Understanding School Refusal Syndrome
Anxiety Disorders, Internalizing and School Refusal Behavior
At its best, attending school can be a positive and enjoyable learning environment, surrounded by school friends and inspiring teachers. However for some students, school – and the stimulation of school – can cause fear and panic.
School refusal, also known as school phobia or school avoidance, describes a child’s persistent distress or avoidance of attending school. It’s not a specific mental health diagnosis but a behavioral pattern that’s associated with emotional issues.
Mental health conditions can include anxiety disorders and depression. According to the American Academy of Child and Adolescent Psychiatry (AACAP), the child or teen who is experiencing school refusal syndrome may also complain of physical problems, including headaches, before leaving for school.
Parents should be concerned if their child regularly complains about feeling sick or asks to stay home from school with physical complaints like an upset stomach.
School refusal behavior may start after a personal loss or trauma
School refusal behavior in students may result in chronic absenteeism and separation anxiety. In children diagnosed with school refusal syndrome, experts find a smaller and more structured classroom setting may be most supportive for students with anxiety or mood disorders.
When fears persist, caregivers and parents should make an appointment with a qualified mental health professional. They can help the student and family to develop a plan to immediately return to school.
Be on the lookout for students who internalize their emotions and display signs and signals of school refusal syndrome:
- Diagnosed as being highly gifted or learning disabled
- Mood disorder behaviors that interfere with school and homework
- Decrease in test scores due to negative, internalizing patterns
- Inability to develop appropriate relationships with peers
Internalizing refers to a child’s emotional or psychological difficulties that are expressed inwardly, rather than outwardly. Internalizing fuels negative patterns for anxiety and social withdrawal.
Not wanting to go to school may occur at any time during childhood but most common in children ages 5-7 and 11-14. These are the years when kids are dealing with the newest challenges of elementary and middle school. According to AACAP, young children may suffer from paralyzing fear of leaving the safety of their parents and their home during these milestones.
Sudden school refusal behaviors might indicate bullying
Sudden refusal reactions to attend school in older adolescents and teens may be directly related to mental health concerns, social problems and bullying in school. The child’s refusal to attend school is difficult for parents to deal with but these fears and behaviors may be treated with professional help.
School refusal behaviors can often follow a stressful occurrence, such as the death of a pet or relative, changing schools or moving to a new neighborhood. Younger students may also:
- Have difficulty going to sleep and staying asleep
- Experience disturbing nightmares
- Feel unsafe in a room by themselves
- Excessively worry about parents or family members
- Have exaggerated, unrealistic fears of burglars and monsters
- Throw tantrums when forced to go to school
Children who experience anxiety about school may benefit from counseling, medication and a gradual reintroduction plan for school.
Foundations Behavioral Health
Call 215-345-0444 to get started. For questions about our programs, complete the online contact form.
