Category Archives: Refuse

School Refusal and Anxiety in Children

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Many parents feel helpless when their child refuses to attend or stay in school. School refusal is an anxiety disorder where your child can feel a real sense of anguish, uneasiness, fear and a sense of danger associated with school. Two to five percent of children will be hindered by this affliction, but it is most common among those aged five, six, ten and eleven. Luckily effective ways of dealing with it exist. Since prevention is usually the best line of defense we will discuss some of the common risk factors. I will also mention a few tips you can use to reverse the situation once it has started.

Personal experiences have an influence on the desire to attend school. Luckily, we can narrow down the most influential environmental factors that have been proven to contribute to this problem: homelessness/poverty, teenage pregnancy, school-violence, lack of connectedness, parental involvement and family variables. These forces do not develop in isolation; they feed off of each other. Poverty can lead to stress; the stress can come from a number of issues like unemployment and inflexible, long work hours. This can have a harmful impact on parental and family involvement. A lack of involvement, especially from the father is also associated with teenage pregnancy. Parent and family involvement helps children become resilient. Resiliency helps them develop the ability to recover from life’s inevitable setbacks. When this is not in place children are less able to take risks and overcome challenges such as violent or unsupportive environments. If a child cannot devise ways of coping with these harsh situations, he or she will naturally avoid them. It can seem like a self-defeating cycle.

Most parents have already worked hard to correct or prevent the influential factors mentioned above. I listed them to make you aware that if these conditions are present, you may have to pay a little more attention to your child’s behaviors. One important consideration is your child’s proneness to feelings of anxiety. Anxiety is at the root of why most children avoid school. Examples of what causes students anxiety are: separation from their parents, bullying and fear of not performing well in school. These negative feelings are often expressed physically through stomach aches, headaches, diarrhea and nausea. In addition, you might notice behaviors such as asking to stay home, disobedience, rigidity, tantrums, seclusion and avoidance. It is important not to minimize or get angry with your child over the symptoms that you see and hear.

This is difficult to do because it is frustrating to see your child behaving in a self-destructive way. In addition dealing with it requires time that parents very frequently had not planned for. In order to make that time effective try to remember some of the most common reasons students give for feeling anxiety over school: bullying, under-performance and separation anxiety. Furthermore, try to remember that admitting anxiety or fears is often considered a weakness and can be embarrassing to many people. Few of us are or were ever comfortable admitting anxiety or victimization. To open the lines of communication it is crucial to offer sincere help, understanding and curiosity for what your child is experiencing. Regardless of how unreasonable an explanation might be to you try to accept it and work to address it. When working with students, I keep in mind that it is extremely difficult to understand and empathize with what others are feeling especially when the source of fear is irrational to us. It is important to remember that functional adults have illogical fears too; many yell, run or scream when they see a water-bug or mouse 1/100000th their weight.

School refusal is an anxiety disorder, and as a result you have to accept that your child’s feelings truly are hindering rational thoughts and behaviors. Determining whether your son or daughter has an anxiety disorder is not your job as a parent. You should carefully observe all behaviors that seem unhealthy to you and communicate with the school regarding absences. If the problem persists for more than four weeks seek professional help from a therapist. The therapist can administer different techniques such as operant conditioning, which involves rewarding, and or exposure therapy. They might also teach relaxation techniques like breathing as well as positive thinking. The therapist can in addition conduct a comprehensive mental evaluation to determine the true cause of the problem. Depending on the therapist’s assessment, the problem could be deemed to be primarily environmental like the causes described earlier or medical.

If the problem seems to be medical, the child may be referred to a psychiatrist. He or she will assess your child further and may introduce pharmacotherapy (drug treatments). Studies have shown pharmacotherapy can be useful when the reason for school refusal is anxiety or depression. However, before taking this crucial step, there are several other tools parents can try. Here are six ideas.

  1. Take morning practice runs weeks before school starts. The hope will be that they will be trained to get up and prepared for school sooner.
  2. Talk to him or her about any fears and feeling they may have towards school. It might help if you talk about your own fears about school and now at work. If you take this approach be careful not to redirect the conversation to yourself.
  3. Help your child connect with others in the school such as teachers and students. They will be an additional source of support outside of the home.
  4. Encourage him or her to participate in extra-curricular activities such as clubs or sports.
  5. Remind your child that other kids are shy too. The shyness is something they can use to connect with other students.
  6. Help them develop friendships by teaching them how to give appropriate compliments regularly. Warn them that good friends do not keep score or tallies of deeds done. Furthermore, remind them that people want to be friends with other people who know when to apologize, forgive and be polite.

These life skills will help your child build connections with others. They will make school a more enjoyable experience, in many cases.

Perhaps most importantly work with your school counselor. The school counselor is trained to provide support in academic, career, college access, and personal/social competencies.He or she should be your liaison to the entire school. Students need to know that adults in a school care, whether or not they attend class and whether they succeed. In addition to emotional support school counselors are prepared with resources to help your child overcome fears of performance and can help him or her improve performance. If the issue is bullying, the counselors will also work with the school’s dean to address disciplinary or safety issues that need to be dealt with.


How to Stop School Refusal

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Everyday, in cities around the world, 1 to 4 children will not go to school. Not because they are ill, or a death in the family, but simply because they refuse to go. Reasons can be as varied as a test the child did not prepare for, or a blemish on the skin. School phobia, or “school refusal is an serious and recognized anxiety disorder. Astonishingly, this disorder is more common than some better known child disorders such as ADHD or autism. Children are vague in their complaints and have a hard time trying to verbalize what is making them refuse to go to school. It is usually dismissed as misbehavior. It’s important as a parent to recognize school refusal, because it can stunt your child’s education.

Christopher Kearney, Ph.D., a director of the UNLV Child School Refusal and Anxiety Disorders Clinic says, “You need to look at whether it’s affecting the child or family’s daily functioning,” in order to draw the line between normal or not. If grades are slipping, or a parent is in jeopardy of losing a job from frequent absences, its time to take action. Kearney also says that parents should pay close attention to their children who refuse to go to school for vague reasons such as stomach aches or other mysterious pains. If other general complaints are combined with school refusal, then this can also be a sign to take a closer look for any issues arising at school.

Kearny also states, “There is a subtle difference between school refusal and school refusal behavior.” Children who skip school to play with their friends are exhibiting school refusal behavior, which can be as innocuous as a just trying to fit in or a sense of rebellion. However, a screaming child grasping at a mother’s leg refusing to leave the car is showing signs of school refusal.

The following are some ways to stop school refusal:

– Look into what the problem is at school. If its bullying, then things need a closer look. If your child’s complaint is a valid one, then parents need to work with your child around the issue, at home and at school.

– Reward the child when they go to school. This might be extra video game time or even a special trip on the weekend. Positive reinforcement is more effective than punishing the child for not going to school.

– Work with the school to find out what the problem is. This might even be asking the school for permission to observer what is happening at school, or for the teacher to pay closer attention to the child.

– Set goals for going to school. If the child can at least go to a school for a hour, or go and sit in the lobby, its better than just staying at home.

– Make home life boring. If the child gets to sit around and play video games instead of going to school, then school refusal is a rewarded. Set some boundaries so that the kid will have more reason to go to school.


Children With School Refusal Behaviour

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School refusal stems from emotional distress and anxiety which could be related to a range of issues either at home, school or both. A recent study reveals that 1 in 5 British children experience phobia or school refusal which has shown to be more prevalent in children’s age groups aged 5 – 6 and 10 – 11 years.

The research also revealed that many parents were not aware of the conditions and those who were aware of it, experienced a major lack of information.

School refusal does and can bring about a range of physical challenges and symptoms for the child or young person and these include:

– stomach aches

– vomiting

– headaches

– trembling

– joint pains

From a behavioural perspective, the symptoms show up as: tantrums, threats of self harm, crying or angry outbursts. These symptoms are likely to subside once the child feels safe and secure, generally in the home environment and/or once they’ve been allowed to stay at home.

School refusal may be triggered by a number of reasons, children of any age may be refusing to go to school for fear of losing their last remaining parent (or main care giver). Their parents may have separated or they might be a bereaved child and the fear of even more loss, keeps them at home and in a ‘protective role’ and with separation anxiety.

As well as anxiety, other stress related situations at home, school or with peers may also be a trigger for school refusal.

From an emotional perspective, symptoms of school refusal include panic attacks, fearfulness, depression and occurs with both genders.

One of my sons had a change of primary schools and the new primary school that he moved to was a trigger for his school refusal right from the first day of school.

He was evidently emotionally distressed by going to that school, was crying and wouldn’t get dressed in the mornings. He said that the school was too big, which I didn’t understand but his deep reaction and distress to attending that school was more than enough for me to take heed. Within a week he had moved yet again to another primary school and was evidently happier, brighter with smiles all round, which brought about the swift end to his short-lived school refusal.

School refusal and a range of other behaviours from children and young people is merely a form of communication that something is not right. This calls for school staff and parents to look more closely at what is not being said. What is their behaviour telling you?

There is always a reason for children’s behaviour and it is invaluable piece of communication for adults.

How Can You Help Children With School Refusal Behaviour?

Doctors, Parents, Educators, and other professionals can all assist in supporting a child or young person back to school, individually or as a team.

Some ways of helping include:

  1. Identify whether the behaviour relates to school refusal for reasons such as those above or whether it relates to truancy. The distinction between the two generally lies on the child’s focus and/or interest in their school work once their anxiety or fear of school attendance and other related symptoms have subsided. That is, how do they behave once they feel safe and secure at home? Do they focus on their school work or is there a total dis-interest and general negative attitude towards school? Another distinction is the extent of their emotional distress relating to attending school versus being indifferent about school attendance.
  2. Explore best possible options of moving the child towards re-entering the school environment as quickly as possible, yet in a supportive manner. This could include making changes, where possible, to conditions at home which might be triggering the school refusal and engendering collaborative approach between parents, doctor, school and mental health professional/therapist. As some of the presenting symptoms are physical, it is important to involve physicians who may also be able to make referrals to relevant therapists.
  3. Research has shown cognitive behaviour therapy to be particularly beneficial and successful in helping pupils to manage their mindsets, depression and returning to school.
  4. Parental involvement to improve school attendance has also shown to be helpful.
  5. Undertake proper preparation at school for the pupil to be re-integrated and positively supported back into the normal school environment
  6. Foster on-going parent-school communication, collaboration and joint support of the child.
  7. Planned, gradual, assisted exposure to the school environment
  8. Relaxation remedies including visualisation.
  9. Positive reinforcements relating to school environment and attendance.