School Refusal and Anxiety: 7 Questions for Parents to Consider
Every student has bad days that justify missing class. From bouts of illness to needing a mental health break, it’s normal for kids to take extra days off now and again. But if your kid is missing school excessively or refusing to attend altogether, it’s possible that a mental health disorder may be at play. “School refusal” describes the behavior of a student who regularly avoids going to school, commonly due to intense anxiety around being on campus. It’s critical for students who regularly avoid school to receive help, as school refusal can have a profound negative impact on their academic future.
Does your kid regularly try to get out of school? If so, here are 7 questions to consider.
What causes school refusal?
It’s important to note that “school refusal” is not recognized as a disorder in the Diagnostic and Statistical Manual of Mental Disorders. Rather, school refusal is a potential symptom of other conditions, including major depression social anxiety disorder, and adjustment disorder. School anxiety can also be brought on by distressing situations at school, such as bullying or test anxiety. Additionally, periods of transition can cause a student to develop school refusal behaviors. A family move, transitioning to middle or high school, or experiencing a trauma can onset school refusal. The loss of one parent, for example, can make a kid highly resistant to being separated from their other parent.
2. Is school refusal the same thing as truancy?
Like school refusal, truancy is characterized by avoiding school. However, there are differences in the behavior and motives of truant students versus school-refusing students. Students who are truant typically keep their school avoidance a secret from their parents; they often leave the house with their parent thinking they are headed to school, only to head elsewhere. Students who exhibit school refusal typically make no effort to hide the fact that they want to stay home. Rather, they will often try to bargain with their parents to get out of school each day. Truancy is typically associated with delinquency and conduct disorders such as Oppositional Defiant Disorder, whereas school refusal is more commonly a symptom of anxiety disorders, mood disorders, trauma, or bullying.
3. What are common signs of school refusal?
Students exhibiting school refusal will regularly show extreme distress or temper tantrums about attending school. Because school refusal often stems from intense fears surrounding academic and social pressures, many of its symptoms mirror other forms of anxiety, such as:
Panic attacks
Shortness of breath
Nausea, vomiting, and other gastrointestinal issues
Trembling or shakiness
Sweating
Feeling weak or tired
Headaches
School-refusing students may only experience these uncomfortable symptoms at school, and symptoms may largely subside when they are at home or in other “non-threatening” settings.
School refusal can have various causes, or even be a sign of different disorders. Schedule your consultation to learn how we can help.
4. How common is school refusal?
It is estimated that between 2%-5% of all students are affected. Of those students, it most commonly affects those between the ages of 5-7, 11, and 14. This correlates with the ages at which students enter elementary school, middle school, and high school.
5. What are the consequences of school refusal?
Excessive absences can have a long-lasting negative impact on students at any age. Academically, a student is likely to fall behind their expected grade-level proficiencies and perform poorly on high-stakes tests. In younger students, this can lead to being held back a grade. For older students, this can jeopardize their college and career prospects.
Socially, peer relationships can suffer as a student avoids school, straining existing friendships and making it harder to form new ones. School refusal can also take a toll on the parent-child relationship, as daily arguments over attendance can be exasperating. Few friendships, family conflicts, and the risk of academic underachievement can also increase a student’s risk of developing depression.
6. What does support look like?
Because school refusal is not recognized as a disability, it cannot qualify a student for a 504 plan or Individualized Education Program (IEP). However, school refusal is often a symptom of other disorders, some of which can qualify students for a 504 plan or IEP. Anxiety disorders, for example, can qualify a student for special education under the “Other Health Impairment” category of the Individuals with Disabilities Education Act (IDEA). Diagnostic testing is the first step in securing support for children who refuse to go to school.
*Important: A diagnosis alone is not enough to qualify a student for special education. A qualified evaluator must also identify how the condition adversely affects the student’s learning or otherwise creates an academic impairment.
7. How do you find the help you need?
Variations Psychology specializes in educational psychology and diagnostic testing to help students reach their academic potential. If your student experiences school refusal, our doctors can identify the root causes of their symptoms, determine whether they have a diagnosis, and guide you in securing the support they need to overcome anxiety and thrive in school.
So you know you need help, but aren’t sure how
to find the right help?
If a loved one has a learning difference or other condition that impacts their mental health and education, you may feel lost in determining the best ways to support them.
Our Diagnosticians can provide psychological testing to remove the
guess-work and guide your family on the best path toward mental health, emotional wellness, and academic success.
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More about Variations Psychology
Variations Psychology is a group practice specializing in diagnostic testing to identify psychological conditions.
Our comprehensive evaluations test for conditions that impact mental health and development such as ADHD, autism spectrum disorders, depression, anxiety, learning disorders, and developmental delays.
In addition to diagnostic services, we offer Independent Educational Evaluations (IEEs) of K-12 students to assess needs for accommodations in school and determine their appropriate placements. IEEs provide an objective second opinion on existing IEP and 504 Plans.
For K-12 and post-secondary students, we offer evaluations to assess needs for accommodations on standardized tests, college entrance exams (e.g. - SAT, ACT, AP Exams), and graduate and professional licensing exams (e.g. - MCAT, LSAT, GRE, CBEST, NCLEX, GMAT, CA Cosmetology Exam, CA Contractors State Licensing Exam, CA Bar Exam).
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References:
Fremont, W.P. (2003). School refusal in children and adolescents. American Family Physician, 68(8), 1555-60. Retrieved from https://pubmed.ncbi.nlm.nih.gov/14596443/
Kawsar, S., Yilanli, M., & Marwaha, R. (2022). School Refusal. StatPearls publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK534195/#:~:text=School%20refusal%20describes%20the%20disorder,a%20vast%20number%20of%20reasons.
Sewell, Jill (2008). School refusal. Australian Family Physician, 37(4). Retrieved from https://www.racgp.org.au/getattachment/c3e1167c-8547-418d-89f7-cbf45202c20f/attachment.aspx
Shinn. M.M. (2019). 10 Tricks for Talking Back and Keeping Safe from Bullies. Psychologically Speaking. [Variations Psychology blog post]. Retrieved from: https://www.variationspsychology.com/blogs/10-tricks-for-talking-back-and-keeping-safe-from-bullies
Shinn. M.M. (2023). Caring for Cognition: 8 Steps for Middle & High School Students to Prioritize Healthy Thinking in the New School Year. Psychologically Speaking. [Variations Psychology blog post]. Retrieved from www.variationspsychology.com/blogs/caring-for-cognition-8-steps-for-middle-high-school-students-to-prioritize-healthy-thinking-in-the-new-school-year
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Shinn. M.M. (2021). Is My Child or Teen Depressed? 10 Tell-Tale Questions to Consider. Psychologically Speaking. [Variations Psychology blog post]. Retrieved from https://www.variationspsychology.com/blogs/is-my-child-or-teen-depressed-10-tell-tale-questions-to-consider
Shinn, M.M. (2019). My Kid is So Defiant! Is it My Fault? Psychologically Speaking. [Variations Psychology blog post]. Retrieved from https://www.variationspsychology.com/blogs/my-kid-is-so-defiant-is-it-my-fault
Shinn, M.M. (2018). Take the Stress Out of Tests! 11 Ways to Manage Test Anxiety. Psychologically Speaking. [Variations Psychology blog post]. Retrieved from https://www.variationspsychology.com/blogs/take-the-stress-out-of-tests-11-ways-to-manage-test-anxiety
Shinn. M.M. (2022). The 13 Categories of IDEA: What Conditions Can Qualify My Student for Special Education? Psychologically Speaking. [Variations Psychology blog post]. Retrieved from www.variationspsychology.com/blogs/the-13-categories-of-idea-what-conditions-can-qualify-my-student-for-special-education
Shinn. M.M. (2022). Why Isn’t My Kid Making Any Friends? Psychologically Speaking. [Variations Psychology blog post]. Retrieved from https://www.variationspsychology.com/blogs/why-isnt-my-kid-making-any-friends
How to Cite This Blog Article:
Shinn, M. (2023). School Refusal and Anxiety: 7 Questions for Parents to Consider. Psychologically Speaking. [Variations Psychology blog post]. Retrieved from www.variationspsychology.com/blogs/School Refusal and Anxiety: 7 Questions for Parents to Consider