| Written by Jessica Lelinho, MA, LPC, LCADC

Do you believe your child is avoiding school? Always giving you a reason on why you should call them out of school? I think it’s safe to say that at times we’ve all wanted to not go to school. Not every child enjoys or likes school. Sometimes there’s more to it than us just thinking that our child doesn’t want to go to school. It’s when our child is asking almost daily to be called out of school that we have to consider what is the real reason why they’re refusing to go to school. 

What Is School Refusal?

The American Psychological Association defines school refusal, also known as school avoidance or school phobia as persistent reluctance to go to school, which usually occurs during the primary school years and is often a symptom of an educational, social, or emotional problem. The American Academy of Child & Adolescent Psychiatry discusses that school refusal could happen at any age, however, it is most likely shown in children ages 5 – 7 and 11 – 14. During these ages are when children are entering elementary school and middle school.  

When Would My Child Refuse School?

The American Academy of Child & Adolescent Psychiatry found that children typically will refuse to go to school after a period of time when becoming close or closer to their parents. For example, it is more common for children to refuse school after summer break, holiday break, long weekend, or overcoming a brief illness. Additionally, the refusal to attend school could come after a stressful event such as death of a family member or family pet, changing schools, or even moving.

Knowing the Physical Symptoms of School Refusal

The American Academy of Child & Adolescent Psychiatry identified various symptoms a child may complain of prior to having to go to school. Children may complain of headaches, sore throats, and stomach aches. 

So I Let My Child Stay Home – Now What?

Your child complains of one of the conditions mentioned above and you agree to let your child stay home. Do you ever notice that after letting your child stay home the physical symptoms magically go away? The American Academy of Child & Adolescent Psychiatry identified that after the child is able to stay home the physical symptoms disappear but only for them to return the next day before going to school. 

Additional Symptoms of School Refusal

The American Academy of Child & Adolescent Psychiatry discussed additional symptoms of children who refuse school. Those symptoms include:

• Clinging behavior 
• Displaying excessive worry and fear about parents or about harm to themselves 
• Shadowing the mother or father around the house
• Difficulty going to sleep
• Nightmares
• Exaggerated, unrealistic fear of animals, monsters, or burglars
• Fear of being alone in the dark
• Severe tantrums when forced to go to school

Know Your Child’s Anxiety Triggers 

Various triggers could account for your child refusing to attend school. It’s important to know your child and their triggers for school refusal. Emedicinehealth discusses various triggers for a child to have school refusal including:

• Ill parents (school refusal typically shows after the parent recovered)
• Separation of parents or parents having marital issues, or frequent arguments between parents
• Death of a family member or family friend
• Moving specifically within the first year(s) of elementary school
• Jealousy due to a new sibling 
• Excessive worrying of the parent over the child
• Bullying

Mental Health Diagnoses Associated with School Refusal

While school refusal is not considered to be a diagnosis on its own, in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the following mental health diagnoses could be associated with school refusal as identified by The National Institute of Health (NIH):

• Social anxiety disorder
• Generalized anxiety disorder
• Specific phobias
• Major depression 
• Oppositional defiant disorder
• Post-traumatic stress disorder (PTSD)
• Adjustment disorder

How Can I Help My Child Who Is Dealing with School Refusal?

Unfortunately, there is no one size fits all solution when it comes to school refusal from your child. However, Stanford Medicine Children’s Health provided the following tips/interventions on helping your child through this difficult time:

• Return your child to school: Don’t just let your child stay home from school for the wrong reasons. Inform your child’s administration team of the issue at hand and ensure that they understand the child’s situation.
• Family Counseling: Think about the benefits of attending family counseling to address the school refusal and other issues that may occur.
• Let Them Talk: Let your child know that it’s okay to talk about their concerns or fears. Don’t just brush it under the rug and think that they’ll “get over it.”
• Slowly Begin to Separate From Your Child: Have the parent sit with the child in the classroom initially. As time goes on, have the parent attend the same school as your child but don’t sit in the same classroom as your child. Maybe try sitting in a different room. As the child becomes more comfortable with you not being there, create more distance between yourself and the child until they are comfortable by themselves in school.
• Referrals: Your child may need to be referred to a child psychologist or child psychiatrist to better understand and assist in this concern.

Not all children love school, however, when your child is refusing to go to school more often than not, the issue will need to be addressed. These are just a few tips on how to help and support your child with school refusal. 

If your child is struggling with school refusal, don’t hesitate to reach out for help. School refusal is a common symptom of anxiety, depression, PTSD, and various other mental health challenges. A licensed professional can assist your child in overcoming these challenges.

When Jessica is not providing therapy, she enjoys spending time with her family and friends, listening to country music, cooking, baking, and going to the beach.

Check out Jessica’s professional bio here

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