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School Refusal

Going to school usually is an exciting, enjoyable event for young children. For some it brings intense fear or panic. Parents should be concerned if their child regularly complains about feeling sick or asks to stay home from school with minor physical complaints. Not wanting to go to school may occur at anytime, but is most common in children 5-7 and 11-14, times when children are dealing with the new challenges of elementary and middle school. These children may suffer from a paralyzing fear of leaving the safety of their parents and home. The child’s panic and refusal to go to school is very difficult for parents to cope with, but these fears and behavior can be treated successfully, with professional help.

obj642geo477pg41p29Refusal to go to school often begins following a period at home in which the child has become closer to the parent, such as a summer vacation, a holiday break, or a brief illness. It also may follow a stressful occurrence, such as the death of a pet or relative, a change in schools, or a move to a new neighborhood.  The child may complain of a headache, sore throat, or stomachache shortly before it is time to leave for school. The illness subsides after the child is allowed to stay home, only to reappear the next morning before school. In some cases the child may simply refuse to leave the house. Since the panic comes from leaving home, frequently the child is calm once in school.

Children with an unreasonable fear of school may:

  • feel unsafe staying in a room by themselves
  • display clinging behavior
  • display excessive worry and fear about parents or about harm to themselves
  • shadow the mother or father around the house
  • have difficulty going to sleep and/or have nightmares
  • have exaggerated, unrealistic fears of animals, monster, burglars
  • fear being alone in the dark, or
  • have severe tantrums when forced to go to school

Such symptoms and behaviors are common among children with separation anxiety disorder. The potential long-term effects (anxiety and panic disorder as an adult) are serious for a child who has persistent separation anxiety and does not receive professional assistance. The child may also develop serious educational or social problems if their fears and anxiety keep them away from school and friends for an extended period of time.

When fears persist the parents and child should consult with a qualified mental health professional, who will work with them to develop a plan to immediately return the child to school and other activities. Refusal to go to school in the older child or adolescent is generally a more serious illness, and often requires more intensive treatment.  Excessive fears and panic about leaving home/parents and going to school can be successfully treated.

Facts for Families© information sheets are developed, owned and distributed by the American Academy of Child and Adolescent Psychiatry (AACAP).