School plays an important role in a child’s life, from providing an education to developing social skills, critical thinking abilities and a sense of responsibility and belonging. For some children, however, going to school can cause extreme stress, anxiety and even fear. If your child regularly resists going to school, exhibits routine problems staying at school or experiences severe distress at the thought of attending, they may be struggling with school refusal.
School refusal is considered a symptom and may be associated with diagnoses such as social anxiety disorder, generalized anxiety disorder and post-traumatic stress disorder, among others.
Sometimes called school avoidance disorder or school refusal anxiety, school refusal is different from simply not wanting to go to school. It is a condition that can significantly impact a child’s education, mental health and family life.
What is School Refusal?
School refusal is a form of school avoidance anxiety where a child consistently resists going to school due to emotional distress. School refusal may begin as school avoidance, and progress to a full refusal to attend. These are not the same as truancy, which often involves deliberate and rule-breaking behaviors, however some school districts treat refusal as a truancy issue. Children often want to attend school but feel they can’t due to overwhelming fear or anxiety, leading to chronic absenteeism.
Unlike occasional reluctance to go to school, school refusal is persistent and can last for weeks or months. It can also happen at any age, but children in certain age groups (ages 5 to 6 and pre-teens, for instance) are more likely to resist going to school.
Cases of school refusal may be triggered by changes in routine, social difficulties, academic pressure, or underlying mental health conditions like anxiety or depression.
What are the Symptoms of School Refusal?
Children with school refusal may experience a range of emotional and physical symptoms, including:
- Frequent complaints of headaches, stomachaches, nausea or dizziness (especially in the morning before school)
- Panic attacks or severe anxiety when discussing school
- Difficulty sleeping or frequent nightmares about school
- Tearfulness, tantrums or emotional meltdowns on school mornings
- Avoidance behaviors, such as hiding in their room or refusing to get dressed
- Clinging to a parent or expressing extreme distress about being separated from home
- Difficulty concentrating in school or falling behind in academic work due to frequent absences
School avoidance can sometimes present as frequent tardiness, repeated trips to the nurse and/or being sent home often due to the symptoms of stress.
If the symptoms listed above persist and interfere with your child’s ability to attend school, it’s important to take them seriously and seek appropriate support.
Causes of School Refusal
There are many reasons why a child may develop school refusal behavior. Some of the most common include:
- Anxiety disorders: Children with generalized anxiety, social anxiety or separation anxiety may struggle with school attendance.
- Bullying or social issues: Fear of being bullied or struggling to make friends can make school feel unsafe.
- Academic challenges: Learning difficulties or pressure to perform well can lead to avoidance.
- Major life changes: A recent move, a change in family dynamics (such as divorce) or a traumatic event can contribute to school avoidance.
- Health concerns: Some children develop a fear of getting sick or manifest physical symptoms related to stress.
- Depression or other mental health issues: Low mood, lack of motivation and feelings of hopelessness can make attending school feel impossible.
- Family issues: Children struggling with issues within the family may feel as though they need to remain home to ensure stability. Children of family strife or divorce may unconsciously refuse school in an effort to seek attention from parents.
- Overprotective Parenting: Overly involved or protective parenting styles can inadvertently reinforce avoidance behaviors and make it difficult for a child to develop independence and cope with challenges.
- Parental Illness or Mental Health Issue: When parents have mental health illness, children may feel responsible to stay home and take care of them.
Strategies to Address School Refusal at Home
School refusal can be a challenging, confusing and emotional experience for both children and parents. However, with patience, understanding and the right strategies, children can learn to manage their fears and return to school successfully.
If your child is experiencing school refusal, there are steps you can take to support them and encourage a return to school, including:
Maintain Open Communication
- Create a safe space for your child to express their feelings about school.
- Ask open-ended questions like, “What worries you the most about school?” or “How can I help you feel more comfortable?”
- Validate their emotions by saying things like, “I understand this feels really hard for you.”
Create a Supportive Routine
- Keep a structured morning and bedtime routine to reduce stress.
- Gradually reintroduce school-related activities, like preparing a backpack or visiting the school during non-class hours.
Work With the School
- Communicate with your child’s teachers, school social worker, counselor or school psychologist about their struggles.
- Explore options such as a modified schedule, counseling services or extra academic support.
- Request a school plan to ease the transition, such as a gradual return to class or a buddy system.
Teach Coping Skills for Anxiety
- Encourage deep breathing exercises and mindfulness techniques.
- Teach your child to challenge negative thoughts, such as replacing “I can’t do this” with “I can handle this.”
- Practice exposure therapy by gradually increasing time spent at school in a manageable way.
Set Realistic Goals and Rewards
- Celebrate small wins, such as making it to school for part of the day.
- Offer positive reinforcement like extra playtime or a special activity when they successfully attend school.
Refrain from Reinforcing Stay at Home Behavior
- If your child is staying home, set learning goals for the day to prevent avoidance behaviors from becoming a habit.
- Limit access to enjoyable activities and screen time.
Finding Mental Health Support
If your child’s school refusal continues despite your efforts, it may be time to seek professional help from your pediatrician, school counselor, child therapist or child psychiatrist. A mental health professional can help identify underlying causes and create a personalized treatment plan.
Consider seeking help from a mental health professional if your child:
- Has persistent anxiety or panic attacks related to school
- Experiences extreme distress that affects daily life
- Has been missing school for more than a few weeks
- Shows signs of depression, such as sadness, withdrawal or loss of interest in activities
Remember, anxiety about returning to school after an illness or family vacation is normal. If the distress starts to become a bigger problem–if it goes on for numerous days, weeks or even months–you should reach out and ask for help. Being open and communicative with your child, creating a routine and seeking professional guidance when needed can help your child navigate their anxiety and return to school with confidence.
