Annmarie Dadoly

What to do when your child refuses to go to school

As summer winds to a close, many children are reluctant to greet another school year. Who can blame them? Swapping swimming, lazy days, camp activities, and late nights for classrooms, homework, and early morning bus rides isn’t much of a trade at all. For most kids, any sour taste is short-lived, and they return to the school routine quickly, even if begrudgingly. For others, though, fears and worries about returning to school runs much deeper, and can appear as school refusal.

School refusal goes beyond an occasional “I hate school” or “I don’t want to go to school today.” Children with school refusal may sob, scream, or plead for hours in an attempt to stay home from school. They may complain of illness or even run home from school if forced to go. Absences can last weeks or even months.

The problem may start at any point, but common triggers are the start of a new school year, making the transition to a new school (middle school to high school, for example), or returning from school vacation. An illness or the loss of a loved one may also set off school refusal. Just how many children are affected is unclear, with estimates varying from 5% to 28%. According to the Anxiety Disorders Association of America, this problem is most common between the ages of 5 and 6, and again between the ages of 10 and 11.

School refusal often stems from an anxiety disorder, according to Coping with Anxiety and Phobias, a new Special Health Report from Harvard Medical School. The underlying condition may be social phobia (anxiety caused by social situations or performing in front of a group), generalized anxiety disorder (excessive worry and anxiety about a variety of things), or separation anxiety (fear of being away from a parent). Sometimes a specific phobia is at the root of the problem, such as fear of being called on in class or fear of a critical teacher or bullies.

When a child refuses to go to school regularly, parents should seek help from a mental health professional. A therapist may meet with parents, school staff, and the child to come up with a plan to address the situation. Usually, cognitive behavioral therapy (CBT) is used to manage the underlying anxiety problem. While CBT is the most effective and most commonly used treatment for anxiety disorders in children and adolescents, antidepressants—particularly selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac) and sertraline (Zoloft)—are sometimes prescribed as well. CBT involves using different techniques to change negative thought and behavior patterns.

One of the most effective methods is to gradually expose the child to the feared object—in this case, school. For example, a student may start out by attending just one or two classes a day while a parent or therapist waits outside in the parking lot. Over time, more classes are added until the student is attending school all day. Other helpful techniques include teaching a child how to use deep breathing or muscle relaxation techniques to calm down.

The Anxiety Disorders of America website offers other tips on coping with school anxiety.

Coping with Anxiety and Phobias, a Special Health Report from Harvard Medical School, provides in-depth information on recognizing and treating a variety of anxiety disorders—including social phobia, post-traumatic stress disorder, panic disorder, and generalized anxiety disorder—in adults as well as children. To order this report—or one of Harvard Medical School’s other special health reports and newsletters—visit health.harvard.edu. There you’ll find summaries, excerpts, and the tables of contents from all our Special Health Reports, as well as  free health news articles and blogs from the doctors and editors at Harvard Health Publications.

Comments:

  1. Anonymous

    I was having the same problem with my kid. She doesnt like to go to school because she is afraid that people will not be kind to her and of course explaining cant be worthy at this time. I accompanied her at school but never really attended inside the room.

  2. Christine

    I work at an online school and we have a handful of students that have been previously unsuccessful at their traditional school. Some students thrive in an alternative environment. Online schools are one option for students who experience severe school anxiety.

  3. Kathy Silverstein

    I am lucky I never had this problem myself, but many parent of kids with Asperger’s have this problem with their kids. Kids with Asperger’s have sensory challenges, and school can feel like a minefield to them. Everything is too loud, bright, and busy. Kids with Asperger’s are also very susceptible to bullying and this can of course also make a child develop a school phobia. Combine that with impatient teachers who don’t understand a child’s particular special needs,and you have yourself a recipe for potential disaster.

    IEP plans are important for those with special needs so that their needs can be addressed. Try to find one adult in the school that the child connects with so they will have a “safe spot” of sorts in the school.

    I have Asperger’s, and this is what helped me be able to handle school at that age.

  4. Paul

    I have not experienced this problem. After reading the artical, I extend my sympathy to all affected by this problem.

  5. Serene

    Bit of separation anxiety going in very young children as it is often the first time they have ever been without at least one parent.
    Glad to see your mention of CBT here.
    Drugs should be an absolute last resort.
    Often it is suggested as a first treatment method.. sadly.

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  6. Rose Bishop

    there is another reason not talked about in this article, and that is when a child is merely responding to the ‘vibes’ a parent puts out — ie, wanting the child to stay home with them. i am not talking about a physically ill parent, i am talking about a parent who is using this child as a substitute spouse. the parent will typically complain about the child’s school refusal, but will send many, many COVERT messages to the child to stay home. this is a very serious and common problem that schools overlook. it is more common than it seems. if all else is ruled out, ie, bullying, a critical teacher, etc., and this problem continues on, then a competent therapist needs to address issues with the parents. the child is merely the identified patient in these cases.

  7. fantasy

    Very nice.

    My dad used to scream so loudly at me if I refused to go to school. It only added more anxiety, fear, and hate to school. It did not made me a better student at all. As I grew up and started thinking of marriage and kids, I thought about issues like this and didn’t know what I’d do. If I didn’t read this article, I think I would do what my dad did to me in case of my kids refusing school because it’d be the only way I knew.

    But not now.

    Thank you Ann!