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School Avoidance: Tips for Concerned Parents

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​School avoidance (sometimes called school refusal or school phobia) is a term used when a child regularly resists going to school. Kids may outright refuse to attend or create reasons why they should not go. They may miss a lot of school, complaining of not feeling well, with vague, unexplainable symptoms.

Many children who try to avoid going to school have anxiety-related symptoms over which they have no conscious control. They may experience headaches, stomachaches, hyperventilation, nausea or dizziness—symptoms that happen most often on school days, and are usually absent on weekends. When these children are examined by a doctor, no physical illnesses are detected or diagnosed.

Here's what else to know about school avoidance and how to work with your child to help solve it.

School-related anxiety

Most often, school-avoiding children do not know exactly why they feel sick. They may have a hard time telling you what is causing their discomfort or upset.

When school-related anxiety is causing school avoidance, the symptoms may be ways to communicate emotional struggle with issues like:

  • Fear of failure or perfectionism

  • Increase in academic struggles

  • Problems with peers (for instance, being teased)

  • Anxieties over toileting in a public bathroom

  • A teacher's perceived "meanness"

  • Online bullying outside of school hours

  • Threats of physical harm (as from a school bully) or actual physical harm

What to do when your child doesn't want to go to school

As a first step, an examination by your child's doctor can rule out physical illness. The doctor also can help you explore the pressures your child may be feeling and create a plan to help them get back to school.

Some suggestions to help your child overcome school avoidance:

  • Talk with your child about the reasons why they do not want to go to school. Consider all the possibilities and state them. Be sympathetic, supportive, and understanding of why they are upset. Brainstorm together to help your child resolve any stressful situations.

  • Acknowledge that you understand your child's concerns, but insist on their immediate return to school. The longer they stay home, the more difficult their eventual return will be. Explain that they are in good health and their physical symptoms are probably from concerns they expressed to you—perhaps about grades, homework, relationships with teachers, anxieties over social pressure or fears of violence at school.

    Let your child know that school attendance is required by law. They likely will continue to put pressure on you to let them stay home, but stay focused on getting your child back in school.

  • Discuss your child's school avoidance with the school staff, including their teacher, the principal and the school nurse. Share with them your plans for your child's return to school and enlist their support and assistance.

  • Commit to being extra firm on school mornings, when children complain most about their symptoms. Keep discussions about physical symptoms or anxieties to a minimum. For example, do not ask your child how they feel. If they are well enough to be up and around the house, then they are well enough to attend school.

  • If your child's anxieties are severe, they might benefit from a step-wise return to school. For example: On day one, they might get up in the morning and get dressed. Then you might drive them by the school so they can get some feel for it before you finally return home together. On day two, your child might go to school for just half a day, or for only a class or two. On day three, your child can return for a full day of school.

  • Your pediatrician might help ease your child's transition back to school by writing a note. They can verify that your child had some symptoms that kept them from attending school, but while the symptoms may persist, they are now able to return to class.

  • Request help from the school staff for assistance with your child while they are at school. A school nurse may be able to care for your child if they become symptomatic, and encourage them to return to the classroom.

  • If a problem like a school bully or an unreasonable teacher is the cause of your child's anxiety, become an advocate for your child and discuss these problems with the school staff. The teacher or principal may need to make some adjustments to relieve the pressure on your child in the classroom or on the playground. Monitor your child's online activities; cyberbullying can happen at all hours outside the classroom and impact your child's sense of security at school.

  • If your child stays home, be sure they are safe and comfortable, but do not give them any special treatment. Their symptoms should be treated with consideration and understanding. If their child's complaints warrant it, they should stay in bed. However, this should not be a holiday. There should be no screen time privileges, no special snacks, no visitors, and they should be supervised.

  • Help your child develop independence by encouraging activities with other children outside the home. These can include clubs, sports activities and socializing with friends and relatives.

When to seek help

You might try to manage school refusal on your own. But if your child's school avoidance lasts more than one week, you and your child may need professional assistance to deal with it.

If their school refusal persists, or if they have chronic or intermittent signs of separation difficulties when going to school—in combination with physical symptoms that are interfering with their functioning—your doctor may recommend a consultation with a child mental health professional.

More information

Last Updated
9/26/2024
Source
Adapted from Caring for Your School-Age Child: Ages 5 to 12, 3rd edition (Copyright © 2018 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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