When Sara’s 11-year-old daughter says she’s not feeling well, she feels her girl’s forehead to check if it is warm. “She is rarely actually sick, but you wouldn’t think it to listen to her complain about feeling bad,” says Sara, who lives in Toronto. These “illnesses” usually strike after she’s been teased or felt excluded from games at school. But Sara doesn’t begrudge her daughter; instead, she cozies up on the couch with her for a cuddle and a chat. “It’s her way of getting TLC from me,” Sara explains.
Almost every parent struggles from time to time with how to respond to a complaint of a stomachache or headache, especially if it seems conveniently timed—perhaps coinciding with a big test at school. So do you dig in your heels and insist he is fine and send him off to class? Or bring out the cold forehead compresses and ginger ale?
The answer is somewhere in between, says Christine Chambers, PhD, a Halifax-based psychologist who specializes in pain and child health. She says most children do feel physical discomfort when they claim to be sick, but they need to learn how to function normally in spite of it. “Our research at the IWK Health Centre has shown that one in five kids has weekly stomachaches, joint pain or headaches,” Dr. Chambers says. “Pain is usually an alarm mechanism, to let you know that something is wrong. But in some children, their pain alarm system is overly sensitive or doesn’t work right, which can cause pain or other symptoms without any identified underlying illness or disease.”
Stress is also a legitimate cause of illness, says Rebecca Pillai Riddell, PhD, a child psychologist and professor at York University in Toronto. When adults experience an upset stomach, they may realize it is due to stress, but children under 12 are less able to “suss out what’s causing their symptoms,” she says. Physical symptoms triggered by stress can be a serious issue in children, Dr. Pillai Riddell adds. “You want to listen to them, not ignore or explain away their symptoms.”
Feigning illness may be an avoidance strategy. Dr. Pillai Riddell recommends parents ask “sick” kids indirect questions, such as ‘Do you like the kids in your class?,’ ‘Is your teacher nice?’ or ‘What subject do you like least?,’ to engage the child in conversation to find out how school is going. Usually, their worries—from fear of failure to bullying to problems managing major changes at home or at school—will become apparent pretty quickly.
If your child tends to call home from school with an ailment, it may signal an important underlying issue. “Children with learning disabilities seem to have a higher frequency of reporting headaches and stomachaches at school,” says Dr. Pillai Riddell. “You can imagine how stressful it would be, being in a classroom and not being able to keep up.”
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Of course, sometimes kids report an upset stomach because they just don’t feel like going to school. Whatever the reason, parents shouldn’t accuse children of lying, but should make it clear that even though they’re feeling “off,” they’re still well enough to go to school. “We really encourage parents to send their child to school unless they have some very clear, objective sign of illness, like a fever or obvious signs of a cold, vomiting or diarrhea,” says Dr. Chambers. Missing school can cause a child to fall behind and then feel stressed. “A child may fall into a negative cycle and want to avoid school.”
The surefire way of discouraging kids from avoiding school? Don’t make being at home sick a fun time. “Sick children need to be cared for and receive special attention, but as soon as children start to feel better they should be encouraged to get back to school,” says Dr. Chambers. “If a child is too sick to be at school, she is too sick to play video games, play with friends, play outside, etc. A sick child should rest in bed with minimal stimulation until they feel better, and can go back to all their usual activities, including school,” says Dr. Chambers, a mom of four who knows that “sometimes kids who ‘felt sick’ in the morning miraculously feel better at 4 p.m.”