Help! My Child Won’t Go to School: Understanding and Addressing School Refusal

Most parents are familiar with their child occasionally, or even frequently, saying they don’t want to go to school. But then the morning comes, and while there might be some grumbling, their child eventually heads out the door and off to school.

For parents of children struggling with school refusal, mornings can go far beyond their child complaining about the day ahead. Their child might refuse to get out of bed and get dressed, refuse to leave the house or car, cry, yell, plead, or say they are too sick to go. School refusal can become a very upsetting dynamic for both parents and kids.

This post breaks down what school refusal actually is, which children may be more at risk, and some do’s and don’ts for supporting a child who is struggling to attend school.

What Is School Refusal?

School refusal involves child-led behaviors aimed at avoiding school, resulting in missed school days, being late to school or leaving early, or spending significant time outside the classroom, i.e. in the nurse’s or counselor’s office.

School refusal can result in chronic absenteeism, which in Colorado is defined as being absent (excused or unexcused) for 10 percent or more of enrolled school days, or about 18 days in a typical school year.

If your child and family are struggling with school refusal, it can feel isolating, but you are far from alone. School refusal has received increasing attention in recent years and appears to have increased significantly following the COVID-19 pandemic.

School refusal is not currently listed in the DSM-5-TR as a mental health disorder. It is instead a pattern of behavior that is often associated with anxiety or other emotional distress. In that sense, it is different from truancy, in which a child or teen skips school for reasons that do not necessarily involve emotional distress and parents are often unaware of the absence.

School refusal can have both short- and long-term consequences for children, including social disconnection, lower academic achievement, and mental health concerns. More chronic school attendance problems can also contribute to school dropout and difficulties later in adulthood. I don’t share this to create panic, but rather to emphasize the seriousness of chronic school refusal and the importance of addressing it early.

So, what is actually happening when a child just can’t bring themselves to go to school? For many children, school refusal is a protective nervous system response to something about school that feels threatening, overwhelming, or difficult to manage. This might look like trying to avoid or escape school, becoming angry or oppositional, shutting down, or feeling unable to move forward with their day.

While avoidance is a very effective coping strategy for reducing anxiety in the short term, it can create a cycle in which anxiety and avoidance reinforce one another. Avoiding school brings immediate relief, which can make the child more likely to avoid it again the next time they feel distressed.

To effectively support a child who is refusing school, it is important to understand what they are trying to avoid. For some children, the difficulty might be separating from a parent, in which case separation anxiety may be contributing to the school refusal. For others, academic challenges may feel overwhelming, or they may lack confidence in their abilities. For another child, the problem might involve feeling rejected or disliked by teachers or peers.

Some common factors associated with school refusal include:

• difficulty regulating emotions

• separation anxiety, particularly in younger children

• social anxiety, particularly in adolescents

• depression or other mental health concerns

• perfectionism or fear of failure

• autism or ADHD

• academic or learning difficulties

• bullying or exclusion by classmates

• health problems

• stressful family circumstances

• difficult or overwhelming experiences at school

School refusal is often complicated, and more than one of these factors may be contributing at the same time.

What Can Parents Do?

While some children may be more susceptible to school refusal than others, the following do’s and don’ts can be useful for many families dealing with school attendance difficulties.

Do:

Support your child’s relationship with their teacher and other adults at school. Children who feel connected to and supported by their teacher tend to be more likely to experience school as a place where they belong. For some children, having a relationship with a counselor, psychologist, social worker, or another trusted staff member can also be helpful.

Be mindful of your own emotional response. School refusal can be extremely stressful and frustrating for parents, particularly in the middle of a rushed school morning. As much as possible, try to avoid escalating the situation when your child is already upset.

Convey confidence in your child’s ability to attend and participate in school while acknowledging that it feels difficult for them right now. Taking your child’s distress seriously does not require allowing them to avoid going to school.

Make a doctor’s appointment if your child frequently reports physical symptoms such as stomachaches, headaches, nausea, or fatigue before school. Anxiety can cause very real physical symptoms, but recurring physical complaints should still be appropriately evaluated rather than automatically attributed to anxiety.

Reach out to your child’s school. Their teacher, counselor, psychologist, social worker, or other school staff may be able to help identify what is contributing to the problem and put additional supports in place.

Make a plan with your child when they are calm. A difficult school morning is usually not the best time to have an in-depth discussion about why they don’t want to go.

Instead, find a more neutral time to try to understand what part of school is especially difficult. Is it separating from you? Entering the building? A specific class? Academic work? Lunch or recess? A particular student or teacher? Sensory overload? Fear of getting something wrong? Understanding what your child is trying to avoid can help you and school staff develop more effective strategies and supports.

Don’t:

Allow staying home to become the default response to school-related anxiety. Of course, there are legitimate circumstances when a child needs to stay home, including illness or significant mental health concerns. But when anxiety and avoidance are driving school refusal, repeatedly staying home reinforces the child’s belief that they cannot handle school and makes returning increasingly difficult.

Make up reasons your child can’t go to school when you call in their absence. Being honest with the school about what is happening gives staff a better opportunity to understand the problem and help address it.

Make staying home from school especially appealing. If children are able to avoid something that causes anxiety and also spend the day using technology, going on outings with parents, or participating in other preferred activities, staying home may become even more reinforcing. This does not mean the day at home needs to feel like a punishment, but it is generally helpful for staying home to remain neutral.

Wait for the problem to become severe before addressing it. An occasional difficult morning is different from an emerging pattern of school refusal. If your child is repeatedly missing school, arriving late, leaving early, or becoming increasingly distressed about attendance, involving the school and seeking additional support early can prevent the pattern from becoming more entrenched.

Lose your cool when your child is experiencing significant anxiety or refusal behaviors. I know this is easier said than done, but yelling, threatening, or engaging in a power struggle is likely to increase everyone's distress and make the situation harder to resolve.

School refusal is complicated and challenging for both families and schools, with particular distress experienced by the children struggling to attend and the parents trying to help them.

Early intervention is important in preventing school refusal from becoming chronic. The longer a child is repeatedly avoiding school, the more established the pattern can become and the more difficult returning will likely feel.

Family-school collaboration can go a long way in addressing school refusal, but sometimes additional help is needed. As a child and teen therapist, I support children and families in understanding what is contributing to school refusal and charting a more hopeful path forward.