By Clinical Psychologist, Danielle Corbett
“I’ve got a really bad headache and I can’t concentrate, you don’t know how bad it is, you’re not me!”
“It’s only sports today, I might as well stay home”
“My stomach hurts, I can’t eat breakfast, maybe I shouldn’t go to school”
“I’ve got assignments to catch up on, I can get more done at home”
If you have heard these phrases more than once, you may have a potential school refuser on your hands.
Understanding School Refusal in older children and adolescents
School refusal is when a child refuses to go to school on a regular basis or has problems staying in school.
Recognising the Symptoms
Children with school refusal frequently complain of unexpected physical symptoms before it is time to leave for school or may repeatedly ask to go to the sick room at school. If the child is allowed to stay at home, the symptoms disappear until the next morning. In some cases the child may refuse to leave the house or be unable to leave the car once at school. Common physical symptoms include headaches, stomachaches, nausea, and diarrhea. Parents should also look out for sleep problems and tantrums.
Early warning signs that parents should look out for include: frequent complaints about attending school, absences on significant days (tests, carnivals), frequent requests to go home during the school day, excessive worrying about a parent when at school, frequent requests to go to the sick room because of physical complaints, and crying about wanting to go home.
Reasons for School Refusal
The reasons for school refusal can vary, however school refusal tends to be about avoiding something unpleasant.
School Refusal = Fear/Anxiety + Avoidance
Sometimes, resistance to attending school is a blip on the radar. Such resistance is common after a legitimate period of illness creating difficulty getting back to school. The young person may be anxious about all the work they have missed. It this scenario, it’s really important not to prolong time at home. Parents can take control by contacting the teacher and negotiating a back to school plan. Similarly, young people can experience blips of anxiety after holidays, especially the long summer break. Other stressors or illnesses within the family can cause school refusal as can academic problems, difficulty with a teacher, changing schools or transitioning to high school.
Reasons requiring further assessment include:
Separation Anxiety: where the child fears that harm will come to their parent while they are at school.
Performance Anxiety: where the child fears taking tests, giving a speech, athletic/swimming carnival, physical education class, or even answering a question in class. Kids with anxiety about performance fear being embarrassed in front of their peers.
Social Anxiety: some students worry about interactions with peers and/or teachers.
Bullying: children want to avoid school because of the real threat of physical and/or emotional harm.
Tips for Parents for managing School Refusal
School refusal tends to be very stressful for parents as they battle their child’s anxiety about attending school. It can be exhausting to face the daily battle and many parents understandably allow the child to stay at home and do their school work, unknowingly making it more difficult to return the next day. Parents have more control than they think and can try the following in order to assist their children. Make a plan to be clear, calm, and consistent.
Send a clear message about school attendance
It should be clear to the young person that the parental expectation is that they attend school all day, every day. Parents can display this by saying: We will do whatever we need to do in order to get you to school; we cannot allow you to stay at home. You have five minutes to get ready for school.
Try not to take your child’s anxiety and respond to it
Sometimes parents can inadvertently get stuck in a battle with the young person’s anxiety. For example parents may ask if their child is going to school today, they may try and reassure that there’s nothing to worry about. Parents may become frustrated and say things like, why are you doing this you’re upsetting everyone, or we don’t know what to do if you won’t go. Responding to your child’s anxiety just makes it more likely that the child will engage in the same problem behaviours in the future. It can sometimes be helpful to identify for your child that their feelings are controlling their behaviour. You can say, “Your feelings are controlling you at the moment, but they cannot control me”.
Manage the morning routine
Try to ensure that your child knows what is expected of them in the morning and keep the routing consistent to eliminate extra last minute stress.
Ignore problem behaviour
If you are sure that the child is well enough to go to school, and then ignore complaints about sickness. Make sure that the child has seen your GP to eliminate any physical cause for their distress. Treat headaches and stomach aches with paracetamol and send the child to school. Plan to ignore any crying or begging.
Show the child through your behaviour that going to school is something that you can manage, and so can your child.
Communicate with the school
Talk to your child’s teacher and guidance officer, and enlist support to make sure that your child has the assistance they need to negotiate the school day. This united plan is also important for the child to feel confident that they can tackle their fears.
Escort to school
I find that once school refusal has become a problem, a really useful step is to have the parents take the young person to school every day. We all tend to lead busy lives, but this short term commitment from parents can lead to huge gains and is really worth the juggle. Importantly, don’t stay at school or allow calls and texts during the day. You want to model confidence.
Encourage anxiety management
You can encourage your child to be well rested, with adequate nutrition on board. Exercise is a great stress buster so a morning walk, run, swim, shooting hoops etc can be useful. You can encourage your child to take deep, slow breaths. Some like to imagine peaceful scenes and some like to listen to music. Distraction is another great way to manage anxiety so that your child’s attention is not focused of their worries. Have your child doing things they enjoy to keep their minds busy.
The reasons for school refusal are varied. The longer a young person is able to avoid school, the more difficult it can become to treat so it’s really important to identify and intervene early. A Clinical Psychologist can help to identify the reasons for school refusal and develop a plan for returning to school with the family and school.
Danielle Corbett is a Clinical Psychologist with 15 years of professional experience. She has spent most of her career working with adolescents with severe, complex, and persistent mental health problems and has presented her work at national conferences and has also been a guest lecturer at The University of Queensland. She also enjoys working with children and adults and has specialised training and experience in the area of parenting skills, trauma, eating disorders, self harming behaviours, substance abuse, depression and anxiety disorders. Danielle works from Newmarket on Wednesdays and Thursdays.
For more information on Danielle Corbett and our team of Psychologists visit our website www.psychologyconsultants.com.au