How to help when your child doesn’t want to go to school

By Dr. Sarah Ruiz, a licensed pediatric psychologist at CHOC Hospital in Orange and CHOC Mission Hospital

Going to school is an important milestone in a child’s life. The ability to successfully navigate and progress through school has been connected to many positive outcomes for children. On the other hand, difficulty attending school, frequent absences, and dropping out of school has been shown to negatively affect a child’s school progress, as well as their peer and family relationships. School refusal can also result in truancy and legal proceedings through truancy court for caregivers. In the long run, school avoidance can even lead to challenges in adulthood, like low self-esteem.

Why is my child refusing school?

Difficulty attending school is more common when children are younger, improves during elementary school, then worsens during the middle school and high school years. Once your child refuses to go to school and is allowed to stay home, you may notice that a cycle may begin, where the child will avoid situations that make them feel nervous or stressed such as going to school, they then experience relief by staying home, and this, in turn, makes returning to school harder. There may be some other benefits to staying home, such as being able to spend more time with a caregiver or being able to do other things at home (for example, sleep in, play, etc.).

During the COVID-19 pandemic, school attendance, globally, was severely impacted, and school attendance has never returned to pre-pandemic levels. This may be in part due to remote or long-distance learning, which has allowed children to stay home. By staying home, children were able to avoid school and unintentionally entered into the cycle of avoidance.

There are many reasons why your child may be refusing school. Some reasons for refusing school can include:

1. Avoiding situations at school that are upsetting or stressful, such as violence or bullying at school
2. Avoiding social or school related situations, such as tests or talking to others
3. Seeking attention from people outside of school, such as wanting to be able to spend more time with caregivers (known as separation anxiety) or spending time with peers outside of school
4. Pursing activities outside of school, for example being able to sleep in or play at home

Some signs or changes in behavior you may be noticing include:

• Crying before school
• Headaches, stomach aches, or other aches and pain that occur before or at school
• Difficulty separating from parents at school, such as not wanting to get out of the car at school
• Frequent calls home during the school day requesting pick-up.
• Needing to be picked up from school frequently

How can I help my child?

Changing habits and helping your child go to school can take time, especially because there can be many complicated reasons for children refusing school. The best time to take steps to make a change is early! The road to being able to attend school can be a long one, and the sooner you seek out help the better. The good news is that you and your child can get a team of support together that includes the school, your child’s pediatrician, educational advocates and even mental health professionals.

If you suspect your child is experiencing school refusal, here are some examples of support you can seek:

1. Talk to your child’s pediatrician.

Your child’s pediatrician may be able to evaluate your child and help address any physical symptoms that may be happening (for example, headaches and nausea) as well as provide education and resources for further support.

The way to help with school refusal is by helping your child return to and stay in school. It can be hard and upsetting for your child, but it is important to not accidentally encourage avoiding school through doctor’s notes to excuse extended absences.

Additionally, resources like home-based learning, also known as home hospital or school approved homeschooling, may seem helpful for a child that doesn’t want to go to school, but these schooling methods may make it more difficult for your child to return to school in the long run.

2. Talk to your child’s school

Share your concerns with their teacher or teachers to learn if there are any concerns at school you may not be aware of, such as bullying, or falling behind in school.

• If you are concerned that your child’s anxiety or behavior is impacting their ability to attend school, you may also ask for an evaluation for a 504 plan or Individualized Education Plan (IEP).
  • This evaluation will help provide appropriate accommodation, or changes in the classroom, that may help your child. The process can be long and take many months to complete. To formally request an evaluation for a 504 plan or Individualized Education Plan (IEP), write a letter to the school district.
  • Once the school district receives the letter, they legally have 60 days to respond to the request and begin an evaluation to understand what accommodations or support your child may need.
  • For more information and a sample letter requesting an evaluation, please visit this article: Individualized Education Program (IEP) resources for caregivers – CHOC – Children’s health hub

3.Talk to an educational advocate

Feel like you need more support to navigate the school system or could use an ally? Organizations like TASK (taskca.org) help families of children with disabilities and special educational needs, and can provide guidance and support around IEPs, 504 plans, and assistive technology. TASK can offer one on one consultation with an advocate, resources, and can be helpful in navigating the school system.

4. Seek out support from a therapist

Working with an individual or family therapist can be helpful to support your child’s return to school. One form of therapy that may be helpful is cognitive-behavioral therapy (CBT) to help your child learn skills to manage their distress or anxiety when attending school.

A therapist will work closely with caregivers and the school to make sure your child is supported when they return to school. This may include a school re-entry plan that may include a special schedule as children gradually return to school, identifying support people at school (like a special teacher or counselor), and changes that need to be made at school (like changing class schedule or switching classrooms).

A therapist may also help support caregivers in making new routines and habits to help school attendance (for example, routines around sleep) and support caregivers when children don’t want to go to school (for example, use of rewards and praise as well as consequences).

Your child’s school may also have a school-based therapist who is able to provide support. One thing to consider is that it may be hard for your child to benefit from school-based mental health services if they are frequently absent and avoiding school.

You’ve got this!

It can be very stressful and hard when your child doesn’t want to go to school, but with support from a team, you can help your child attend school. Act fast if you have concerns about your child’s attendance so you can access the support your child needs to be successful in school.

Further reading/other resources

For more information about how to help your child with anxiety, visit Anxiety – CHOC – Children’s health hub). To help your child if you suspect they’re being bullied, visit Bullying – CHOC – Children’s health hub.

For school-aged kids:

• The “What to Do When” books help with school attendance worries and may be available at libraries or for purchase.
  
  • What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety
  • What to Do When You Don’t Want to Be Apart: A Kid’s Guide to Overcoming Separation Anxiety
  • What to Do When You Feel Too Shy: A Kid’s Guide to Overcoming Social Anxiety

For help with school accommodations and support:

• Individualized Education Program (IEP) resources for caregivers – CHOC – Children’s health hub
• TASK – Southern California’s Parent Training and Information Center. TASK specializes in special education support for people with disabilities from birth to age 26 and their families.  TASK provides emotional support and education to parents as they navigate special education systems and processes.

Orange County-based resources that can provide support through positive parenting skills:

• Triple P Online: www.triplep.online/oc
  • This online parenting program is provided free for Orange County residents for caregivers of children ages 0-16 and available in English, Spanish, and Arabic. This program teaches positive strategies to address child behaviors and support your relationship with your child, among other skills.
• BrightLife Kids: BrightLife Kids – A CalHope Program by Brightline
  • This is a free coaching program for caregivers in California providing personalized support for families with children ages 0–12. Topics covered via coaching include things like sleep issues, worry, social skills, and more.

Get more expert health advice delivered to your inbox monthly by subscribing to the KidsHealth newsletter here.