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Understanding School Refusal

What is school refusal?

The transition back to school after a long summer can be challenging, both for kids and for caregivers. Sometimes, kids and teens can experience so much emotional distress when returning to school, that they can repeatedly attempt to avoid going to or staying in school.

School refusal is often associated with high levels of anxiety, and it can be caused by a number of school-related worries. Some kids worry about school routines and structures, that something could happen to their parents while they are apart, the possibility of failure in school, and social/peer issues.

How can I recognize it?

School refusal can manifest in many ways, including struggling to arrive at school on time, leaving before the school day ends, spending time in the nurse’s office, or not attending school at all. It can often start slowly, with vague complaints and slight resistance, and it can progress to total refusal. Children and teens with school refusal may frequently report physical complaints right before leaving for school, or to the nurse at school. Examples include headaches, stomachaches, or feeling tired, and they may go away once the child is allowed to stay at home. Because of anxiety and stress, kids may become upset when asked to go to or stay in school, sometimes throwing tantrums or expressing severe emotional distress.

To avoid these worries and physical feelings of anxiety, kids may begin to refuse going to or staying in school, which allows them to escape from distressing parts of their school day. Kids and teens who are experiencing school refusal do not attempt to hide their absence from caregivers, are often willing to complete homework and lessons at home, and they do not express significant anti-social behaviors. The main motivator for staying at home is to make sure that they are remaining safe and secure, away from school related triggers that may cause anxiety. However, when this behavior goes on for a while, there are often secondary gains from staying home, such as alone time with a caregiver or the opportunity to do fun, non-school related activities like playing video games. This is part of why school refusal is so tricky! It gets rewarded very quickly and then the cycle gets hard to break.

Why does it matter?

School refusal impacts around 1 to 5 % of all school aged children, although it is more common in younger children (most common in kids ages 5-11 years old). It is often associated with anxiety disorders for younger children, and mood disorders for adolescents.

Addressing school refusal as early as possible is important to setting your child up for success. Failing to attend school can lead to negative short term and long-term effects. As a child continues to miss school, returning can feel more and more difficult since they may be falling behind on the curriculum, and they are missing out on social time with the classmates and teachers. Continued avoidance of school can lead to the feeling that they will never be able to get over their school-related worries since they aren’t challenged to face them head on. If your child never has the opportunity to learn that they can handle their school-related anxiety and cope with challenges in school, the cycle of anxiety and avoidance will continue. Additionally, school refusal is a topic that many schools are not tuned into. Often schools will categorize school refusal as a truancy issue rather than a mental health one. Therefore, it’s really important that all members of a child’s team (parents, clinician, school staff) understand the problem and work together to solve it as quickly and effectively as possible.

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