An action plan for your child who exhibits school refusal

Written by Sussan, Greenwald & Wesler

School refusal, a significant, persistent refusal to attend school based on emotional distress, is more common than you think. It can be a terrible dilemma for a parent: You know your child needs to go to school, and you know she is not physically ill, but she still refuses to go and you don’t know what to do about it. She promises every night tomorrow she will go, but when school time approaches, she just can’t get out of the car, throws a tantrum or spends the day in the nurse’s office complaining she does not feel well. The school may be saying: “She’s fine; just send her in” or even threatening to call a truancy officer if you don’t. But it’s not that easy.

Understanding School Refusal

School refusal is often rooted in anxiety over school or a school-related situation. What is commonly referred to as “school refusal” is not the same as school refusal due to truant behavior. Students who exhibit anxiety-based school refusal are reacting to extreme discomfort relating to attending school. They are not looking to cut school to spend the day as they choose. Often they are of above-average intelligence and they want to do well in school. Their school refusal is a symptom of a problem they likely need some support to address.

Putting An Action Plan In Place

The first thing a parent of a child with school refusal should do is let the school know that you take your child’s school refusal seriously. Parents can help the school understand that their child’s school refusal is a symptom of an underlying cause that caring adults need to determine. You should also ask to be part of a team to include school administrators and counselors, and mental health professionals, working cooperatively to understand the needs of your child and put an action plan in place.

Here are some steps you can take to ensure that you are addressing your child’s needs:

• If your child has somatic complaints (i.e. stomach aches), it may make sense to rule out a medical cause by starting with a visit to the pediatrician.
• Early intervention is best. Don’t wait to address persistent and significant school refusal—one where the need to avoid school is intense.
• Reach out to the school guidance counselor to share information about your child and about her school refusal, so that everyone can work together with the best understanding of the situation possible.
• If your child exhibits persistent school refusal, seek an evaluation from a mental health professional. School refusal is often an indication of separation anxiety (especially in younger children) and social anxiety (in elementary school-age children and older). A mental health professional can also help explore other causes such as school bullying, or an underlying learning disability that could be making school especially challenging or anxiety-provoking.
• Request a meeting with the school to explore the findings of all involved professionals, and put in place a plan to help your child return to school. In some cases, you may want to request a child study team evaluation to determine whether he or she a disability—possibly anxiety—that is affecting his or her ability to function in school such that your child requires special education and related services. The child study team can create an Individualized Educational Plan or recommend a 504 Plan to spell out a specific plan to help your child return to school.
• Know that most professionals will suggest keeping your child in school, if possible, or returning your child to school as soon as possible. A treatment plan often entails increasing the length of your child’s exposure to the school environment in a gradual way. Cognitive-behavioral therapy has also been successful.

The Good News

Parents should be aware that outcomes for students who experience school refusal—roughly 2% to 4% of school-aged children are excellent.

School officials and mental health professionals seem to agree that a coordinated effort is the best approach to help children who exhibit school refusal overcome their challenges and return to school. Parents should know that school refusal is a very common occurrence—and that parents can do much to put effective solutions in place.