Mother: It’s quite shocking to me, my four-year-old kid joined us in our prayer routine, and I heard him saying…please God make my life easy. I don’t want to go to school…Show me some way… I will be a good boy.
Therapist: I see.. Is there any difficulty you are facing with him?
Mother: A lot of them actually. He cries every day in the morning before leaving for school; he requests me not to send him to school. I tried to dig but he remains scared all the time. I see there is a lot of resistant… I am really worried… It’s been more than a year …
Therapist: I see you are distressed
Well as a parent it is worrisome if your child misses school frequently. Mostly children take leave of absence from school for legitimate reasons however there are few who refuse to go to school but have no reasonable or justifiable circumstances for the absence. We use a number of terms for problematic absenteeism such as school refusal, school phobia, truancy, separation anxiety or dropping out.
Christopher Kearney, a professor, at the University of Nevada, Las Vegas, proposed that the most appropriate term that covers problematic absenteeism under one heading is school refusal. He defined school refusal as a collection of behaviors along a continuum which includes:
- Complete absence from the school.
- Leaving school in the middle of the day.
- Attending school for all or part of the day, but only after showing a behavioral tantrum at home or on the way to school (tantrum, vomiting, etc.) .
- Displaying unusual distress during the school day.
- Plead for non-attendance or create excuses to go home.
Mother: Yes, I get it. I remember visiting my grandma’s house when I was in 5th grade during summer vacation after which I had difficulty in attending school. But it did get resolve on its own within a few weeks. But with my son it’s been more than a year! I really want to help my child.
Therapist: I understand your concerns…regarding your child’s difficulties…To answer some of them …
Every child has a brief period in their life when attending school becomes emotionally overwhelming. This might get resolve on its own within a few days without any help. However, sometimes the problematic absenteeism persists for a longer period of time.
Children find it difficult to verbalize what is making them uncomfortable. Thus, behavior becomes an important source of information. School refusers may frequently complaint of:
- Dizziness, abdominal pain, back pain, joint pain, headaches, shakiness/trembling, palpitations and chest pains.
- Nausea, Vomiting, and diarrhea usually during the morning hours.
- Crying episodes, temper tantrums, in the morning which improves if the child stays home.
So if school refusal persists for more than a year and behavior becomes highly disruptive; it signals that the child needs help.
Mother: Why he does this? I don’t understand it all.
Therapist: It’s okay to feel this way…. Let me help you understand human behavior in a more comprehensive way…
All human behavior adaptive or maladaptive is supposed to serve some purpose. Broadly speaking school refusal can serve two important functions for a child –
- Avoid some negative event
A child may not want to go to school because of various negative events.
Bullying could be one. Bullying is usually seen among school children in whom one person usually more powerful might hurt or frighten someone smaller or less powerful, often forcing that person to do something they do not want to do. In such vulnerable circumstances school refusal may become an active strategy to avoid threat. Further, a child might refuse to go school due to a negative school/classroom climate/environment, unpleasant teachers (e.g., fear of the teacher and/or a lack of teachers’ support) etc.
Other reason could be to avoid social situations that provoke anxiety such as interactions with peers, extracurricular activities, speaking before the classmates , being called on in class, performance classes (i.e., physical education, music, etc.), or writing exams and receiving exam results.
School refusal could also be a sign of underlying depression, generalized anxiety disorder, specific phobia, social phobia and separation anxiety disorder. To add, research has shown those who avoid school are more prone to long-term emotional issues and psychiatric disorders such as depression and anxiety, poor academic achievement, dropping out of school, substance abuse and suicide.
- Increase Positive Outcomes
Sometimes school refusal is motivated by a desire to gain something positive and pleasing such as extra sleeping hours, screen time, television, video games, friends, day parties, the mall, etc.
Mother: Now that I know…What should be the next step?
Therapist: I am glad to see you wanting to help your child…
School refusal brings a lot of distress to the parents. One reminder that can bring relief to anxious parents is that school refusal is a manifestation of psychological distress and not a sign of physical illness. Therefore, the treatment requires individual intervention with the child, parental skills training as well as some changes in the child’s immediate environment. The overall goal is to increase attendance and decrease absenteeism.
Some of the tips that could help struggling parents at the initial stage are as follows:
Being non-judgmental
Remind yourself it’s not the child’s fault. His behavior is a product of series of emotional, social and environmental factors. Allow your child a non-judgmental space where he/she can talk freely. One way to do this is by sharing your own routines and difficulties with them. Be open. Avoid being harsh, rude and critical.
Follow a time table
Children learn what they observe. Establish a regular morning, daytime, and evening routine for your own self and the school-refusing child.
Encourage
Encourage your child for attending school by providing rewards (a candy, stars, smileys, hug etc.). Discourage non-attendance by withdrawing some pleasant stimuli from that day routine (For example, taking away playtime, cutting down TV time etc.)
Be Aware of ATTENTION- SEEKING Behavior
Avoid being overly attentive to the child’s tantrums and crying when going to school. This only feeds his/her anxiety and becomes a tool of getting the attention he/she wants.
Increase Support
Let the child sit with his friends in the classroom. Parents of younger children can accompany them to school and sit with them. Then gradually phase the parent out of the classroom through successive approximations. Let the child bring loved objects to school such as a toy or a cushion.
Keep a Record
It’s always good to keep a record of absenteeism and disruptive behavior. If the problem persists for a longer period of time and behavior becomes highly disruptive, seek professional help.
Lastly, do not forget to take care of yourself in the process. You deserve the same love and care that you readily and unconditionally give to your children.
Please remember school refusal is not a disorder but a behavioral issue which demands mental health care. Therefore, it becomes necessary to get your child assessed with behavioral experts such as ABA therapists, psychologists, clinical psychologists and counselors so that a thorough assessment could be initiated, and effective intervention could be planned at the earliest.
Wishing you the best of mental health today and always!
Huda Naaz
Apala Aggarwal Tuteja