Laura Koehler, Psy.D., Clinical Psychologist at Edward-Elmhurst Health shared that according to the Centers for Disease Control and Prevention, more than 7 percent of kids ages 3-17 are diagnosed with anxiety. When left untreated, these kids are at risk to perform poorly at school and, in some cases, it will lead to school refusal behavior.
School refusal is emotionally based and tends to occur with underlying mental health issues. It’s often to avoid some type of anxiety – general, social, performance or separation. The most common ages for school refusal are ages 5-7 and 11-14. This is attributed to the transition from kindergarten to 1st grade, and going to and leaving middle school.
Here are some of the most common signs of school refusal:
- Chronic headaches or stomachaches
- Frequently asking to stay home from school
- Repeatedly leaving class or going to the nurse’s office
- Refusing to participate in extracurricular sports or activities
- Lack of concentration or focus
- Sleep difficulties
- Lack of appetite or overeating
It’s important to promptly identify school refusal as it can lead to several consequences when left unaddressed. Grades often suffer due to not fully learning and experiencing things at school. Later on, this can lead to being unprepared for college or work. Depression and unhealthy coping mechanisms – such as substance abuse or self injury – can also occur.
It’s time to seek help when school refusal interferes with how your child functions. For example, if he or she misses most days of the school week or drops from being a B student to a D student. Another thing to look at is if your child is no longer interested in participating in an activity he or she always loved.
Your primary care provider and child’s school along with a therapist can help your child get back on the right path. Through a psychological evaluation, your child’s care team can gather more information about what might be causing the underlying anxiety. A medical evaluation may also be conducted to rule out physical conditions, such as hyperthyroidism or migraines. Treatment is individualized and may include:
- Dialectical behavior therapy encourages relating to anxiety differently. Instead of thinking of ways to get rid of anxiety, the focus becomes values and activities that are important to the child. Accepting uncomfortable feelings helps keep anxiety from taking over every minute of the day.
- Creating a crisis kit containing items to soothe or distract when anxiety hits. This may include a fidget toy, coloring pages, word searches, crosswords, encouraging letters from family and friends, a favorite lotion, gum or mints.
- Small accommodations, such as leaving a classroom five minutes before class ends to avoid busy hallways.
- Social skills training that allows kids to practice reactions and responses to various social situations.
- Establishing healthy habits, including eating a balanced diet, exercise, drinking enough water and following a sleep routine.
Linden Oaks Behavioral Health offers a school refusal program to help kids overcome these issues. Our goal isn’t to make all anxiety go away – instead, we want kids to relate with it differently. We explain it’s a common emotion and it can even be helpful as long as it’s managed.