Understanding school refusal

In an ideal world, by now school-aged children have settled into their school-year routines and are up in the morning in time for a nutritious breakfast and off to school, rested and fed, and eager to learn. That idyllic version is not a reality for many of us, at least not most of the time. For many kids, school is a complex place and sometimes fear or worry about going to school shows up as a refusal to go.

There are many reasons for children not wanting to be at school and the ways it shows up are also varied. It is very common for kids to resist going to school when they are starting for the first time.  Fortunately, that tends to get better quickly as they get more used to the change and the routine.  Sometimes moving to a new school or a new home, loss of loved one, or other changes within the family can manifest as school refusal.  Other reasons are if school is a stressful or scary place due to bullying, exclusion, perfectionism in schoolwork, or fears about violence.

Some kids are able to identify what it is they are worried about, but many will not, and it will show up as crying and refusal to go to school, or vague illness symptoms such as nausea, headache, stomachache, and dizziness. Very often kids know they feel bad, but they don’t connect it to the stress they are experiencing at school. Sometimes these symptoms are caused by physical disease and sometimes they are the physical signs of fear and worry. That can be really hard to figure out as a parent. The first step, if your child is regularly complaining of these symptoms, and tare unable to go to school because of them, is to take your child to see a provider. They can look for any evidence of a physical disease.  If none is found, you can create a plan together to help your child feel safe to go back to school.

Usually that plan involves partnering with the school to explore if there are things going on there that are making your child feel unsafe.  It also is important to talk to their teachers and the school nurse about what is going on and what symptoms you should be called for to pick them up and when they can gently return your child to class. The key part of treating school refusal is that once there is no physical disease found, the goal is to get the child back in school as soon as possible. The longer they are out, the harder it is for them to return.

At a time that is not on a school morning, talk and listen to your child about their experience with school, anything they are finding hard there, anything they are worried about, and validate their feelings, but also make it clear they need to be back in school. Make school mornings simple with the clear expectation that they are going to school – this is not a time for exploring their worries and opening the door to resistance. If, despite these efforts, school refusal persists for longer than a week, behavioral health provider support can help address the fear, grief, or worries of your child and help build tools for them to start feeling better.

Even kids who have school avoidance will get sick sometimes. If they have symptoms such as fever, earache, vomiting, diarrhea, severe cough, then keep them out of school and see a provider.

For more information about school refusal or avoidance, check out https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/School-Avoidance.aspx or https://www.stanfordchildrens.org/en/topic/default?id=school-refusal-90-P02288. You can make an appointment for your child to be seen at the Southern Ute Health Clinic for school refusal concerns or anything else by calling 970-563-4581.