How to Manage School Refusal Behaviors

How to Manage School Refusal Behaviors (aka when ‘playing hooky’ becomes a serious situation)   

by Christina Walker, Psy.D., Site Director at Menlo-Atherton High School

“I don’t want to go to school today.”  Is there a parent who hasn’t heard this plaintive cry from a child or adolescent?  Children and teenagers can and will miss school because of illness, or because of family issues.  However, there are times when saying, “I don’t want to go to school today. I think I’m coming down with a Math test.” may be a more accurate reflection of a child or adolescent’s motivation for staying out of school.  Children and adolescents can produce highly convincing, Oscar worthy performances replete with a hand to the forehead, holding one’s stomach all while in a raspy voice describing a list of aches and pains that would prevent school attendance.  Can you recall Shel Silverstein’s poem Sick?  The intervention for the child’s long list of maladies keeping her from school was the prescription of ‘Saturday’, which can have amazingly miraculous effects on a plethora of aches and pains for children…as well as adults.   Some researchers (Evans, 2000) have actually noted that it is part of typical development to refuse school at least once during the school career.  However, the seemingly innocuous wish to stay home can quickly transform into a serious situation when a child refuses to go to school for extended periods of time.  This pattern of behavior is termed School refusal.

School refusal behavior is seen as a continuum that includes youths who always miss school as well as those who rarely miss school but attend under duress. Hence, school refusal behavior is identified in youths aged 5-17 years who:

  1. are entirely absent from school, and/or
  1. attend school initially but leave during the course of the school day, and/or
  2. go to school following crying, clinging, tantrums or other intense behavior problems, and/or
  3. exhibit unusual distress during school days that leads to pleas for future absenteeism.

(Taken from

Children with school refusal may complain of physical symptoms shortly before it is time to leave for school or repeatedly ask to visit the school nurse. Common physical symptoms include headaches, stomachaches, nausea, or diarrhea. Mornings can be rushed for families, and it can be difficult for parents to intervene.

Children and teenagers can begin to manifest symptoms of school refusal at points of transition. We will often see school refusal when a child is starting a new school.  It commonly takes place between the ages of five and six and between ten and eleven while entering middle and high school (Taken from September 28, 2011).  The onset of school refusal symptoms usually is gradual. Symptoms may begin after a holiday or illness. Some children have trouble going back to school after weekends or vacations.

As a parent, when you realize that your child is refusing school they are communicating something highly important to you.  They truly do not want to go to school and the distress is genuine.  The motivations or reasons for refusing school can be difficult to determine.  It may start out as difficulty with assignments, it may be peer problems, it may be anxiety; the reasons for school refusal behavior are as unique and varied as children and adolescents.  School refusal can be one of the most frustrating things to deal with as a parent.  It is at those times that a parent experiences the tenacity of their child.  The longer a child stays out of school, the more difficult it becomes to begin attending school.  This is why prompt action on the part of the parent, and working with the school is important.

What can you do?

  • Recognize the difference between playing hooky and school refusal; this can be a good time for a physical or a check-up to rule out any underlying medical issues
  • Connect  your child with a mental health counselor to begin to address the underlying reasons for refusing school; understanding the reasons behind the school refusal can help with treatment interventions and planning
  • Seek support for yourself whether from a partner, a friend, family member or a mental health counselor because parental motivation is a key to success in situations of school refusal
  • Maintain your child and adolescent in school, even simply stepping foot on the campus is a good start
  • Communicate with the appropriate school personnel, whether that is your child’s guidance counselor or administration
  • Help your child to identify ‘safe’ people on the campus whom they can talk to and seek support

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