What is school refusal?
School refusal is when a child gets extremely upset at the idea of going to school, or often misses some or all of the school day, and this distress doesn't go away.
School refusal can mean that children have trouble going to school or trouble leaving home - they might not go to school at all. Children who refuse to go to school usually spend the day at home with their parents' knowledge, even though their parents try really hard to get them to go.
School refusal is not a formal psychiatric diagnosis. It's a name for an emotional and/or behaviour problem.
School refusal is different from truancy or 'wagging'. Children who 'wag' usually aren't interested in school, don't like authority or have behaviour problems like oppositional defiant disorder (ODD). Often their parents don't know they aren't at school.
Signs and symptoms of school refusal
If your child refuses to go to school, you might feel that school mornings are a 'battle of wills'. Your child might:
- have crying episodes or tantrums
- hide under the bed covers
- refuse to move
- beg or plead not to go
- complain of aches, pains and illness before school, which generally get better if you let your child stay at home
- show high levels of anxiety.
Causes of school refusal
There's rarely a single cause of school refusal. It might be linked to separation anxiety, worries about leaving home, a phobia, depression, learning difficulties or social problems at school.
School refusal might start gradually or happen suddenly. It can happen at the same time as or after:
- stressful events at home or school or with peers
- family and peer conflict
- academic problems - for example, learning difficulties
- starting or changing schools
- moving home
- bullying or teasing
- problems with a teacher.
By not going to school, a child might be able to:
- avoid scary things - for example, difficult schoolwork, teachers, the canteen and so on
- get out of social situations with peers or teachers
- avoid separation anxiety
- keep an eye on what's happening at home
- get more attention from parents.
It's important for children to get back to school as soon as possible. If children keep avoiding school, their anxiety about school will probably get worse. They're also likely to fall behind with schoolwork and feel socially isolated. The longer children are away from school, the harder it is for them to go back.
Working on school refusal at home: practical strategies
School refusal is usually very challenging, but there are some practical things you can do at home to encourage your child to go to school.
When you're talking to your child
- Show your child that you understand. For example, you could say, 'I can see you're worried about going to school. I know it's hard, but you need to go. Your teacher and I will help you'.
- Use clear, calm statements to let your child know that you expect him to go to school. Say 'when' rather than 'if'. For example, you can say, 'When you're at school tomorrow… ' instead of 'If you make it to school tomorrow… '.
- Show that you believe your child can go to school by saying positive and encouraging things. For example, 'You're showing how brave you are by going to school'. This will build your child's self-confidence.
- Use direct statements that don't give your child the chance to say 'No!' For example, 'It's time to get out of bed' or 'Jo, please get up and into the shower'.
- Talk about what needs to happen to help your child feel safe and comfortable at school. Use a problem-solving approach. That is, help your child work out what the problem is, brainstorm solutions, and choose a solution to put into action.
When you're at home with your child
- Stay calm. If your child sees that you're worried, stressed or frustrated, it can make your child's anxiety worse. And by staying calm, you model a positive way of handling the situation.
- Plan for a calm start to the day by establishing morning and evening routines. For example, get uniforms, lunches and school bags ready the night before, and get your child to have a shower or bath in the evening.
- Make your home 'boring' during school hours so that you don't accidentally reward your child for not going to school. This means little or no TV, video games, leisure activities, internet use and so on.
- Get your child to do work provided by the school while at home. This will help to make sure your child doesn't fall behind with class work.
- Provide consequences that reduce the amount of attention your child gets for not going to school - for example, an early bedtime or limited time with you at night.
- Help your child stick to a reasonable sleep and wake cycle. It's very hard to help your child get to school if she's sleepy during the day and awake at night.
Getting to school
- Get someone else to drop your child at school. Children often cope better with separation at home rather than at the school gate.
- When your child goes to school, praise him by describing what he might be feeling. You could say, 'I know this is very hard, and I'm proud of you for trying'.
- Reward your child for going to school. This could be some special time with you or your partner, or stopping on the way home at the playground. Make sure the reward is on the same day and your child knows what it's for.
Working with the school on school refusal
You can help your child start back at school - and keep going to school - by communicating and working with school staff:
- Talk to your child's teacher or the school principal for ideas and advice. Teachers have lots of experience with children who refuse to attend.
- Ask the teacher or principal to refer you and your child to other support staff, like the student welfare coordinator, school psychologist or counsellor.
- Find out about the school's attendance and absence policies and procedures. The principal, student coordinator or school welfare coordinator should be able to help you with these.
- If your child needs ongoing support to stay engaged in school, ask the school about forming an attendance student support group. This group can work with you to find the best ways to support your child's attendance.
- Set up regular appointments with your primary contact at the school - class teacher, principal, counsellor or welfare coordinator. This will help you and the school check your child's progress and ongoing support needs.
- Talk with the school about a gradual start back at school for your child. For example, your child might be able to start with a shorter school day or with her favourite subjects, and build up from there.
School refusal probably won't go away by itself, so your child needs professional help to deal with it. Without help, your child risks school drop-out, poor school performance, problems with friendships, family conflict and mental illness.
Getting professional help for school refusal
Families can get professional help to learn about managing school refusal and to sort out the problems behind it.
If your child is saying he feels sick, make an appointment with your GP to check it out.
If there are no physical reasons for your child feeling sick, your GP might refer you to a paediatrician, psychiatrist or psychologist.
A psychiatrist or psychologist will usually do an assessment to see whether the school refusal is linked to issues like anxiety or depression. It's often easier for your child to deal with treatment for school refusal if she's getting help for anxiety or depression.
Treatment for your child might involve cognitive behaviour therapy (CBT), which helps your child learn skills to deal with anxiety about going to school. These skills include relaxation, social skills and helpful thinking about school.
Going back to school for your child might start with small steps toward full-time attendance. For example, your child might spend half an hour in class, then one hour and then two hours and so on.
You might also work with the psychologist or psychiatrist to understand why your child won't go to school and to learn parenting strategies that encourage your child to go.
Your GP will probably talk with you about a GP Mental Health Treatment Plan for your child. Getting a Plan doesn't always mean your child has a serious problem. But if you have a Plan, you can get Medicare rebates for up to 10 sessions with a psychologist. You can also get Medicare rebates for visits to a paediatrician or psychiatrist.
Looking after yourself
If your child is going through school refusal, it can be hard on you and the whole family. If you can find ways to look after yourself, you'll be better able to look after your child.
Here are some ideas:
- Look after yourself with enough rest, some physical activity, a healthy diet and some time to yourself. If you're feeling well and relaxed, you'll be in better shape to help your child - and cope with any frustration you're feeling.
- Remind yourself that school refusal is a challenge for families. Stick with your efforts to get your child to go. Keep in mind how important it is for your child to go to school.