School Refusal - Symptoms

Symptoms

Symptoms of school refusal include the child saying they feel sick often, or waking up with a headache, stomachache, or sore throat. If the child stays home from school, these symptoms might go away, but come back the next morning before school. Additionally, children with school refusal may have crying spells or throw temper tantrums.

Warning signs of school refusal include frequent complaints about attending school, frequent tardiness or unexcused absences, absences on significant days (tests, speeches, physical education class), frequent requests to call or go home, excessive worrying about a parent when in school, frequent requests to go to the nurse’s office because of physical complaints, and crying about wanting to go home.

It is important for parents to keep trying to get their child to go back to school. The longer a child stays out of school, the harder it will be to return. However, it may be hard to accomplish as when forced they are prone to temper tantrums, crying spells, psychosomatic or panic symptoms and threats of self-harm. These problems quickly fade if the child is allowed to stay home.

Parents should take their child to the doctor, who will be able to rule out any illness that may be causing the problem. Parents should also talk to the child’s teacher or school counselor. Although school refusal is not a clinical disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, it can be associated with several psychiatric disorders, including Separation Anxiety Disorder, Social Phobia, and Conduct Disorder. Therefore it is critical that youths who are school refusing receive a comprehensive evaluation by a mental health professional.

Whereas some cases of school refusal can be resolved by gradual re-introduction to the school environment, some others may need to be treated with some form of psychodynamic or cognitive-behaviour therapy. Some families have sought alternative education for school refusers which has also proved to be effective. In extreme cases, some form of medication is sometimes prescribed but none of these have stood out prominently as solutions to the problem.

A medical condition often mistaken for school refusal is delayed sleep phase syndrome (DSPS). DSPS is a circadian rhythm sleep disorder which causes difficulty falling asleep at night and waking in the morning.

The attempt to control by means of threats or pressure, the behaviour of the student, is also still in danger as external (extrinsic) motivation to undermine intrinsic motivation and a sense of self-control, self-worth and self-responsibility.