School Refusal: Distress not Defiance.

Ask any child – going to school is not typically at (or even near) the top of their list of favourite things to do. A daily routine of having to wake up at what seems to be the break of dawn, combined with tasks of brushing teeth, fixing hair, getting dressed quickly, eating breakfast and having to get out of the front door all at lighting speed often signals the beginning of each school day and can be a real struggle – especially after a long and leisurely holiday. Once at school, tasks of having to face and interact with peers, teachers and school work can also be overwhelming. It is common, therefore, for some children to express reluctance about these routines and about the thought of having to go into school. Some degree of trepidation, hesitation, fear and frustration is normal and can be expected.

There are instances however, when difficulties become more concerning and a child shows signs of what is known as ‘School Refusal’, which is school non-attendance that parents are aware of (as opposed to truancy which refers to avoiding school without parents’ knowledge). The term ‘School Refusal’ might conjure thoughts of naughtiness or even defiance – after all the word refusal appears to suggest that the child is refusing to do as their parents or teachers say. However, school refusal can be driven by several factors in home and school environments– with anxiety often playing a major role. It is not simply a case of disobedience on the part of your child.

One of the key driving factors of school refusal, in contrast to truancy, is that a child’s distress is often driving their non-attendance. In such instances, a child may show discomfort through vocalization of their thoughts, but often more frequently through their behaviours. When faced with the mere thought of going to school, the child avoids having to do so. Stomachache, headache, “butterflies in the tummy”, muscular pain and other bodily ailments are often the body’s physiological responses to distress and can be cited by your child as reasons why they just can’t go to school.

A psychologist working with a child who has this difficulty is likely to help with getting them back into school, usually at a gradual pace. There is no one size fits all, blanket solution to the problem and often a psychologist needs to work closely with families to find out what specific factors or triggers have contributed to the development of the problem, what is maintaining or keeping the problem going and what specific things the child can start doing to get back into school.

A major focus is likely to be on what small steps a child, with the support of their parents, can start taking towards getting back into school and realizing that it is not such a scary place after all. To address specific fears and worries related to their experiences, the therapist will also likely work with helping the child to identify and actively challenge unhelpful thinking contributing to the problem.

It is important for parents to act early and get support as soon as they start to notice difficulties with school non-attendance, as early intervention can be helpful. If the problem is left to develop over a long period of time, it becomes harder to address and the child misses out on their education and may develop more anxiety about the prospect of re-entering school. With early support, a child can get back into their school routines and can be equipped with strategies to help deal with difficulties.

Prathna Singh, Child and Adolescent Psychologist, Vivamus Dubai.