We published a post related to school refusal and what to do about it

Based on societal expectations, most children will regularly and voluntarily go to school the majority of the time. When your child refuses to go to school, can be representative of a larger issue at play. It’s not always just your child being oppositional and argumentative, but could also be an expression of anxiety or depression. A thorough assessment of your child’s problems can be helpful to better understand why your child is refusing to go to school.

Difficulty with attending school is typically related to some form of emotional distress, often related to anxiety or depression. It is a serious issue, especially because the law mandates school attendance. It can cause severe consequences to not only their grades, but it can also negatively impact on both, peer and family relationships, influencing your child’s social and emotional learning.

Recent research shows that approximately 5% of children refuse to go to school, and typically occur between ages 5-6 and 10-11. One study evaluated 80 school-refusing children and found that 1/3rd had a disruptive behavioral disorder, and 1/5th had an anxiety or mood disorder. Within the domain of anxiety, researchers found that the most common anxiety disorders that contributed to school refusal were separation anxiety disorder (38%), social phobia (30%), and specific phobias (22%) (Berg et al, 1993; Last & Strauss, 1990)

Often times, these children may express physiological and somatic complaints, such as autonomic or gastrointestinal concerns. When you hear these complaints as a parent, it’s important to consider that psychological factors may be contributing to your children’s somatic complaints.

Additionally, school refusal may be due to several other reasons such as problematic family functioning, or academic and communicative frustration stemming from a learning disability. Before assuming the cause of school-refusal, it’s important to get a thorough assessment by a professional to identify the underlying cause of the truancy.

Fortunately, there are effective treatments available for school-refusing children. The American Academy of Child and Adolescent Psychiatry (AACAP) in 1997 provided a list of multimodal recommendations for school-refusing children, encouraging education and consultation initially, then behavioral or cognitive-behavioral strategies (such as exposure therapy, coping skills, contingency management, and behavioral plans) with family interventions. If the symptoms are severe enough, medication may be needed, but behavioral interventions should be the first line to address these issues (AACAP, 1997; Eville et al., 2001).

If you’re struggling with a school-refusing child, it’s important to get help from a professional to thoroughly assess and provide the most effective treatment recommendations for your child.

American Academy of Child and Adolescent Psychiatry (1997). Practice parameters for the assessment and treatment of children and adolescents with anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry 36(suppl):69S–84S

Berg I, Butler A, Franklin J, Hayes H, Lucas C, Sims R, (1993). DSM-III-R disorders, social factors and management of school attendance problems in the normal population. Journal of Child Psychology and Psychiatry 34:1187–1203

Eville J. King, Gail A. Bernstein. (2001) School Refusal in Children and Adolescents: A Review of the Past 10 Years. Journal of the American Academy of Child & Adolescent Psychiatry, 40(2), 97-205. 10.1097/00004583-200102000-00014.

Last CG, Strauss CC, (1990). School refusal in anxiety-disordered children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 29:31–35


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