School Refusal Symptoms & Causes

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In-Depth

School refusal is the third most common cause of children missing school.

  • Fifty percent of children with school refusal have other behavioral problems.
  • Twenty percent of parents who have a child with school refusal have a psychiatric problem.
  • There is usually a strong bond between the parent and child.
  • Children may be depressed.
  • School refusal is more common in girls than in boys.

What are the signs of school refusal?

Your child:

  • may complain of other symptoms (stomach ache, headache) that get better as soon as she is allowed to stay home
  • may tell you that she is anxious or afraid of a certain situation that happens at school
  • may not want to leave you because of a change in her life, such as the following:
    • new school
    • has just moved
    • new brother or sister
    • a sick brother, sister or parent
    • divorce
    • death in the family

Clinician Q&A

School refusal, which affects around 4 percent of school-aged children, can lead to long-term school absence and have serious consequences if left untreated. We spoke with Jayne Singer, PhD, clinical psychologist in Boston Children's Hospital's Developmental Medicine Center, to learn more.

Q: What should a parent do if her child refuses to go to school?

A: Treatment depends on the root cause, so moving quickly is crucial. A child who's afraid to leave her mother requires very different management than a child who has a phobia of a fire alarm. The longer the child is allowed to stay home, the harder it is for her to get back into the routine of feeling comfortable in school. So the sooner the root is identified and treated, the better.

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