Nearly every parent has heard their child complain of a school morning tummy ache, or fielded a suspect call from their child begging to be picked up from the school nurse’s office. However, when bad days start outweighing the good, and family routines are disrupted, a more serious matter may be the culprit. Children with extreme or age-inappropriate anxiety related to school may actually suffer from a very real condition known as School Refusal.

According to Jeffrey Sapyta, Ph.D.
, a child psychologist with the Duke Child and Family Study Center in Durham, School Refusal is more common than many parents think. Between 1%-5% of children suffer from school refusal. It’s even more common when children transition to a new school.

“For these kids, the fear is real,” says Sapyta. “When kids have a stomach ache or other physical discomfort that appears to be directly related to a school activity or school attendance, in most cases, they aren’t faking those sensations.” Parents need to know how to help their children when these situations occur.

“Learning to react appropriately is important because ignoring a child’s heightened fears, or overreacting to them, may exacerbate the situation, and can lead to further academic issues down the road,” he said. Allowing the anxiety to go untreated also makes it harder for families to cope.

What to Look for

Warning signs of School Refusal include excessive anxiety, temper tantrums, aches and pains that peak at school time. In boys aggressive, defiant behaviors are more common while girls typically become more anxious and complain of physical discomfort. When those complaints magically disappear on the weekends or after school,  parents should become suspicious.

What to Do

Sapyta says the first thing parents can do is ensure their children are following healthy living habits. “That includes a good diet and consistent sleep schedule.” Creating a system that links rewards and out-of-school privileges to positive behavior and school attendance can also be helpful. Sapyta says parents can unwittingly make an anxiety issue worse by allowing them to miss school in response to their child’s complaints. “A child who is too ill to go to school, should also be too ill to have home privileges, including access to social media, television and gaming.  That is especially true if parents suspect that a child is actually gaining screen time by missing school.”

When children are out of school for more than one to two weeks, Sapyta says it’s time to seek professional help. “The longer a child misses school, the more difficult it will be to return to a normal routine.” Child psychologists and psychiatrists can help identify the root of the anxiety, and teach both parents and children appropriate cognitive behavioral techniques that helps children gradually return to a normal school routine. In some cases, medical referrals may be necessary when physical complaints like pain or chronic fatigue become a serious issue.