School Refusal

School refusal, school avoidance or school phobia are terms used to describe the signs or anxiety a school-aged child has and his or her refusal to go to school.

School refusal can be seen in three different types of situations, including:

Young Children Going to School for the First Time

This is a normal type of school refusal. This develops with a child's normal separation anxiety or uneasiness about leaving a parent figure. This type of fear usually goes away within a few days of the child attending school.


Older children may have school phobia based on a real fear of something that may happen to them at school, such as a bully or a teacher being rude. In this situation, it is important to talk with your child to determine what is causing his or her fears.


The final type of school refusal is seen in children who are truly distressed about leaving their parent and going to school. Usually, these children enjoy school but are too anxious about leaving their parents to attend.

  • 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.
  • The child may complain of physical symptoms (i.e., stomach ache, headache, chest pains) that get better as soon as the child is allowed to stay home
  • The child may tell you that he/she is anxious or afraid of a certain situation at school (i.e., bullying, learning problems or trouble getting along with a teacher or peers).  
  • The child may not want to leave the parent because of a change in the life of the child, such as:
    • New school
    • Just moved
    • New brother or sister
    • A sick brother, sister, or parent
    • Divorce
    • Death in the family
    • Separation anxiety

School refusal is usually diagnosed with a team approach, including your physician, you, the child, and teachers and counselors.

Your child's physician will be involved to rule out any medical problems that may be occurring. A complete history and physical examination will be done. School officials may be contacted to obtain more information.

Since every child is unique, each situation will be handled on an individual basis. 

  • Return the child to school. Make sure the school officials understand the situation and do not send the child home for the wrong reasons.
  • Consider family counseling if other problems exist.
  • Allow the child to speak and talk about his/her concerns and fears.
  • Slowly separating the parent from the child in school may also be used. One approach is to have the parent sit with the child in the classroom at first, and then the parent may attend school, but sit in another room. Next, the parent may continue to get farther away.
  • A referral to a child psychologist or psychiatrist may be necessary.

Last Updated 08/2013