School Refusal

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School Refusal: What is it?

School refusal is when children display high levels of distress and reluctance about going to school on a reoccurring basis, leading to a prolonged absences from school under the parents’ knowledge. It is common for the child to express that they are feeling physically ill, either at home to their parents prior to leaving for school, or during school hours through repeated visits to the school nurse or sick bay. The most common symptoms of physical sickness they may experience, include stomach upsets, nausea, diarrhoea, headaches, and dizziness — although other behavioural symptoms such as tantrums, avoidance, or defiance may also be present. There are many possibilities why children may not want to go to school, and it is important for parents not to assume they are directly to blame themselves. Instead, parents should acknowledge that school refusal is not a disorder in itself, but the child’s way of responding to an underlying issue, deeply rooted in fear, anxiety and avoidance, and there are several steps parents can take to help resolve it.

What are the symptoms?

  • Tantrums, crying, or defiance about going to school
  • Extreme distress about being separated from their parents or home before school
  • Intense feelings of nervousness about going to school
  • Complaints about feeling physically sick before or during school such as:
    -Stomach upsets
    -Diarrhoea
    -Headaches
    -Dizziness
  • Refusal to leave the house or get out of the car to go to school
  • Constant visits to the school nurse feeling ill and asking to be sent home
  • Absence of anti-social or other serious behavioural problems

It is also common for children who demonstrate school refusal to be the youngest sibling of the family. Although, if treatment is delayed, and school absence is lengthy, it may impact the child’s social and learning competencies.

How do you know when it’s a problem?

School refusal becomes problematic when it begins to cause a prolonged absence in the child’s school attendance. It is therefore essential for parents to be able to recognise the early symptoms as warning signs, and follow the necessary precautions to ensure they are not fuelling and worsening their child’s behaviour themselves.

What can cause it?

  • Bullying
  • Transition from primary to middle or high school
  • Change of school at the beginning or middle of year
  • Separation anxiety: the child experiences overwhelming feelings of distress when parting from their parents or family home. This could be caused from the child being over-reliant on their parents, or having negative memories of when they were separated from them in the past.
  • Anxiety about a parent leaving or losing a parent: the child may be fearful that something bad will happen to their parents while they are at school such as:

    - parents divorcing or running away
    - having friends whose parents have separated and fearing that it may happen to theirs
    - fear of a parent becoming ill again after recovering from prior illness

  • Family stress
  • Academic pressure or problems
  • Problems with teachers
  • Social anxiety or fear of not having friends
  • Moving house
  • Change in parent’s job or experiencing change in home life

School Refusal is NOT the same as Truancy

The behaviours of children who display truancy symptoms are very different to those of school refusal. Truancy, or commonly termed “wagging”, is when children pretend to go to school to their parents, but either skip classes and wander off, or don’t show up at all to spend their day elsewhere.

Some common behaviours children with truancy:

  • The child may run away from school or skip school due to school or home related problems, to gain popularity, or as an act of rebellion or defiance
  • May have learning difficulties or other behavioural problems
  • Will usually try to keep their behaviours secret from their parents
  • Can happen when parents are not very caring and do not invest an interest in the child or their education

What can parents to do help?

It is important that parents act on the early signs of school refusal when recognised in their child’s behaviour. The first step for parents to help their child overcome school refusal is to learn and grasp an understanding of the deeper issues causing it in the first place. To do this, it is strongly advised for parents NOT to make a half guessed self- diagnosis of their child, but to obtain a comprehensive evaluation from a qualified mental healthcare professional. From here, the psychologist will help parents to identify and define the larger problems that may be triggering their child’s anxieties.

They will then guide them through an appropriate plan of action to take, and educate them on facilitating and promoting their child’s gradual exposure back to school, to see them resuming normal school attendance.

  • Give clear & firm messages about school attendance: Instead of asking the child, “Are you going to school today?” tell them “As parents we will do whatever it takes to get you to school, it is non-negotiable and we can’t allow you to stay home”
  • Offer rewards or incentives: sometimes it can be helpful in the initial stages of exposure back to school, if parents offer rewards to their children for their attendance. For example, parents could say, “When I pick you up from school today we can go past the shops and get a treat for your afternoon tea” or “After a full week of going to school every day, we can go to a theme park of your choice on the weekend”
  • Ban or make enjoyable toys & electronic devices off limits: If the child pleads they are too unwell to go to school, they should not then be allowed to engage in enjoyable non-school related activities that they would not otherwise have access to at school, such as gaming devices, television, and other technologies.
  • Consistent & joint approach: Make sure both parents are working together to instil the same messages. Otherwise, the child may single out one parent over the other if they know the ‘softer’ one will give in.
  • Make contact with school & teachers: it is important the school is contacted and the appropriate teachers are notified, so that they can work with you, the child, and the healthcare professional to develop and implement an appropriate attendance plan for them.
  • Build a stable morning routine: The more structure, the better. If the child has a set time to wake up and get ready by each morning- with uniforms laid out ready to go, and lunch packed the night before, it can give kids less wiggle room for excuses. It can also be helpful if one of their friend’s parents picks them up to go to school at a certain time, so you say your goodbyes at home.
  • Talk & listen: it is important the child feels as though they can open up to you about what’s worrying them, and that you will support them through their struggles.
  • Encourage hobbies and interests: If the child develops a hobby or joins a team sport, it can be a great form of distraction and relaxation for them. It can also help provide structure to their week, giving them something to look forward to either before or after school, or even during school lunch breaks.

More harm than good

While parents may think they are doing the right thing for their child by letting them stay home from school, they may not know that by pandering to their needs, they are actually reinforcing the child’s negative behaviours.

Common mistakes parents make:

  • Showing you are worried: If parents openly express their worries to their child, it can reinforce the child’s idea that there is something to worry about
  • Getting frustrated: Being firm and being angry are to very different responses. It is important for parents to draw the line between the two, by offering strong and consistent messages without the aggression.
  • Don’t be late: If children are left waiting after school for an extended time, they may become fearful that you have forgotten about them. Have a backup plan for the days you may be running late to pick them up.

What can the school do to help?

It is essential for teachers to understand that school refusal is not just disobedient children expressing “naughty behaviour” or the result of “bad parenting” – they must accept that it is a much more complicated problem, rooted in deeper psychological issues.

The first step for school teachers is ensuring consistent absences are noticed and acted upon, and parent contact is made immediately – early intervention is paramount! It is essential thereafter that the school maintains contact with parents, and the appropriate teachers and staff are savvy with the child’s progress. The school will need to devise an appropriate plan of action to facilitate the child’s gradual attendance back to school, while helping them to confront the issues they are experiencing once they have been identified.

It may be helpful for the school to include the following strategies:

  • Curriculum modifications
  • Providing a quiet room for the child to go to before class or in the lunch break
  • Reduced homework incentives
  • A contingency plan for child running away
  • Teacher to avoid trigger points or touchy subjects in class
  • Work with treating team and parents to facilitate exposure plans

Who we recommend

Clinical Psychologist