School refusal (also referred to as school avoidance) is a repeated pattern of behavior that occurs when a child resists attending school or a specific class for a period of time. Oftentimes, the pattern begins with consistently arriving at school late or leaving early, which, if not addressed at that stage, can develop into refusing to attend school for entire days. School refusal is frequently driven by anxiety. It is essentially a physiological response to a perceived threat. This response can lead children to avoid situations that feel overwhelming or distressing.

While school refusal is not limited to students with learning challenges, kids with ADHD and LD, as well as other neurotypical learners, are among the growing group of students who refuse to attend school to the point where it affects their academic development and social-emotional well-being.

Diverse Learners & School Refusal

To understand the challenges that diverse learners face at school is to realize why many of them find school an unsettling place to be. For children with ADHD who experience difficulties with attention, organization, and impulse control, the school day is filled with challenges in the classroom, the cafeteria, the hallways, and on the playing fields. Their ongoing struggles may lead to feelings of frustration, anxiety, or low self-esteem, which can increase the likelihood of refusing a part of the school day or all of it.

Likewise, school refusal is often seen in children with learning disorders, such as dyslexia, dysgraphia, or dyscalculia, as these students may struggle with academic tasks that their peers find manageable. Without the proper support through an IEP or 504 Plan, they are left to navigate learning concepts that come more easily to their peers. With time, this can impact their self-esteem and how they feel about school. As a result, these students may avoid school to escape these negative experiences, which can further impact their academic progress and emotional well-being.

While school refusal is not a new phenomenon, it has become more prevalent since 2020, in part as an unintended consequence of the COVID pandemic. Before 2020, most students did not have the option to enroll in school-based instruction from home. But with the pandemic, many schools closed their doors and replaced in-person learning with alternatives, including hybrid and remote learning. That’s when today’s students became aware of alternative educational settings that enable them to avoid anxiety-provoking situations. We’ve since learned that learning from home may provide short-term relief, but it often reinforces anxiety over time, ultimately making a return to in-person learning more difficult.

How to Help a Refusing Child

1. Collaborate with your child’s school! The school shares your goal to get your child back into the learning environment and help them to feel safe and supported!
2. Ensure your child feels connected and supported at school. Keeping connection points alive at school will make the transition easier when they do return to in-person learning. This can be an administrative staff member, a teacher, or a faculty member. A positive relationship can help to facilitate the transition into the building and act as a reminder to the student that they are a valued member of the school community.
3. The home environment should mirror school during the daytime. Make sure that the home environment does not accidentally reinforce staying home. To do that, ensure that your child is waking up and going to bed at the same time on school nights. Also, limit access to preferred activities, like television, electronics, the internet, friends, and video games. Instead, your child should be engaging in school activities, like making up class assignments.
4. Make their morning routine as simple as possible. Complete tasks like making lunches, packing bags, and laying out an outfit the night before to set your child up for success in the morning. This will reduce the morning rush and help to start the day smoothly. Routine helps to ease anxiety!
5. Ask for help. Cognitive behavioral therapy (CBT) or another evidence-based, thought-focused therapy can help address the underlying reasons your child is avoiding school. Pairing child therapy with a parent-based approach, such as SPACE (Supportive Parenting for Anxious Childhood Emotions), may further strengthen outcomes.

What to Look For

The signs of school refusal vary by child, but common indicators include the following:

• Noticeable mood changes, particularly as the weekend ends. (e.g., irritability or distress on Sundays)
• Avoiding talking about school or specific classes.
• Age atypical behaviors such as excessive clinging, hiding behind a caregiver, tearing up at the prospect of separation, or refusing to exit the car at school drop off
• Physical complaints such as headaches, stomachaches, nausea, or vomiting without a medical cause.
• Over time, patterns may emerge, such as increasing absences or tardiness, frequent visits to the school nurse, and spending more time out of the classroom

Dr. Erin Micali is a clinical neuropsychologist at Sasco River Center in Darien, CT, who specializes in pediatrics. Her focus areas include neurodevelopmental disorders and early childhood evaluations.