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A back-to-school refresher on school avoidance

child sick in bed with mom helping

Back-to-school nights have come and gone and calendars have quickly filled with school activities. Most students have settled into their school routine. But for some, being back in school might be a struggle. School avoidance can emerge, consciously or not. Knowing what to look for allows you to address it and ask for help if needed.

School avoidance is normal­–if it doesn’t last too long.

It is okay for kids to be a little nervous at the start of a new school year. Taking time to listen and work through feelings of uncertainty, worry or fear helps equip most kids to manage anxious feelings.

School avoidance may emerge if there is impactful and persistent worry, fear or lack of interest in school. Some triggers for lack or loss of interest in school include depression, substance use, learning disability and vision or hearing problems that make learning difficult. It can also begin after a big change in the life of your child, such as a home or school move, divorce, new sibling and/or sick family member. School avoidance is a common cause of missed school days in kids and it can be very hard to tell the difference between beginning school avoidance and illness. If the pattern lasts longer than 1 week, it’s time to seek help.

Here’s how school avoidance may look:

  • Physical symptoms (i.e., headache, belly pain, chest pain) that get better when allowed to stay home from school
  • Nausea and/or vomiting every morning before school (but not on the weekends or before other desired social events)
  • Recurrent stomach pain or school nurse visits at certain times of the day (for example, around reading class for a student who struggles with reading)
  • Refusal to go to school because of bullying, fear of violence, or difficulty with other kids or teachers
  • Separation anxiety or close relationship with a parent that leads the child to seek one-on-one time by missing school

Diagnosing school avoidance requires the detective skills of a team including parents, teachers and health care providers. Discussing your child’s physical complaints with your pediatrician is an important first step to rule out other treatable causes.

Be firm, but caring

Once school avoidance is identified, there are some ground rules for getting back to regular attendance. It is important to remember that each case is unique and requires a plan created with the help of your health care provider and school staff. Engaging a child or adolescent psychologist or therapist may also be important, particularly if separation anxiety or mental health conditions are contributing. Intervening quickly is best. The longer a child stays out of school, the harder it is to transition back.

Some ground rules:

  • Going to school every day is expected (school is a child’s “job”). You can still listen to fears, worries and concerns while holding firm to this expectation. Simple statements can help: “You can do something even if you don’t want to.”
  • Check-in with school staff to get everyone on the same page to avoid the child being sent home unnecessarily.

Missed school days

If you decide to keep your child home from school and you aren’t sure whether symptoms are due to illness or school avoidance, it is important to allow an environment that is, essentially, boring. This includes avoiding things like extra-special time with a parent and extra TV, screen or game time. Going to after-school activities or special events after a missed school day is generally not advised if school avoidance is suspected.

School avoidance can be tricky, but it is treatable. Enlisting the help of your child’s health care provider, counselor and school staff will support your child in being successful in returning to school.    

Adolescent Medicine