Getting Help > Children & Teens > School Refusal or Avoidance

School Refusal or Avoidance
A child experiencing more than just "school jitters" usually refuses to go to school on a regular basis or has problems staying in school. This should not be confused with truant children who avoid school because they display antisocial behavior or delinquency.

School refusal or avoidance is often a symptom of a deeper problem, and if not treated it can have a negative effect on socialization skills, self-confidence, coping skills and, of course, education. Anxiety-based school refusal affects 2 to 5% of school-age children. It is common at times of transition, such as graduating from elementary school to middle school and from middle school to high school. Anxieties tend to differ among age groups, but these are the most common stressors:

The most common ages for school refusal are between five and six, and between ten and eleven. Children who suffer from school refusal tend to be average or above average in intelligence.

Their stress may come out in physical symptoms such as the following:

In addition to physical symptoms, they may exhibit behavioral symptoms:

Older children not only experience the stress that goes along with transition from one school to the next, but they have the added academic pressure in the higher grades when they begin to consider what their futures hold. These stresses may manifest themselves in an extreme preoccupation with appearance, sleeplessness, or rebellion. As with younger children, it is important that they remain in school, although they may fight it. Missing school reinforces anxiety rather than alleviating it.

There may be many fears related to school, but these are the most common:

Separation Anxiety Disorder
Many children experience separation anxiety between the ages of 18 months and three years old. It is normal for children to feel somewhat anxious when a parent leaves the room or goes out of sight, and they can usually be distracted. Crying at being left at daycare or preschool is also common, and it usually subsides when children become engaged in their surroundings.

Most four-year-olds are able to leave their parents. If not, they may have separation anxiety disorder, which affects approximately 4% of children. Onset can occur any time before age 18, but it is quite common in children between seven and nine.

Children who have this disorder experience extreme anxiety away from home or when separated from parents or other caregivers. Their desire to be in contact with missed persons is excessive, and they often have extreme homesickness and feelings of misery. It is also common for these children to have fears regarding the health and safety of their parents.

Children suffering from separation anxiety disorder may exhibit the following behavior: