Here's What You Need to Know About School Refusal
When most parents are confronted with problems such as school refusal, they don't take it seriously at first. They think that their child's absence from school a day here and there is normal. But skipping school isn't always simply playing hooky. In fact, it isn't really playing at all. Parents should be concerned about school attendance, concerned that avoiding school might be an indication of another more serious problem.
Depression and anxiety disorders are common psychiatric problems that cause children to miss school. It is estimated that at least fifty percent of children who miss school regularly have both depression and anxiety. These disorders are often manifested as school refusal. With these particular children, school refusal is a symptom of a disorder (or disorders) that demand(s) treatment.
Following are thirteen common questions that parents ask regarding their child and school refusal, and problems that may cause it. The answers to these questions might help you and your family understand why your child is refusing school, and help you find a way to get your child back in school and working up to his or her potential.
Why is my child skipping school?
Some children who refuse school do so because of peer pressure or simply because they want a 'day off.' If the refusal is only occasional it may not be serious. But, as previously stated, it is estimated that at least fifty percent of the children who regularly skip school suffer from depression and/or anxiety disorder(s). These disorders can cause children to feel fearful, helpless, and hopeless. When these feelings become overwhelming these children feel that they can't go to school. And, sometimes they cant even explain what they are feeling.
Skipping school is normal for kids, isn't it?
No. Most children enjoy school and go to school regularly. They like the social activities that go with it, and they usually like the work. If children don't go to school, they are likely to be unhappy or fearful. In any case, skipping school is a problem that needs to be addressed.
School is the work of a child. If an adult could not get himself up in the morning and off to work, family members and coworkers would become concerned, and they would intervene if the problem went on. Yet, many times, a child will stay at home for days, weeks, even months, and parents feel at a loss for what to do. It is important for a parent to recognize when a problem exists, and to take action before a small problem turns into a big one.
How do I know if our daughter is avoiding school due to depression and anxiety?
The only sure way to determine if an adolescent is suffering from anxiety, depression, or a less serious behavioral problem that is affecting school attendance is to rule out depression and anxiety disorders. If an adolescent is not clinically depressed or is not suffering from anxiety, then the school refusal may be treated as a simpler behavioral problem. Having your daughter evaluated to determine if anxiety and/or depression are at the root of school refusal is important.
How do I know if my child is depressed or anxious?
Sometimes depression and anxiety are difficult to detect. Symptoms of childhood depression are often different than the symptoms of adult depression. While depressed adults are often withdrawn and isolative, children may or may not be. Some depressed adolescents will seem 'hyperactive' to a casual observer. Other symptoms of depression can include irritability, inability to concentrate, change in sleep and eating patterns, and low self-esteem. In more serious cases, depressed children may have thoughts of suicide and may even make attempts on their own lives. They might steal, run away, or get into fights.
Anxiety disorders in children and adolescents are sometimes difficult to detect. These children and adolescents may be fearful of being away from home, or being away from parents even for short periods of time. At school, they may be fearful of talking in class, and may refuse to raise their hands to answer questions. These children may worry excessively about things that happened in the past or things they anticipate happening in the future. Sometimes symptoms of anxiety are absent on weekends and school breaks because stressors that 'trigger' these feelings (i.e., talking in class, fear of going to certain classes) are no longer present.
The most important things to remember about depression and anxiety disorders are that: (1) they are very treatable, and (2) they need to be evaluated by a qualified mental health professional. Anxiety and depression are the two most treatable psychiatric disorders.
Isn't depression caused by some event in a person's life?
Sometimes depression is related to a life event such as a death in the family or another traumatic event, but sometimes depression is unrelated to factors such as these. Depression in some instances is caused by a neurochemical deficiency in the brain. (One rule of thumb is that if symptoms of depression last more than two weeks, an evaluation should be completed and treatment should be considered.)
Some depressed child and adolescent patients may benefit from anti-depressant medication. If medication is prescribed, it should be done so only after a thorough psychiatric evaluation, and should be monitored by a psychiatrist.
Will my child outgrow problems of depression and anxiety?
Depression and anxiety, in some instances, abate in time. In other instances, however, depression and anxiety require treatment. Treatment can help to shorten the course of these disorders. With adolescents, delaying treatment not only results in unnecessary suffering, but can result in school failure and avoidance. It is best for parents to intervene before school failure becomes difficult to overcome.
When should I begin to be worried about my child missing school?
Parents should always be aware of the reason their child is missing school. If physical symptoms that prevent a child from going to school persist, the child should receive medical attention. At the first signs of a child making up reasons for missing school, avoiding school for an unexplained reason, or avoiding school because of fearfulness or withdrawal, parents should address the issue immediately and seek help.
My son is very intelligent and complains of feeling 'bored' with school. I think that if they challenged him more he would be more willing to go. What do you think?
Sometimes children and adolescents feel low energy and lethargy as symptoms of depression. They use the word 'bored' because it is a word that comes closest to describing what they are feeling at the time. 'Bored' may just be an alternative term for 'depressed.'
Regarding these disorders and intelligence, you should know that very intelligent and talented people suffer from anxiety and depression. Intelligence, per se, has little to do with these disorders, and if your son is clinically depressed, intelligence will not necessarily make it easier for him to resolve these feelings by himself. In fact, in some ways it makes it more difficult. A parent, teacher or friend might think, He is so smart and has so much going for him. I can't understand why he doesn't just pull himself together and go to school. It's important to remember that intelligence and emotions are separate. If your child is having trouble with grades, you might consider using a tutor; if your child is having trouble with anxiety and depression, you may want to consider seeing a mental health professional to give him the help he needs.
We are afraid of our child not finishing his current grade level. Should we contact the school for help, or will this just call more attention to the problem? Should we deal with the problem ourselves at home?
Guidance counselors, school social workers and psychologists, and attendance officers are professionals who commonly work with children who refuse school and their parents. Also, principals and assistant principals can be of assistance. It is important for you to work closely with these people to get your child back in school. They can be a valuable resource. Mental health professionals at your local community mental health center, or private mental health treatment providers also may be consulted to work together with your family and the school. School refusal is very often a stubborn problem, and the support of many people can make a solution easier.
Can attendance officers, truant officers and court personnel put pressure on our child to return to school?
A child in this situation doesn't usually need additional pressure. But letting a child know that refusing school is against the law, in some cases, will motivate him to accept help. Court systems in many areas are increasingly aware of the underlying mental health problems of school refusers. And they can be an advocate to parents in getting children the help they need.
Couldn't we just put our child on homebound instruction? Wouldn't that help?
Keeping your child at home on homebound instruction will not resolve school refusal for several reasons: One, the extra attention of a teacher coming to your home to work with your child may make staying at home even more attractive. Two, it may 'mask' the anxiety that he is experiencing, but it doesn't get rid of what triggers it. Three, it socially isolates him when it's likely that he is in need of friends and peers. And four, when it comes time to return to school, it will be just that much harder.
I am worried about my son getting involved in drugs when he skips school. Should I be worried?
It is more common that drug and alcohol abuse results in school refusal than school refusal resulting in drug abuse. It happens frequently that when a child or adolescent gets involved in drugs or alcohol, he begins to miss school because (1) he is not 'available' for classwork; or (2) he is skipping class to get'high.' In either case a parent should have their child evaluated quickly before experimentation with drugs and alcohol becomes a pattern that leads to home, school, and social difficulties.
What do I do if my child refuses to accept help?
Refusing help is not uncommon for kids who are school avoidant due to depression. Feelings of helplessness and fear make it very difficult for them to connect with avenues that will help create healthy changes. It feels better to avoid. However, this does not mean that parents should take no for an answer. It is appropriate for parents to set firm limits when their child's well-being is at stake.
Parents needing assistance in conquering opposition from their child should contact a school guidance counselor or mental health professional for suggestions.
Dominion Hospital specializes in working with school-avoidant children and adolescents. Our intensive, therapeutic, day treatment program, and inpatient hospitalization program both includes mental health and chemical dependency services.
We offer free screenings to help parents understand how their child can be helped. In addition, we can work with parents to help overcome their child's resistance.
We have more information for parents, teachers and mental health professionals about school avoidant behavior and symptoms, and how they can be treated.
Call us. We can help. All information calls are free and strictly confidential.