Identifying School Refusal

Sometimes children and adolescents have difficulty attending school on a regular basis. When absences are reasonable (e.g., due to illness), missing school is appropriate. When young people fail to attend school for other reasons, the term “school refusal” is sometimes used to describe these occasions. School refusal includes the following circumstances:¹

1. Child or adolescent refuses to attend school, which may lead to prolonged or repeated
   absences
2. Child or adolescent usually does not try to hide absences from parents (i.e., remaining at
   home during school hours, rather than skipping school with friends)
3. Child or adolescent becomes upset (e.g., excessive anxiety or sadness, temper tantrums, unexplained physical symptoms) about having to attend school
4. Caregivers try (or have tried) to force the child or adolescent to attend school

School refusal can come on suddenly or escalate gradually. Young people can exhibit a number of behaviors when confronted with the requirement to attend school when they do not want to:^1,3 School refusal can be caused by a number of underlying issues, and while not currently, in and of itself classified as a mental disorder, often has an underlying or co-morbid mental health issue.⁴

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