A Parent’s Guide to School Refusal and What to Do

Published August 22, 2025


“When your child refuses to go to school, it can feel frustrating and overwhelming—especially in a busy household. I always try to remind parents though that school refusal can often be more than just defiance; it can be a warning sign that something deeper is happening.”
Dr. Mary Perleoni, PhD, LMHC


As a parent, you know mornings can be chaotic, but when your child cries, complains of stomachaches, or flat-out refuses to go to school, it can feel overwhelming and isolating. This isn't just "laziness" or "bad behavior"; it's often school refusal, an issue rooted in anxiety, depression, or other emotional factors. At It Begins Within, we support families like yours every day, helping children regain confidence, overcome social anxiety, and manage confusing emotions.

If you're searching for "school refusal in children" or "how to help a child who refuses school," this guide provides evidence-based insights, practical tips, and when to seek professional help. Remember, early intervention can make a big difference. If you are in the Tampa, St. Petersburg or Sarasota area, contact us for a free consultation if this resonates.


What Is School Refusal?

School refusal (also called school avoidance) involves a child's persistent reluctance or refusal to attend school, often due to emotional distress rather than defiance. Unlike truancy (skipping for fun or rebellion), school refusal is typically linked to fear or overwhelm. Symptoms include physical complaints (e.g., headaches, nausea), emotional outbursts, or avoidance behaviors like hiding.

Recent research indicates school refusal affects up to 5% of school-aged children across the country, with indications that rates are potentially higher post-pandemic. In some regions, like Australia, over one-third of parents reported dealing with it in the past year. While school refusal is not a diagnosis, it is a behavior often tied to underlying conditions.


When Does School Refusal Usually Start?

School refusal can emerge at any age but spikes during transitions:

  • Early elementary (ages 5-7): Starting kindergarten or first grade.

  • Middle school (ages 10-13): Shifting to a new environment with more social pressures.

  • High school (ages 14-18): Heightened academic demands, peer issues, or identity struggles.

These align with developmental milestones, where anxiety about separation, performance, or social dynamics intensifies. Post-2020, rates have risen by up to 50% in some areas due to pandemic disruptions like remote learning and social isolation.


Causes of School Refusal

Understanding the "why" is key. Common triggers include:

  • Anxiety Disorders: Separation anxiety, social anxiety, or generalized worry about school events.

  • Depression or Burnout: Low mood leading to apathy or overwhelm.

  • Bullying or Social Issues: Fear of peers, rejection, or conflicts.

  • Learning Challenges: Undiagnosed ADHD, dyslexia, or academic stress.

  • Family Factors: Home stressors like divorce, illness, or inconsistent routines.

  • Other: Trauma, neurodiversity (e.g., autism spectrum), or physical health mimicking symptoms.



How School Refusal Differs by Age

Symptoms and causes evolve with age. Here's a breakdown:

Elementary School (Ages 5-10)

  • Symptoms: Clinginess, morning tantrums, "tummy aches," or refusal to dress.

  • Causes: Often separation anxiety or bullying; learning disorders may emerge.

  • Common Diagnoses: Separation Anxiety Disorder, Generalized Anxiety Disorder (GAD), Specific Learning Disorders.

  • Parent Tips: Create consistent routines. If physical symptoms persist without medical cause, explore emotional roots. Avoid reinforcing avoidance by letting them stay home.

Middle School (Ages 11-13)

  • Symptoms: Vague illnesses, social withdrawal, academic dips, or skipping after conflicts.

  • Causes: Social anxiety, self-consciousness, or intensified bullying/academics.

  • Common Diagnoses: Social Anxiety Disorder, GAD, ADHD, Early-Onset Depression.

  • Parent Tips: Listen without judgment; involve school counselors. Therapies like CBT or DBT for Adolescents are highly effective here.

High School (Ages 14-18)

  • Symptoms: Chronic absences, tardiness, irritability, or isolation.

  • Causes: Depression, panic attacks, perfectionism, or college pressures.

  • Common Diagnoses: Major Depressive Disorder, Panic Disorder, Social Anxiety, sometimes Oppositional Defiant Disorder.

  • Parent Tips: Approach calmly; encourage gradual return. Pair with therapy and check for deeper issues like trauma.


Parent Strategies for Helping Kids Who Refuse School

Many parents feel concerned ("My child is hurting, but how do I help?") or frustrated ("Mornings are battles"). Both are valid—school refusal drains families emotionally. Recognize it's a symptom, not willful defiance. At our clinic, we've seen families transform through collaborative support.

What Parents Can Do Right Away

  1. Rule Out Medical Issues: Visit a pediatrician to exclude physical causes.

  2. Track Patterns: Note triggers (e.g., weekdays vs. weekends, specific classes).

  3. Communicate Openly: Ask, "What feels hardest about school?" to build trust.

  4. Partner with School: Share insights with teachers or psychologists for accommodations.

  5. Seek Professional Help Early: Therapy within weeks improves outcomes dramatically.


Why Diagnosis and Treatment Matter

A proper diagnosis guides effective interventions:

  • Anxiety: Cognitive Behavioral Therapy (CBT) and exposure techniques to build resilience.

  • Depression: Therapy plus possible medication evaluation.

  • ADHD/Learning Issues: Executive function coaching and school supports.

  • Bullying/Trauma: Trauma-informed care and school advocacy.

At It Begins Within, we use evidence-based approaches like those from Dr. Kearney's functional model, aligning parents, schools, and therapists.

Commonly Asked Questions About School Refusal

How do I know if this is just a normal adolescent challenge or something more serious?

It’s normal for kids (especially teens) to push back against routines or complain about school. The difference is in persistence and impact. If your child’s refusal lasts more than a few days, causes significant distress, or leads to frequent absences, it’s likely more than a typical phase. School refusal is often tied to anxiety, depression, or bullying and deserves attention sooner rather than later.

How long should I wait before intervening?

The short answer is don’t wait too long. Research shows that the longer school refusal goes unaddressed, the harder it becomes to resolve. If your child misses more than a few consecutive days, or if morning battles are escalating, it’s a sign to step in. Early intervention, whether through school collaboration or therapy, leads to much better outcomes.

What if my child won’t open up and talk to me?

Many kids, especially teens, struggle to explain why school feels so overwhelming. Avoid pushing or lecturing, which can shut them down further. Instead, try open-ended prompts like, “What part of the day feels hardest for you?” Sometimes kids open up more to a neutral third party, such as a therapist. Professional support can help them put words to feelings they can’t yet express.

Will this just resolve on its own?

Occasional reluctance to go to school often passes, but true school refusal rarely goes away without support. Hoping your child will “grow out of it” can lead to extended absences, worsening anxiety, and falling behind academically and socially. Early, intervention is the best way to help your child return to school with confidence.

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