Causes and Signs of School Refusal

For the most part, John really likes school. He gets along with his teacher, he has a nice group of friends and doesn't find the work too challenging. One day he wakes up and tells his mother "I don't want to go to school."

Since he doesn't typically have school anxiety, his mother does a little prodding and discovers there's a video game level he's dying to beat. John's mother tells him he can play the game afterschool.

"No," says John, "I don't think I'm going to school today."  While John is exhibiting school refusal behavior, he's not the child for whom school refusal is an issue.

What is School Refusal?

School refusal is sometimes referred to as school avoidance and used to be known as "school phobia." It is not truancy and it's not the occasional day when your child doesn't want to go to school for a specific reason. It's when a child persistently avoids or refuses to go to school and is truly distressed with visible anxiety about attending. Often, no matter how much a parent cajoles or reasons, the child will not enter the school building.

Signs of School Refusal

There are a number of signs common to children who have issues with school refusal. Many children:

  • complain of vague physical ailments such as stomaches, headaches, nausea, fatigue or just "not feeling well."
  • worry about something happening at school. Sometimes the complaint is specific, such as bullying, but sometimes it can be just a worry that "something" is going to happen.
  • feel anxious about what will happen to their parents while they are in school
  • have learning problems or trouble getting along with their teacher and/or peers

Reasons for School Refusal

The reasons for school refusal are as varied as the children it effects. However, the National Association of School Psychologists (NASP) outlines some of the more common reasons as being anxiety-related:

  • Separation anxiety: Children with separation anxiety worry about what will happen to their parents when they are apart from them. This is often the reason that younger children refuse to go to school. It can result in temper tantrums before and at drop-off time and sometimes even leads children to run away from school once they arrive.
  • Performance anxiety:  More common in middle and high school age students, children who refuse school, for this reason, may be extremely concerned about doing well on tests, having to speak in class and worry about how failing will affect their relationship with peers.
  • Social anxiety: Children with social anxiety have tremendous difficulty in social situations and worry about how to interact with peers and teachers.
  • Generalized anxiety: Children with generalized anxiety are often fearful of the world and tend to worry about things like the 9/11 attacks and extreme weather events occurring while they are at school.

NASP also points to childhood depression, bullying and health-related concerns as other reasons for school refusal. In fact, in some cases, school refusal begins after a prolonged absence due to a real illness.

Diagnosing School Refusal

Diagnosing school refusal relies on a number of different professionals working together with a parent.

Firstly, it's important to bring your child to his pediatrician to rule out any medical reason for his physical complaints or anxiety.

Then, you and your child's teacher, the school counselor and administrator will need to sit down to look at his attendance records, any noticeable patterns in his refusals or absences and discuss any instigating factors that can be identified. Further evaluation may be recommended to look for learning problems.

Dealing With School Refusal

Managing school refusal is a multi-pronged approach. First and foremost, it's important to get your child back in the school. To do so, you, school personnel and any outside providers (such as psychologists or clinicians) will need to create a school refusal management plan specifically tailored to your child's needs.


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