“I caaaan’t go to school today,” your kid says. “My stomach hurts.”
Maybe you stop in your morning-rush tracks to check for fever. None. Other symptoms? Nothing. Could it be food poisoning? Nobody else is sick.
But your kid looks pitiful—and adamant. So you rearrange the morning and reach for your phone to call in the absence.
Now let’s change one detail: This is the third time in three weeks that it’s happened.
“School refusal” is more than just skipping class.
Most kids dodge school sometimes, or try to. It’s the childhood equivalent of taking a mental-health day. “We all have bad Mondays when we don’t feel like doing something,” says child psychologist Brendan Pratt, PhD, who works extensively with families and schools on school refusal (as the behavior is known) at The Pratt Center in Los Altos, California.
School refusal, he says, is different. It’s when a child (at any age):
- Increasingly or regularly begs off attending school due to being “sick” or another reason, or for no reason
- Suddenly announces he’s never going back
- Attends school but often asks to come home early, visits the school nurse, falls asleep in class, or pretends to be asleep
- Has a legitimate long absence (say, due to vacation or an illness like mono) then grows reluctant to return
- Is persistently tardy because getting to school is so distressing
- Cuts class and disappears on his or her own
In addition to complaining of sore throats, stomachaches, or headaches, some kids work themselves into a state where they really do develop a rash or diarrhea, or even vomit—ailments that mysteriously vanish when safely at home. School refuseniks may also throw tantrums, refuse to get dressed, cry, sulk, argue, or have full-blown panic attacks.
To schools, the missed class time is “truancy” when a threshold of unexcused absences or tardies is crossed. (Definitions vary by locale.) Truancy is a legal term that can result in penalties ranging from administrative finger-wagging and a risk of not being promoted to fines and legal action—even to having a truancy officer come to the home to drag a child to class.
The question of how much missed school is too much sidesteps a more pressing issue: Why is it happening in the first place?
School refusal is a SYMPTOM of a problem.
“Most kids generally want to please their parents, follow the routine, do well in school, want to be with other kids, and want those kids to like them,” Pratt told me. “When we see a kid who doesn’t want that, there’s usually something else going on.”
Missing school is an alarm bell that signals a wide range of possible problems that a child doesn’t know how to deal with. Feeling cornered or overwhelmed, he or she thinks: I’m in trouble, I don’t know what to do. So I’m going to avoid it in the only way I know how—by controlling one of the few things I can control.
Anxiety, depression, and bullying are “the big three” underlying reasons for refusing to go to school, Pratt says. But the trigger can be as minor as dread of being called on to read aloud or as major as a crisis like a parent’s illness, divorce, family financial stress, or abuse.
Smart, perfectionistic, popular kids do it. So do kids who struggle with shyness, autism, or other challenges. Schools see it at every grade, from kindergarten through high school (and beyond).
Other common triggers in elementary-school kids:
- Separation anxiety: Some is normal in the first few weeks of kindergarten, but it can persist into second grade.
- Dyslexia or other learning problems: These start showing up in second and third grades as kids’ deficits in reading or writing become obvious.
Other common triggers in older kids:
- Starting a new middle school, high school, or college
- Social problems, like being excluded or mocked
- Social-media bullying
- Anxiety about test taking, athletic competition, or another type of performance
- Intensely felt academic pressure
- Sleep disorders
- Drugs and alcohol
Between 5 and 28 percent of kids avoid school at some point, according to research by Christopher Kearney, who directs the University of Nevada’s Child School Refusal and Anxiety Disorders Clinic.
And yes, it stresses out the whole family.
It helps to get an early jump on the problem.
When it starts, experts say, don’t be too quick to agree to let your child stay home. Accommodating your child without resolving the “why” only snowballs the problem—the less they go, the less they want to.
If you don’t see signs of fever or actual illness, Pratt suggests, try to distract your child and give him an incentive to look forward to once the day begins. Maybe it’s extra playground time before the class day or a chance for a teen with a learner’s permit to take the wheel while you drive to school. “For some kids, once they get there, they’re fine,” he told me.
If your child is really resistant, it’s better to get to the root of the problem early—seeing school refusal as the red flag it is, Pratt says—rather than getting bogged down in power struggles, arguments, or just giving in, none of which ultimately helps a kid.
Avoid making it too pleasant to stay home: Nix the electronics, outings, and pampering, and avoid picking up homework for your child for days on end.
Look for patterns that can help explain what’s wrong.
- Is your child sick mostly on Mondays? Never on weekends? Those are early signals that there’s something about the school environment that’s hard for the child.
- Does she or he want to bail on days when there’s a test or presentation? An underlying learning or social issue might be creating anxiety—even for kids who seem to be bright, good students.
- Does it happen whenever there’s P.E. class, or a new skill unit in gym (like swimming)? Locker rooms and other unstructured times at school are notoriously hard for kids with social anxiety, as well as common settings for bullying.
- Does your child always want to leave during the school day at about the same time? Sometimes stress builds up in the day for anxious kids, or a specific class or situation is being avoided.
- Are there other changes you’re noticing in your child as well? Examples: avoiding other situations, changes in appetite, withdrawing from favorite people or activities.
- Is this a sudden, dramatic new behavior? That might point to a specific, transformative incident, such as sexual abuse or bullying.
Talk to your child.
“You’d be surprised how often kids will be honest with you—even about very serious things like suicidal thoughts—if you ask them directly,” Pratt says.
Try mentally walking through the school day together, he suggests. Ask things like, “When you get to school, who do you see first? What parts of the day do you like best? What don’t you like? How is your teacher? What makes you happy? Sad? Is anyone mean to you or teasing you? Who do you eat lunch with and hang out with?”
Raise your concern with teachers.
They see what’s happening on the ground—inside the classroom as well as out. Pratt says, “They can observe younger kids at recess, for example: Is he always excluded? Picked last for teams? Are there signs of systematic treatment from the other kids that’s a problem?”
In middle school and high school, teachers may have insights into related behaviors that parents are unaware of: being teased or excluded, falling asleep in class, plummeting grades, angry outbursts, or even delinquent behaviors like stealing or abusing drugs.
School staff may be able to work with you to prevent a problem from escalating. One counselor got a kid with separation anxiety to work on study skills with video games, which he loved, for 10 minutes before first period.
Once made aware of an issue, teachers may be able to provide supervision, organized games, or safe places for kids to go during unstructured times, like lunch. One set up a Dungeons & Dragons club for kids with high-functioning autism who had poor social skills. “They were so happy to have a place to go rather than wandering around waiting to be mistreated,” Pratt says.
Avoid covering for your child when you report the absence to school.
“Parents feel a lot of compassion for their child’s issues, so they often excuse absences and hide the reason,” Pratt says. “But it’s better not to lie and say your son has a cold. Say ‘My son seems depressed and won’t go to school.'” If your daughter repeatedly wants to be picked up early, say that she’s having panic attacks rather than “Oh, she has another doctor’s appointment.”
Even if you aren’t sure, don’t cover up with a fake excuse.
Why that’s important: You want to create a paper trail of what’s happening. If absences escalate to chronic levels and you need to get help from the school or other resources, you’ll be much better positioned to get them.
“Clear documentation in writing can show all of the steps a parent has taken,” Pratt says. “You don’t want to be in the situation where something goes on for six months and you need the school’s help, but the school says, ‘Well, this is the first we’re hearing about it!'”
Some schools are quick to report “educational neglect,” file child abuse or truancy claims, or involve truancy officers, who will track kids down at their homes and force them to school—often before taking any steps to find out what’s going on. That doesn’t do much to solve the issue for the child, and can even make it worse. Picture a kid who has social anxiety being dropped off at school by a patrol car.Other schools are sympathetic and supportive. But even then, it doesn’t mean they’ll turn a blind eye to endless absences. (Public schools, for example, receive funding based on attendance.)
Consider connecting to outside help.
Good detective work—along with thoughtfulness, compassion, and patience—can help coax even the most skittish kid back on track.
A diagnostic assessment by a school psychologist or outside mental-health professional, including educational and psychological testing, can be a key step in getting to the heart of the matter. Testing can also document the need for free extra school support made possible under a 504 plan or Individual Education Plan (IEP).
One boy’s parents were convinced he had language-processing issues because he was so anxious about his foreign-language class. Testing revealed no problems. It turned out that he found it so unbearably mortifying to stand up and speak Spanish in front of his classmates that he stayed home instead. Embarrassment and anxiety about reading aloud or public speaking are common, Pratt says.
Midway through tests to explore another boy’s anxiety, the high schooler blurted out to Pratt, “I don’t know how to say this, but I’m gay.” His parents and classmates turned out to be loving and accepting. But fear and confusion had led the boy to avoid school. Once he was out, and without much of a ripple, he was fine.
Along with sorting out the actual issue, mental-health professionals can help figure out what kind of supports are needed, if any, such as:
- Therapy. This may include cognitive-behavioral therapy to teach skills that reduce stress and build confidence, and exposure therapy to get a child used to a new situation.
- Medication. Antidepressants, for example, might be prescribed for depression.
- School supports. Learning or testing accommodations, tutoring, and building up the child’s support system are common examples.
- A different school. Moving a child to a smaller school or a special-therapy school, for example, is a common and effective approach.
- Residential treatment. This may be appropriate for serious cases such as severe aggression, eating disorders, or drug abuse.
Whatever the issue behind phantom tummy aches and “I hate school!” rants, there’s a corresponding path to making it better.
One boy’s undiagnosed depression led to plummeting grades, spotty attendance, frustrated parents, and accusations by the school that he just wasn’t trying. A truant officer began showing up at the young teen’s house to escort him to class. “For him the answer was to pull him out of school so he could get therapy for his depression and attend 1:1 school to catch up and get his confidence back before returning to his old school,” Pratt says.
For another school ducker, the root turned out to be as straightforward as dyslexia, which led to performance anxiety in English class. Extra reading support and the teacher’s awareness were all it took to turn her humiliation around.
What all cases of school refusal have in common is this: Resolution starts as soon as parents reach out—to the school, to professionals, and especially to the child. Early is best, experts say. But it’s never too late.
Photos from top: Miguel Pimental/Flickr; Abdelrahman Osama/Flickr; Nathan Csonka/Flickr; alex yosifov/Flickr; woodleywonderworks/Flickr; Stuart Richards/Flickr; Cassandra Jowett/Flickr; Rafael Sato/Flickr