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Last Updated: Jan 10, 2023

School Refusal - Symptoms, Causes & Treatments Of It!

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Dr. Neha SalhotraPsychiatrist • 12 Years Exp.MBBS, DNB - Psychiatry
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There is always a sense of anxiety, whenever we tend to start off with something new, as people are resistant to change. It is more so in the case of young children. School refusal refers to the refusal of children to attend school as a result of emotional distress. This school refusal can wreak a kind of havoc on families.

Elaborate on symptoms a little more and causes -

Symptoms - 

There are certain symptoms related to the refusal of children to attend schools. They include:

  • Often it comes in the form of tantrums
  • Frequent complaints of stomachaches, vomiting, nausea, exhaustion, headaches or diarrhea
  • There could be loud meltdowns in an overwhelming manner, which include their refusal to leave the house, running down the street to avoid getting inside the car or on the school bus
  • Children might even become aggressive and lash out at their parents with physical blows
  • Child feeling fearful of being alone in a room or dark

Causes - 

Some of the primary causes include:

  • It arises out of students having a feeling of separation from their parents and homely atmosphere, hence, leading to anxiety
  • It comes out of an emotional attachment which children tend to have with their parents, especially mothers
  • Children tend to feel scared with the thought of getting into an unknown atmosphere all of a sudden.
  • Consistent fear of criticism, ridiculing, confrontation or punishment by the teacher or any other person in the school
  • Having learning difficulties
  • Being afraid of qualifying the tests
  • Not feeling comfortable with school activities like singing, playing or attending school assembly
  • Fear of being ridiculed due to appearance, clothes, weight, etc.
  • Fear of being bullied by a class or schoolmate

How can children be helped to get rid of this problem?

The ideal treatment to help all those children struggling with school refusal includes a team approach. It will be beneficial to have a strong team which includes the class teacher, family and if possible, a mental health professionals. The steps include:

1. Assess: The very first step is to complete medical and psychological examination. Given the fact that school refusal is usually linked to an underlying anxiety or depressive disorder, it is necessary to get to the root of the problem and begin there. This would include both family and teacher questionnaires for interviews.

2. Cognitive behavioral therapy: This is a very structured form of therapy, which helps children to identify their maladaptive patterns of thought and also learn replacement behaviours. It would help children to confront and work through their anxiety.

3. Desensitization in a systematic manner: Those children who struggle with school refusal, need a graded approach to return to school. They can return for a some increased amount of time and then gradually build upon it.

4. Training for relaxation: This is extremely essential for all those children who struggle with anxiety. Some of the relaxation strategies include deep breathing, guided imagery and mindfulness, which kids practice at home and also utilize in school.

5. Plan for re-entry: The treatment team even creates a plan to help children re-enter the classroom. The plan includes contingencies to help the student during anxious moments throughout the day.

6. Routine and structure: Children who are anxious can even benefit from routines at home that are predictable. Establishing healthy sleeping habits and a regular sleep cycle during holidays and on weekends can yield positive results.

In case you have a concern or query you can always consult a specialist & get answers to your questions!



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