About 5-10% of children struggle with significant anxiety. Anxiety can interfere with a student’s ability to perform in school and socialize with others. Times of
change (e.g., first day of school) or performance/ evaluative situations (e.g., writing a test) typically cause some anxiety; There are times when a child’s anxiety gets in the way of going to school.

“School refusal”

describes the problem of a child who does not stay at school or refuses to go to school on a regular basis. Children who struggle with school refusal tend to complain of not feeling well before leaving for school (e.g., stomachaches). They could also display tantrums, separation anxiety, or defiance, and when at school, they ask to go home. If allowed to stay home, the symptoms quickly disappear, only to reappear the next morning. In some cases, a child may refuse to leave the house.

There are four typical reasons why children refuse school:

1) to avoid school-related objects and situations that cause distress (e.g., worries about reading, recess, group activities),
2) to avoid evaluative or negative social situations (e.g., science test, teasing/bullying),
3) to receive attention from parents, and/or
4) to obtain/pursue tangible rewards outside of school (e.g., playing video games)¹.

What can parents do?

• Focus on gradually increasing school attendance.
• For younger children, start with integrating them during morning class time.
• If your child is at home, do not let them engage in fun activities during the regular school hours (i.e., do academic tasks, like reading).
• Track your child’s level of distress each day (e.g., use a 1 to 10 scale).
• Make small goals, such as increasing the amount of time spent in class each day.
• Consider attending school in a room outside the regular classroom (e.g., special education room, the office).
• Extreme levels of anxiety may require medication to decrease the physical anxiety symptoms and ease exposure to school.
• Severe delinquent activity may require residential or inpatient treatment before outpatient therapy.
• School absence longer than a calendar year may require alternative school programing (e.g. part time, night, home instruction, vocational, etc.)

The most important thing is to get a comprehensive assessment from a mental health professional, such as a school or clinical child psychologist. That evaluation will highlight the reasons behind the school refusal and can help determine the best treatment options. Meanwhile, work with the school and do not allow your child to stay home. Missing school maintains or increases anxiety rather, than alleviating it.

REFERENCES:
¹ – Adapted from “When Children Refuse School: A cognitive-behavioral therapy approach,” by C. A. Kearney and A. M. Albano (2007)