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School refusal: when kids say no to school

Morgan Smith won't go to school. It's not a whim or simply bad behavior. School refusal, which experts say is a common childhood behavior problem for kindergartners to high schoolers, is wrenching for kids and parents alike.

Photo credit: Design Cortex

By Connie Matthiessen

It was the middle of a typical school day at Midway High School in Waco, Texas, and the hallways were packed with noisy clusters of teens, laughing and jostling and clanging locker doors, slowly wending their way to class.

But Morgan Smith wasn’t part of the clamor. The fifteen-year-old was in the restroom, hunched in a bathroom stall, frantically texting her parents over and over: “Please, please, please, you have to come get me!

Morgan, who qualifies as a GATE (Gifted and Talented Education) student, is articulate and self-possessed. She’s never been bullied and has lots of friends. So why does she dread school so much? She hates the constant noise and crowding. She isn’t crazy about some of her peers, either, many of whom she says are privileged and supercompetitive.

But Morgan’s reaction to school is about more than likes and dislikes — it’s a sensation of total panic. “As soon as I got to school, I would start worrying about having a panic attack and that would consume everything,” she recalls. “I’d sit in class and it would feel like something awful was going to happen if I didn’t get out of there. I was terrified. I’d shake and start freaking out. It was the worst feeling in the world.”

The panic made it impossible for Morgan to concentrate. “I’d get home and have no idea what the homework was,” she says. “I wouldn’t remember anything the teacher said in class because I was worrying so much.”

Many kids don’t like school, but for Morgan it was unendurable — every single day. “Sometimes it was worse in the morning, sometimes it was worse in the afternoon, some days it was bad all day,” she says. “I never had a day at school when I felt like, ‘I’m fine.’ The fear never left my head.”

Yes, there is a name for it

Morgan’s problem has a name: it’s a behavior known as “school refusal” — and it’s more common than you may think. In fact, school refusal is one of the most common childhood behavior problems, according to Chris Kearney, who directs the School Refusal and Anxiety Disorders Clinic at the University of Nevada, Las Vegas. Kearney estimates that eight to 10 percent of all school children exhibit school refusal behavior — and miss school as a result — at some point during their school career.

If you add the many kids who resist going to school but ultimately make it in the door, the number shoots up to 28 percent. “Some of the kids we work with show up at school, but they are complete terrors before they get there,” says Kearney. “They throw tantrums, they run and hide, they refuse to get dressed — getting them to school is miserable for their parents, but they show up at school and are marked as present.”

School refusal is hard to define precisely because it shows up in very different forms depending on the individual child. Kearney distinguishes “school refusal” from “school phobia,” which is fear-based and linked to fear of a specific object or situation at school, like the fire alarm or the class snake.

School refusal is a sign of broader anxiety — separation anxiety, social anxiety, or general anxiety. Sometimes kids with school refusal complain of physical symptoms like stomachaches or headaches, but not all kids who refuse school have physical complaints. Some kids throw tantrums before school every morning; others make it to school but have trouble staying in the classroom. Some kids refuse school after a disruption or crisis at home — a move, divorce, illness, or death in the family, for example — but in many cases, school refusal behavior has no obvious trigger.

To some, school refusal may sound like a fancy name for a standard-issue schoolkid whine — A kid who doesn’t like school? So what else is new? — one that a little tough love and smart parenting could easily fix. But the behavior is often a symptom of a more serious condition, and simply laying down the law and forcing the child to go to school is likely to make the problem worse.

School refusal isn’t just an invented pathology among over-indulged American kids, either. Kearney says he gets calls from educators and practitioners from around world. “We’ve heard from people in Japan, China, Sweden, Denmark, Canada,” he says. “School refusal seems to be pretty universal.”

Why kids say no to school

Why a particular child develops school refusal can be difficult to untangle. The causes can include psychological, developmental, and external factors like bullying — either alone or in combination. According to Kearney, most cases appear around the beginning of middle school. “Kids are going through the upheaval of puberty at the same time that they’re facing bigger challenges, both academically and socially. It’s a perfect storm,” he says.

But younger kids refuse school, too. According to educational consultant James Dillon, a former elementary school principal and author of No Place for Bullying, the reason for school refusal in the younger grades is typically developmental. A number of his students began refusing school at the age of nine or 10. “That’s the age when kids start figuring out that their parents have separate identities and that bad things can happen to people,” Dillon explains. “Some kids become overwhelmed with fear that something is going to happen to their parents when they are at school. They panic and cling to their parents and don’t want to go to school.”

Dillon says most of the students who developed school refusal weren’t unpopular or emotionally fragile. “These were kids who had a generally positive school experience,” he says. “Their parents would say, ‘What did I do wrong?’ But school refusal doesn’t have a single cause. It isn’t necessarily linked to a divorce or other problems at home. It just happens, and trying to identify a specific cause isn’t particularly productive.”

However, external circumstances at school, particularly bullying, can also trigger the problem — and in that case, it's essential to get to the bottom of the issue. Dillon points out that for some tweens and teens, school refusal may be a rational reaction to an intolerable situation. “If a child is suffering peer abuse and bullying every day — and I don’t think adults realize how painful that can be — the best way for that child to protect himself is to not go to school.”

Connie Matthiessen is an associate editor at GreatSchools.