School avoidance: Why won’t my child go to school?

Do you recognize these school avoidance scenarios?

• Your child feels sick every school-day morning, but not on weekends. 
• Your kid outright refuses to get on the bus or into your car on school mornings. 
• After witnessing another kid throwing up in school, your kid refuses to go back to school in fear that they might throw up in school. 
• Beginning with the second or third day of school, your child says it doesn’t “feel right” to be away from mom or dad for the day. 
• Your middle schooler or high schooler gets ready for school and then feels too tired to actually leave the house. They go back to sleep for several hours and that convinces you and them that they needed to stay home and rest. 

It can happen at any age, in any grade. School avoidance is the older kid version of daycare separation anxiety.

Before getting into the why’s of school avoidance, let’s jump to the most important part of how to treat school avoidance: While it may feel difficult for you and cause tears to flow, you need to get your school-avoiding child BACK TO SCHOOL!

All other treatment modalities and all other issues can be dealt with while your child continues to attend school. The longer you let your child stay home, the more difficult it will be for them to return to school.

Can there be legit reasons that your child avoids going to school? Of course! Think about the following factors that might come into play:

• Is your child being bullied? Or is he, in fact, the bully?
• Can your child not see well enough or hear well enough to learn in the classroom?
• Is the teacher “a yeller” and does that scare your child? Or does the teacher fail to control the classroom, and the resulting chaos causes your child discomfort?
• Is your kid holding in pee or poop to avoid using the school bathroom? Are they afraid of “foreign” bathrooms? For older kids, are other kids vaping in the bathroom and your kid doesn’t want to be around that? Is the teacher not allowing your child to use the bathroom when they need it? Bathroom woes cause a lot of anxiety in many of our patients.
• Has something changed your family’s structure? Did a parent move out? Is someone very ill? Did a caretaker die? Are they now afraid you will die or disappear while they are away at school?
• Was your child’s sleep disrupted? Are they exhausted by late night phone texts or are they having difficulty calming their mind before bedtime?
• Are sick days “fun” for your child? When they are home, do they receive special privileges such as playing on their phone all day?
• Some kids just cannot come up with a reason. They just “don’t want to go” to school.

Absolutely talk to your child about why going to school is hard for them. However, have the conversation AFTER school or during the weekend, not right before school. On school mornings, stick to the morning routine and send them to school.

Often, kids “listen” better to people other than their parents. Enlist the help of a neighbor or relative to get your child on the bus. Have a plan in place with school for when they arrive. A teacher who reinforces how they are looking forward to seeing your child the next day will make a world of difference.

First take your school-avoiding child to their pediatrician to evaluate for any medical causes of their symptoms. Ideally this appointment takes place before or after school hours but not during school. Your pediatrician will give advice specific to your child and may recommend therapists as well. Kids who show signs of depression or anxiety can benefit from cognitive behavior therapy, and a select few might need medication. For kids who feel sick, often simply the reassurance from a pediatrician that they are healthy is enough to get a kid to school.  The adage “little pitchers have big ears” is true. Share any information you would like to discuss privately with the pediatrician beforehand in a separate communication. 

Parents and kids, together with a therapist, your child’s teacher or school principal and pediatrician, can work on ways to smooth your child’s return to school. Again, keep in mind that the longer your child stays away from school, the harder it is for them to return.

What if you are not sure if your child is actually sick on a particular school morning? For kids who rarely miss school, you can choose to err on the side of caution and give them the morning, or the day, off. However, if your child had one time of feeling sick, stayed home, and then appeared well within 30 minutes of missing school, or for the teen who went back to sleep for several hours and then appeared quite well afterward, only to complain of feeling too tired the next day, then parents need to enforce tough love. Kids who feel sick but have no fever and are not vomiting can and should go to school.

Kids take cues from their parents. Anxious kids cause their parents to feel anxious, who in turn ricochet that anxiety right back to their kids. Or sometimes parents are the ones who have anxiety about their children leaving them.  If you recognize this propensity in yourself, then you may benefit from your own therapy as a way to help your children manage their anxiety. It’s like when you fly in an airplane and heed the instructions: if needed, place the oxygen mask over your own face first, before assisting others.

Don’t let the morning routine paralyze your family. Enjoy the school year.

Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®