FAMILY RELATIONS IN THE DEVELOPMENT OF SCHOOL PHOBIA DR. WALDFOGEL: While school phobia has been recognized as a distinct disturbance of childhood for several decades, relatively little discussion of this problem has appeared in the literature. In most published reports the number of cases described has been small, and there seems to be some disagreement among the various authors regarding both its course and treatment. Although school phobia in its acute form does not occur very commonly in children, it can, once entrenched, become one of the most crippling disorders of childhood, with the principal symptom persisting indefinitely.Our desire to increase our clinical effectiveness in dealing with this acute problem was one of the principal reasons for undertaking the present investigation. While our central purpose has been to explore possibilities for more effective treatment and management through closer cooperation of the school and clinic, we have not confined ourselves to therapeutic considerations alone. We have also been interested in learning more about both the etiology and epidemiology of this disturbance, particularly as they shed light on such basic theoretical issues as the specificity of symptom choice, the relation between the structure of personality and symptom formation, and the dynamics of parent-child relatipships in the development of neurosis.The term school phobia refers td'reluctance to go to school as a result of a morbid dread of some aspect of the school situation. The fear may be attached to the teacher, the other children, the janitor, eating in the lunchroom, or almost any detail of school life. It is invariably accompanied by somatic symptoms, usually involving the gastrointestinal tract, but sometimes including such diverse symptoms as sore throat, headache, or leg pains. The somatic complaints are used as a device to remain a t home, and often disappear once the child is assured that he does not have to attend school. The most typical picture is that of a child nauseated and vomiting at breakfast or complaining of abdominal pain, resisting all attempts at reassurance, reasoning, or coercion to get him to school. Often other phobic symptoms may accompany the fear of school-fear of animals, fear of noises, night terrors, etc.During the period of this study, 53 cases of school phobia of varying de-*
