School Refusal

What is school refusal?  

Anxiety in kids and teens can take the form of school refusal. School refusal is when a student simply refuses to go to school or fights so hard against going to school that it becomes a miserable battle each morning.  

School refusal is different from truancy. Children who are truant refuse to go to school because they want to do something else. They will often concoct elaborate schemes to avoid going to school. However, school refusal is related to anxiety about situations or expectations at school.

Symptoms of school refusal?

  • Complaints of physical symptoms such as headaches and stomach aches.  Some children will even become so anxious they vomit or experience diarrhea.  The child’s symptoms tend to occur the night before or the morning of school and often subside once given permission to stay home.  
  • Children with school refusal anxiety may have a history of separation anxiety or develop a strong fear of being separated from parents or other caregivers.  They may also develop strong fears that something will happen to their parents or caregivers.
  • Significant changes in mood or behavior.  Children may throw temper tantrums, become clingy or anxious, get in trouble at school or act in other ways that are out of character.  
  • An increase in talking about fears about school.  This may include being afraid to give a presentation, expressing worries about getting sick at school or being concerned about school violence.  

What’s happening in the brain and body when experiencing anxiety?

First, it is important to understand that anxiety is a strong healthy brain doing exactly what it is supposed to do – protect us from threat.  Anxiety happens because the part of our brain called the amygdala is interpreting a situation as being threatening.

The amygdala is the part of the brain that is responsible for the flight or fight response.  It is the part of the brain that enables us to run away from bears and lift cars off people.

Once the amygdala perceives a threat, it immediately goes into action.  It releases a hormone called adrenaline. This increases your heart rate to send blood to your muscles, making you faster and stronger.  It changes your breathing to short rapid breaths, flooding your body with oxygen to go to your muscles (but not your brain).

Your blood sugar spikes, making your senses stronger.  You may start to sweat to release some of the heat from your body. The spike in adrenaline and change in blood flow often cause your stomach to hurt.

The amygdala is a doer, not a thinker.

So, during anxiety, the amygdala has perceived a situation to be threatening when it is not.  The amygdala treats speaking in front of a class the same as being chased by a bear.

Once you understand the anxiety a child is experiencing is real and you understand the why of the physical symptoms, the next step is offering support.  

Here are some ways you can support your child:

  • Be a supportive listener.  Pay attention to any specific event that has occurred that may be causing the student anxiety.  You don’t have to agree or disagree with them, but paying attention shows you care that they are experiencing difficulties.  
  • Schedule a meeting with the school and the student to develop a plan to attend school that  your child feels comfortable with. Developing a plan with the student allows them to feel as though they have some control in the process.  However, you do want to keep the child in school as much as they can tolerate. The more you are exposed to something, the less anxious you become.  
  • Talk about the positive aspects of school, such as classes they enjoy, friends and activities without ignoring their feelings.
  • Help your child build a support system.  This may include finding activities they enjoy doing and developing new relationships within those activities.  Help them to find a caring, trusted adult at school that they can go to when feeling anxious.

Be prepared for setbacks.  

Long breaks such as winter break and spring break can lead to an increase feeling anxious.  Keeping a similar routine during breaks, such as going to bed and waking up around the same time, can help.  If your school building is open over breaks, go back and spend a little bit of time there before school resumes.

If the school refusal behavior persists, we would be happy to work with you and your child.  Please contact us at (217.203.2008) to schedule an appointment.

Some other resources that may be helpful: