Online Parent Support Chat

10.3.07

School Refusal


My son is 16 years old and refuses to go to school. He demonstrates all the symptoms and behavioral signs of school avoidance/ social phobia. I have held incentives during the day and he becomes very angry and disrespectful. He has overriding anxiety as well as some depression and is being medicated for the same.

In the evenings, he demonstrates normal behaviour, ventures out with friends. He has been an exceptional student of math and science until this behavior became worse this past November.

I had the school counsellor visit him in the house yesterday and he promised to go to school this am. He has not done so and is still in bed this am. He plans to go to a sleep-over tonight. We have informed him that will not be possible if he does not go to school today.

Would appreciate any other suggestions to get him back to school.

M.

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Parent-teacher interventions include clinical sessions with parents and consultation with school personnel. Parents are given behavior-management strategies such as escorting the child to school, providing positive reinforcement for school attendance, and decreasing positive reinforcement for staying home (e.g., watching television while home from school). Parents also benefit from cognitive training to help reduce their own anxiety and understand their role in helping their children make effective changes. School consultation involves specific recommendations to school staff to prepare for the child's return, use of positive reinforcement, and academic, social, and emotional accommodations.


Parents or other caregivers can do several things to control school refusal before it becomes a routine, troublesome behavior.

· Listening to the child's actual concerns and fears of going to school is important. Some of the reasons for refusing to attend school may include another child at school who is a bully, problems on the bus or carpool ride to school, or fears of inability to keep up with the other students in the classroom; these issues can be addressed if they are known. On the other hand, making too big a deal of school refusal may promote the child's behavior to continue.

· Firmly getting the child to school regularly and on time will help. Not prolonging the goodbyes can help as well. Sometimes it works best if someone else can take the child to school after the parent or caregiver says goodbye at home.

· It truly helps to believe that the child will get over this problem; discuss this with the child (the parent or caregiver needs to convince himself or herself of this before trying to convince the child).

· The parent or caregiver should reassure the child that he or she will be there upon the child's return from school; this should be repeated over and over, if necessary. Let the child know that the parent or caregiver will be doing "boring stuff" at home during the school day. Always be on time to pick the child up from school if you provide transportation rather than a school bus.

· Whenever events occur that could tend to cause students to miss school (for example, traumatic events such as terrorism, school shootings, or other traumas) all attempts should be made to help students return promptly to school and to help them to feel safe at school.

· Supportive counseling is often made available at school in these circumstances so as to minimize reinforcement of school avoidant behaviors and to prevent secondary gain from school refusal and should be encouraged for any student who wishes to have it. If the child simply refuses to go to school, some parents have found that decreasing the reward for staying home helps, for example, do not allow video games or television, or find out what work is being done in the school and provide similar education at home, when possible. This is especially if the "illness" seems to disappear once the child is allowed to stay at home.

Items from the School Refusal Assessment Scale-Revised

Items from child version
How often do you have bad feelings about going to school because you are afraid of something related to school (e.g., tests, school bus, teacher, fire alarm)?

How often do you stay away from school because it is hard to speak with the other kids at school?

How often do you feel you would rather be with your parents than go to school?

When you are not in school during the week (Monday to Friday), how often do you leave the house and do something fun?

How often do you stay away from school because you feel sad or depressed if you go?

How often do you stay away from school because you feel embarrassed in front of other people at school?

How often do you think about your parents or family when you are in school?

When you are not in school during the week (Monday to Friday), how often do you talk to or see other people (other than your family)?

How often do you feel worse at school (e.g., scared, nervous, sad) compared with how you feel at home with friends?

How often do you stay away from school because you do not have many friends there?

How much would you rather be with your family than go to school?

When you are not in school during the week (Monday to Friday), how much do you enjoy doing different things (e.g., being with friends, going places)?

How often do you have bad feelings about school (e.g., scared, nervous, sad) when you think about school on Saturday and Sunday?

How often do you stay away from places in school (e.g., hallways, places where certain groups of people are) where you would have to talk to someone?

How much would you rather be taught by your parents at home than by your teacher at school?

How often do you refuse to go to school because you want to have fun outside of school?

If you had fewer bad feelings (e.g., scared, nervous, sad) about school, would it be easier for you to go to school?

If it were easier for you to make new friends, would it be easier for you to go to school?

Would it be easier for you to go to school if your parents went with you?

Would it be easier for you to go to school if you could do more things you like to do after school hours (e.g., being with friends)?

How much more do you have bad feelings about school (e.g., scared, nervous, sad) compared with other kids your age?

How often do you stay away from people in school compared with other kids your age?

Would you like to be home with your parents more than other kids your age would?

Would you rather be doing fun things outside of school more than most kids your age?


Items from parent version

How often does your child have bad feelings about going to school because he/she is afraid of something related to school (e.g., tests, school bus, teacher, fire alarm)?

How often does your child stay away from school because it is hard for him/her to speak with the other kids at school?

How often does your child feel he/she would rather be with you or your spouse than go to school?

When your child is not in school during the week (Monday to Friday), how often does he/she leave the house and do something fun?

How often does your child stay away from school because he/she will feel sad or depressed if he/she goes?

How often does your child stay away from school because he/she feels embarrassed in front of other people at school?

When your child is in school, how often does he/she think about you or your spouse or family?

When your child is not in school during the week (Monday to Friday), how often does he/she talk to or see other people (other than his/her family)?

How often does your child feel worse at school (e.g., scared, nervous, sad) compared with how he/she feels at home with friends?

How often does your child stay away from school because he/she does not have many friends there?

How much would your child rather be with his/her family than go to school?

When your child is not in school during the week (Monday to Friday), how much does he/she enjoy doing different things (e.g., being with friends, going places)?

How often does your child have bad feelings about school (e.g., scared, nervous, sad) when he/she thinks about school on Saturday and Sunday?

How often does your child stay away from places in school (e.g. hallways, places where certain groups of people are) where he/she would have to talk to someone?

How much would your child rather be taught by you or your spouse at home than by his/her teacher at school?

How often does your child refuse to go to school because he/she wants to have fun outside of school?

If your child had fewer bad feelings (e.g., scared, nervous, sad) about school, would it be easier for him/her to go to school?

If it were easier for your child to make new friends, would it be easier for him/her to go to school?

Would it be easier for your child to go to school if you or your spouse went with him/her?

Would it be easier for your child to go to school if he/she could do more things he/she likes to do after school hours (e.g., being with friends)?

How much more does your child have bad feelings about school (e.g., scared, nervous, sad) compared with other kids his/her age?

How often does your child stay away from people in school compared with other kids his/her age?

Would your child like to be home with you or your spouse more than other kids his/her age would?

Would your child rather be doing fun things outside of school more than most kids his/her age?


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