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School Problems in Adolescents

By Sharon Levy, MD, MPH, Harvard Medical School;Children's Hospital, Boston

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 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 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, and alternative programs.


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

  • Rebellion and a need for independence (most common)

  • Mental health disorders, such as anxiety or depression

  • Substance use (drugs or alcohol)

  • Family conflict

  • Learning disorders

  • Behavior disorders

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—see Attention-Deficit/Hyperactivity Disorder (ADHD)) and learning disorders (see 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.

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.

* This is the Consumer Version. *