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School Refusal: Is Anxiety Behind Your Child’s School Avoidance?

I developed school refusal in eighth grade. It wasn’t sudden. Over several months, I went from a straight A student who was reluctant to miss school even when sick, to a near dropout. First, my schoolwork suffered. I hid the cause of my academic decline behind rebellion and dyed black hair, so my school blamed hormones and started handing out detentions.

By suspending privileges and dispensing punishments, my teachers hoped to incentivize me to improve my performance. Unfortunately, this made school less appealing. Finally, after being removed from my advanced algebra class and placed in remedial pre-algebra, school became unbearable. I refused to attend. My parents offered rewards and punishments. My guidance counselor suggested I was taking drugs. My homeroom teacher thought it had to do with an eating disorder. A school nurse made the asinine suggestion that I was trying to avoid boys who were pressuring me to have sex; her belief being that girls lack sex drives of their own.

Anxiety and School Refusal

The real cause of my downfall was anxiety. Over the summer, my preexisting separation anxiety had followed a common trajectory and given way to Panic Disorder. Focusing in class became impossible because I was constantly panicking over some news story or imagined health issue. I was terrified and confused, and I just wanted to stay home.

Causes of School Refusal

School refusal can be a vexing problem for parents.Many children who suffer from anxiety disorders develop school refusal at some point in their lives. In my experience, school refusal cannot necessarily be predicted by the severity of a student’s anxiety. Take, for example, the anxious brother and sister I taught in Los Angeles. Although the girl’s anxiety appeared to dwarf her brother’s, she was eager to attend preschool, while he stubbornly stayed home. His difficulties attending school continued until fifth grade, when he came home one afternoon and explained that he was too scared to ever go to school again.

In such instances, parents typically suspect bullying, and bullying is of course a very real issue. However, there are myriad potential anxiety triggers at school. Some well-known causes of anxiety at school include tests, oral reports, auditions and sports try-out, and intimidating teachers. Parents and teachers may fail to consider more esoteric causes of school refusal, like germ phobias, anxiety about eating, and concerns about school shootings. Frequent class discussions about 9/11, which had occurred earlier that year, contributed heavily to my own school refusal. Although the attacks were fresh, I lived in California, so no one at my school guessed that I was preoccupied with fears of a terrorist attack.

School Refusal Treatment

Getting a child back to school can be complex and time-consuming. Because there are many causes of school refusal, it’s important to listen to students and ask questions. Sometimes a new school is enough to solve the problem. Such was the case with the boy I taught in LA. For other students, the only effective cure for school refusal is ongoing treatment for anxiety. My pediatrician finally identified my anxiety, and diagnosis and treatment allowed me to resume normal attendance and improve my grades. I’ve included more tips for parents of students with school refusal here.

If you have experience with school refusal, either directly or as a parent, I hope you’ll share them in the comment area below.

Kiri Van SantenThis article was written by Kiri Van Santen, a homeschool teacher, tutor, and coach specializing in the education of children with anxiety disorders. She was diagnosed with Panic Disorder and OCD in her early teens. Ms. Van Santen is also the author of the blog at www.fearless-learning.com. Follow her on Twitter @fearnolearning.

To be a guest author on the Your Mental Health Blog, go here.

4 thoughts on “School Refusal: Is Anxiety Behind Your Child’s School Avoidance?”

  1. my gr4anddaughter has crohn’s disease. She copes really well with it now. She is 12 years old but has become a school refuser. My daughter has tried everything fromgetting annoyed to being calm. My granddaughter now refuses to see the child psychologist and just sits at home all day. Any advice would be appreciated

    1. Hi Majella,
      Your granddaughter is fortunate to have a grandmother and mother who care and want to help. That’s not always the case. Has she had other behavior changes? Sometimes a health problem (crohn’s is a difficult thing to have at age 12 — even if she coping well physically, she may not be coping emotionally) can lead to anxiety and depression. The three things together can correlate with school refusal and other behaviors. This is only a thought rather than a diagnosis. Maybe she’d like to try a different therapist or to be involved in making a plan to gradually ease back into school. It might take some time and patience, but your granddaughter will quite likely return to school willingly.

  2. My son has been in special education since pre-school. All but two years he was placed in private day-schools that our county pays for. In 3rd grade he went to a school that was just terrible, authoritarian, strict, all academic — and he is a sensitive kid with PDD (on the autism spectrum). He freaked out one day from the pressure, and he ended up hospitalized for two weeks. All they did there was overmedicate him. A chance comment someone there made made me realize the school was the problem, so we switched to a new one.

    It was better, although they had a very brutal disciplinary program involving isolation rooms and rarely “therapeutic holds” — physical restraint. In 7th grade, his classroom was moved to where the rooms were, and he heard kids crying, begging, yelling all day. He was put there once or twice, although I had made it clear never to do this to him. He broke down and was desperate every day he had to go to school. We tried various things but he continued to be unable to handle going to school. Finally, I insisted we pull him out home school him. That made the fear go away, and after a year, he asked to return school if we found a better one and he chose it. That’s what we did, and he’s been at the new wonderful school since 9th grade. He is on track to graduate with a diploma, and he is no longer anxiety-ridden. He takes a small dose of Cymbalta for anxiety. He also went to a sleep doctor, and his sleeping is now better regulated. I think many other people with anxiety could benefit from better sleep.

    My son has epilepsy, though it is controlled. He had his first seizure at the old school, so that probably contributed to his anxiety. I also, like the previous commenter, have bipolar and anxiety. I had an attack of some sort (panic, seizure, dissociation — doctors weren’t sure) while I was driving him to school one day and had to be taken to the hospital. I’m sure that was traumatic for him. I think it came from my extreme anxiety and stress about him. At one point, his psychiatrist actually told him if he didn’t start going to school the police would get involved and he might be sent to jail! I made my outrage known to that doctor; he actually apologized! Rare for a doctor in my experience!

    My poor son has been through hell. So many people misinterpreted his anxiety and made it worse. I felt powerless and anguished, watching him suffer. I think training all teachers to recognize the signs of anxiety (and other psychiatric problems) would go a long way toward treating them before they’ve become intractable.

  3. This sounds a lot like my son. He is now in 9th grade. In 7th grade, halfway through the year, he started refusing to go to school. Of course we suspected a bully even though I already knew he had anxiety and he was seeing a therapist. But he had a ipod touch stolen from him and he said he was be bullied. I alway wondered about the bullying because he story seemed to change slightly a few times. The school swore there was no bullying going on. Maybe there wasn’t but I didn’t like how the school handled it. His refusal was so bad that in 8th grade the school came out to get him a few times. His grades started to go down in 7th grade and he started gaining weight which just added to his anxiety. Now he has gotten a little thinner because he is getting taller, but he still is getting bad grades, he’s failing practically all his classes and he hates school. I really don’t know what to do with him. I feel like such a failure as a parent. Also a lot of his anxiety started when I was hospitalized, 4 times in 14 months in a psych hospital. I have bipolar and anxiety as well.

    Michele

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