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School Avoidance

By

Stephen Brian Sulkes

, MD, Golisano Children’s Hospital at Strong, University of Rochester School of Medicine and Dentistry

Last full review/revision Mar 2020| Content last modified Mar 2020
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School avoidance is a disorder affecting school-aged children who, because of anxiety, depression, or social factors, avoid attending school because attendance causes stress.

  • Some psychologic and social factors may cause school avoidance.

  • Children may fake illnesses and make up excuses to avoid going to school.

  • To re-establish regular attendance at school, open communication between the child, parents, and school personnel is recommended.

  • Sometimes psychologic therapy may be needed.

School avoidance occurs in about 5% of all school-aged children and affects girls and boys equally. It usually occurs between age 5 and age 11.

The cause of school avoidance is often unclear, but psychologic factors (such as stress, anxiety, and depression—see also Overview of Mental Health Disorders in Children) and social factors (such as having no friends, feeling rejected by peers, or being bullied) may contribute. If school avoidance escalates to the point that a child is missing a lot of school, it may be a sign of a more serious problem such as a depression disorder or one or more of the anxiety disorders, particularly social anxiety disorder, separation anxiety disorder, and/or panic disorder. Sensitive children may be overreacting with fear to a teacher’s strictness or rebukes. Younger children tend to fake illness or make other excuses to avoid school. Children may complain of a stomachache, nausea, or other symptoms that justify staying home. Some children directly refuse to go to school. Alternatively, children may go to school without difficulty but become anxious or develop various symptoms during the school day, often going regularly to the nurse’s office. This behavior is unlike that of adolescents, who may decide not to attend school (called truancy or "playing hooky”—see School Problems in Adolescents). Children who are frequently truant from school often have a conduct disorder.

In children who do not have a serious psychologic disorder, school avoidance tends to result from

  • Poor academic performance

  • Family difficulties

  • Difficulties with peers

Most children recover from school avoidance, but some develop it again after a real illness or a vacation.

Home tutoring usually is not a solution. Children with school avoidance should return to school immediately, so that they do not fall behind in their schoolwork. If school avoidance is so intense that it interferes with the child's activity and if the child does not respond to simple reassurance by parents or teachers, the child may need to be seen by a mental health practitioner.

Treatment

  • Communication with school personnel

  • Attendance at school

  • Sometimes therapy

Treatment of school avoidance should include communication between parents and school personnel, regular attendance at school, and sometimes therapy involving the family and child with a mental health practitioner. Therapy includes treatment of underlying disorders, adaptation of the school curriculum for children who have a learning disability or other special education needs, and behavioral techniques to cope with the stresses at school.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
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