School Avoidance: Tips for Concerned Parents

School avoidance – sometimes called school refusal or school phobia – is not uncommon and occurs in as many as 5% of children. These children may outright refuse to attend school or create reasons why they should not go.

They may miss a lot of school, complaining of not feeling well, with vague, unexplainable symptoms. Many of these children have anxiety-related symptoms over which they have no conscious control. Perhaps they have headaches, stomachaches, hyperventilation, nausea or dizziness. In general, more clear-cut symptoms like vomiting, diarrhea, fever or weight loss, which are likely to have a physical basis, are uncommon.

School refusal symptoms occur most often on school days, and are usually absent on weekends. When these children are examined by a doctor, no true illnesses are detected or diagnosed. However, since the type of symptoms these children complain of can be caused by a physical illness, a medical examination should usually be part of their evaluation.

School-Related Anxiety:

Most often, school-avoiding children do not know precisely why they feel ill, and they may have difficulty communicating what is causing their discomfort or upset.

When school-related anxiety is causing school avoidance, the symptoms may be ways to communicate emotional ​struggle with issues like:

• Fear of failure
• Problems with other children (for instance, teasing because they are “fat” or “short”)
• Anxieties over toileting in a public bathroom
• A perceived “meanness” of the teacher
• Threats of physical harm (as from a school bully)
• Actual physical harm

Tips for Concerned Parents:

Here are some guidelines for helping your child overcome this problem:

• Talk with your child about the reasons why he or she does not want to go to school. Consider all the possibilities and state them. Be sympathetic, supportive, and understanding of why he or she is upset. Try to resolve any stressful situations the two of you identify as causing his worries or symptoms.
• Acknowledge that you understand your child’s concerns, but insist on his or her immediate return to school. The longer your child stays home, the more difficult his or her eventual return will be. Explain that he or she is in good health and his or her physical symptoms are probably due to concerns other things – perhaps about grades, homework, relationships with teachers, anxieties over social pressure or legitimate fears of violence at school.
• Discuss your child’s school avoidance with the school staff, including his or her teacher, the principal, and the school nurse. Share with them your plans for your child’s return to school and enlist their support and assistance.
• If a problem like a school bully or an unreasonable teacher is the cause of your child’s anxiety, become an advocate for your child and discuss these problems with the school staff. The teacher or principal may need to make some adjustments to relieve the pressure on your child in the classroom or on the playground.
• Help your child develop independence by encouraging activities with other children outside the home. These can include clubs, sports activities, and overnights with friends.

Excerpted from “School Avoidance: Tips for Concerned Parents” from healthychildren.org from the American Academy of Pediatrics. For more details and additional tips for parents and caregivers, read the full article online.

Source: healthychildren.org | School Avoidance: Tips for Concerned Parents, https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/School-Avoidance.aspx | © Copyright 2022 American Academy of Pediatrics. Article last updated in 2017.

If you have concerns about your child or teen, CHC Care Coordinators can arrange a free 30-minute consultation so you can explore options with an expert. We invite you to call or email us at 650.688.3625 or careteam@testing.chconline.org to set up an initial Parent Consultation appointment. CHC teletherapy services are available now.