Razia, an eight-year-old girl, has always had difficulty attending school. Since she began third grade two months ago, her problems have significantly worsened. She constantly begs to stay home from school, having tantrums that cause delay in dressing and often result in her missing the bus. After arriving at school, Razia frequently complains of stomachaches, headaches and a sore throat to her teacher and asks to visit the school nurse with whom she pleads to call her mother. Her mother typically picks her up early twice a week. When Razia gets home she spends the remainder of the afternoon watching TV and playing with her toys. When her mother is unable to pick her up early, Razia calls her mother’s cell phone periodically throughout the afternoon to “check in” and reassure herself that nothing bad has happened. Razia’s teacher has expressed concern about her missing so much class time which has resulted in incomplete assignments and difficulty learning.