School Refusal

March 15, 2016

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School refusal is not always considered truancy. School refusal can be characterized as a difficulty attending school associated with emotional distress, especially anxiety and depression. There are many instances in which due to severe anxiety or stress that a student refuses to attend their regular classroom experiences. School refusal can look like many things: suspicious sick days, vague symptoms including headache, stomach ache, etc. It may also progress to more extreme behaviors involving arguing, yelling, screaming, and physical reactions with the end result being that the student does not attend school.

School refusal can be an extremely challenging situation for parents and schools alike. For families, school refusal can add stress to what already is likely a challenging situation. However, if families allow a student to stay home, they may inadvertently be reinforcing school refusal.

Possible Causes of School Refusal

Determining the reasons for school refusal is best approached from many perspectives. These include a physical evaluation by a medical doctor to rule out any health issues which may cause the reported symptoms. In addition, a functional behavior assessment (FBA) may assist in determining the reason for school refusal. The FBA should lead to a Behavior Intervention Plan (BIP) which details the targeted behaviors as well as the goals and objectives to decrease the targeted behaviors and replace them with more adaptive behaviors.

Managing School Refusal

The main goal in managing school refusal is to get students back to school. Best practice suggests that the Child Study Team, the family, and when possible, the child develop a plan for him/her to return to the school setting. This does not need to occur all at once. After reviewing the FBA results and what may be causing the anxiety or stress factors that are keeping the student from attending school, changes to the school environment may need to occur. One way to address this is to consider the student attending for a particular class, activity or a partial day, all with the intention of expanding on school attendance gradually over time as the student is successful.

In the interim, home instruction may be put in place in order to prevent the student from falling behind his/her peers. Home instruction may consist of only a few hours per week. If the team determines that home instruction is the best course of action for a student then this is considered the student’s educational setting and it would be appropriate for any testing (including an FBA) to be conducted in that setting. Further treatment may also be necessary and could include counseling or care provided by a psychiatrist or psychologist. Typically these services are not provided in the home and would require a student traveling to outside offices. Finally, home instruction is often considered one of the most restrictive settings and is logistically and financially challenging for school districts. Thus, with the student’s needs and best interests in mind, the Individualized Education Program team (of which parents are equal participants) should continue to work toward a lesser restrictive environment.

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