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    When anxiety keeps kids from school

    Isabelle Pitrowski (with her mom and her dog Lily) missed almost all of her seventh grade year due to anxiety about school.
    Cheryl Senter for The Boston Globe
    Isabelle Pitrowski (with her mom and her dog Lily) missed almost all of her seventh grade year due to anxiety about school.

    Isabelle Pitrowski loves animals. She has two rabbits, three guinea pigs and a tiny dog named Lily. On a recent solo trip to Australia to stay with a family friend, she got to hold a koala.

    “He bit me on the nose. Rude!” says the 14 year old, smiling.

    By the time she was 8, the Peabody resident already knew she wanted to study veterinary science at Essex Tech, the agricultural and technical high school in Danvers. For years, though, it seemed there was no way that would happen.

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    Following a family crisis, Isabelle began to struggle with depression and anxiety while she was in sixth grade. She skipped school and fell behind, “and it had a snowball effect,” she recalls. During her entire seventh grade year, she made it to school less than 10 times.

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    Isabelle’s was a textbook case of “school refusal.” It’s an issue that has only recently earned wider recognition, but one that school administrators say is a persistently vexing problem.

    “The most accurate number I consistently see is that 5 percent of school populations experience school refusal,” says Matt Doyle, a clinical social worker and therapist who specializes in the issue. “And I think it’s way underreported. The recognition and scope of the issue are definitely growing.”

    Sometimes referred to as school phobia or school anxiety, the issue includes chronic absenteeism and students who have difficulty remaining in class. Though hard to quantify, according to one study published in the journal of the American Academy of Family Physicians, school refusal occurs in “approximately 1 to 5 percent of all school-aged children.”

    Doyle, founding director of Castle Hill Counseling & Consulting in Salem, says there are many reasons why some children develop debilitating anxieties about school. Some have learning disabilities or social difficulties. Others have been bullied or have poor sleep habits or, like Isabelle, have suffered emotional trauma.

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    “She didn’t feel like she could relate to any of her peers,” explains Isabelle’s mother, Jen Pitrowski, sitting with her daughter at the kitchen table. “She had the perception that everyone had the perfect life, and she didn’t.”

    The one unifying factor among students who become school-averse, say experts such as Doyle, is that those kids historically would have been considered a disruption, and treated as such. They were “problem” kids for whom the usual solution was a visit from the truant officer. Now, says Doyle, some administrators concede that it’s not always the students who need to adjust — it’s the school environment.

    At the Clark School in Rowley, a non-traditional K-12 private school that has had some success with students grappling with school aversion, the staff has incorporated a Web-based curriculum so that students who can’t find their way to school can keep up with the work from home.

    The school, which has a mix of gifted and special needs students, has also attracted a number of students whose travel for extracurricular activities — they’re child actors, say, or dancers or ice skaters — would otherwise require that they be home-schooled. By offering remote access to the curriculum, Clark’s absentees, including those who suffer from school anxiety, don’t automatically fall behind academically.

    “We don’t pull and push the student,” says Head of School Jeff Clark, whose mother, Sharon, founded the school in Beverly in 1978. “We walk with the student.”

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    When Doyle began working with a troubled young man at the Clark School, he did precisely that — walked with him. Rather than grill the student about the things that were bothering him in a school conference room, he took him outside the school for trail walks, or to shoot baskets. The student is now thriving in college.

    ‘The most accurate number I consistently see is that 5 percent of school populations experience school refusal. And I think it’s way underreported.’

    Doyle, who grew up in Needham, went to Boston College and completed his graduate studies at Simmons College. He has developed a so-called “wraparound” program for students who need help, including close contact with teachers and guidance counselors and routine home visits. For one young man in Beverly, a 21-year-old who didn’t finish high school, Doyle remains in the picture, now serving as his “life coach.”

    When her now 21-year-old was still in school, Deb Wilson says, he felt bullied and would lash out. His behavior sometimes resulted in suspension, which only made it easier for him to refuse to go back.

    “It was a vicious cycle,” Wilson says.

    Doyle says he’s grown a thick skin in the job. He acknowledges the difficulty of reaching any teenager on an emotional level, let alone one who is struggling.

    “It’s very rare a 16-year-old is excited to meet with me,” he says with a smile. But for any successes his clients achieve, he says, “the reward is astronomical.”

    Dr. Ross Greene, a former associate professor at Harvard Medical School and founder of Lives in the Balance, a non-profit organization addressing the care of behaviorally challenging kids, says that while there have always been students who don’t show up to school for various reasons, only in the last five or 10 years has the issue attracted collaborative efforts to move toward non-punitive responses.

    “We can think of ‘school refusal’ as the signal, or the fever — something’s the matter. What is the matter remains to be found, in each individual kid,” says Greene, who wrote the books “The Explosive Child” and “Lost at School.” His organization hosts an annual summit for parents, educators, and clinicians on Oct. 2 in Portland.

    The bottom line, Greene says, is flexibility. Some school systems have “zero tolerance” programs in place. Many are committed to high-stakes standardized testing; many more have pressing budget concerns.

    “There are all kinds of factors that end up speaking to whether this is a school system that can be responsive to the needs of a kid who isn’t fitting so easily into the norm,” Greene says.

    In Isabelle’s case, Doyle was able to convince the Peabody schools to forgive her long absence. As her mental health improved, he advocated that she be allowed to rejoin her classmates in eighth grade. “To not move her forward with everyone she’d gone to school with since kindergarten would do her a lot more harm than good,” recalls her mother.

    Last year, Isabelle was disappointed to learn she’d been wait-listed for Essex Tech. In May, she delivered an impassioned speech about her struggle to a room of about 300 potential donors at a United Way fund-raiser for Children’s Friend and Family Services.

    Her speech led to several offers to write letters of recommendation, which eventually helped gain her acceptance into the high school of her dreams. At home after her second day of classes, Isabelle tells her mother about how the freshmen move from shop to shop as they’re introduced to the school’s range of vocational opportunities.

    “It doesn’t even feel like school,” she says.

    James Sullivan can be reached at jamesgsullivan@gmail.com, on Twitter @sullivanjames.