School Refusal: What to Do When Your Child Has Anxiety About School

Dad hugging his daughter before school
School refusal and separation anxiety are common, but a little reassurance can go a long way.

Breakfast is eaten, teeth are brushed, school clothes are on and shoes are tied. It’s time to head to the bus stop or car, but then it happens: huge tears roll down the face of your child, who says, “No, Mom,” or “No, Dad, I can’t go to school today.” What’s this school refusal about, and what’s a parent to do?

This is a struggle many parents are facing with a new school year underway. Child and adolescent psychiatrist Vishal Madaan, MD is familiar with this challenge, and I met with him to discuss the causes and recommended solutions.

School Refusal Doesn’t Look the Same for Every Child

Kids aren’t always going to be so upfront about why they don’t want to go to school. School refusal might appear as a tummy ache that suddenly resolves once the child gets to stay home for the day. Sometimes it’s tantrums or clinginess or defiance. School refusal is very common, and at times, just a phase a child will work through. It can, however, take the form of chronic anxiety disorder that may require professional help.

When School Refusal Tends to Happen

According to Madaan, school refusal is probably the most likely to happen after a school break ends. That could be a Monday morning or the first day of school after a holiday break. It can also crop up anytime a student changes schools due to a move or transitioning from elementary to middle or middle to high school.

Madaan says school refusal is just the “presenting symptom.” It’s a signal that something else is going on, sometimes separation anxiety. Other signs of separation anxiety can include not wanting to sleep alone, not wanting to have a sleepover with friends, or asking to call the parent from school.

Big life changes may also bring on phases of separation anxiety in children:

  • Parental separation or divorce
  • The death of a relative or family pet
  • Moving

Consider whether it could be anything other than separation anxiety. Other reasons children refuse to go to school include:

  • Bullying
  • Struggling to keep up in class
  • An undiagnosed learning disorder
  • Generalized anxiety disorder
  • Depression

Use Your Best Judgment and Look for Patterns

If a child claims to have a minor ailment and doesn’t want to go to school, it’s ultimately the parent’s call about how they would respond, Madaan says.

However, if there seems to be a pattern of these things happening on Monday mornings, or symptoms disappearing once the child is camped out at home for the day watching a movie, it’s time to consider whether the child is staying out of school due to anxiety. If so, addressing the cause of the anxiety and getting the child back to school is the solution.

How to Respond to Your Child

The most important thing, according to Madaan, is to be supportive and try to understand the possible reasons for the child’s anxiety and behaviors. Explain to your child that it is perfectly normal to experience anxiety from time to time, especially during times of change. If the child is upset, resist the urge to force him or her to continue on with the normal morning routine. Instead:

  • Take a deep breath and give your child a moment to calm down.
  • Encourage the child to explain what he or she is nervous about.
  • Listen to the child’s concerns, but also state firmly that school is important and attendance is not up for negotiation.

Help them talk through some solutions for the things they’re unsure of. For example, the child may be nervous because they don’t know what their new routine will be or who their friends will be. By talking through the fear, you may be able to explain more about the routine, or give them ideas about making friends. Tell them how you handled similar scenarios when you were their age.

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Share with the child that other children are likely nervous about the change, too. It often helps for kids to know that what they’re feeling is normal and they aren’t alone.

When to Seek Professional Help

If school refusals continue happening, Dr. Madaan recommends that parents loop in the child’s school – explain what’s going on to the teachers and even the school nurse or counselor. Ask teachers if they’re seeing anything unusual from the child at school. These experts can partner with parents to keep an extra eye on the child at school, giving extra attention and reassurance when necessary. If the school refusals continue, it’s time to loop in a therapist.

If the underlying issue seems to be bullying or trouble with academics, definitely get your child’s school involved. They can work with you to identify solutions.

It might be more than just separation anxiety if:

  • You’re seeing vast changes in behavior
  • Your child’s school performance is suddenly deteriorating
  • Your child is withdrawing socially or from other activities they used to find enjoyable
  • The anxiety is extreme and interfering with the child’s daily life
  • The child voices thoughts of self-harm or suicidal thoughts

In these cases, contact a therapist or a child psychiatrist. These professionals can address thought and behavior patterns associated with anxiety, and give the child tools for dealing with their anxiety. In the case of severe anxiety or depression, a psychiatrist might even recommend prescription medications.

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