the option of staying home is boring. If she is not sleeping then, ideally she should be doing some school work. Certainly there should be no friends or visitors to entertain her.

You can also establish some rewards for going to school.

Be firm and remain calm. Let her know that you expect her to go to school, but don't argue with her if she resists. The goal her is for her to want to go back to school. Once she goes and finds out that she's fine, her previous symptoms should disappear.

If these techniques don't work and you think she may be seriously depressed or anxious, then find professional help by asking your family doctor for a referral.

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