School Refusal

Some children exhibit a persistent refusal to attend school.

True. It may commence as a mild reluctance, but progresses into a total refusal. It may remain despite persuasion, threat or punishment.

This abnormal behaviour may be associated with an obvious fear, anxiety or even panic that takes hold when the time to go to school arrives.

Some cannot even force themselves to leave home to make their way to school. Others will go part of the way, then turn back and come home. Others may reach school, then suddenly rush out of the building, run home in a state of abject misery and near panic. Many of these children insist that they want to go, but when it comes to the actual event, they fail.

Some cases present with this clear-cut picture. But more often it’s disguised in some form of somatic overlay.

The child may complain of any one of innumerable symptoms. Loss of appetite, limb pains, nausea and vomiting, feeling faint, are all well-known symptoms. They are present before school. But they invariably disappear soon after the decision to remain home has been made. They are generally surprisingly lacking at weekends.

This may occur acutely in a younger child, and is associated with a fear of leaving the parent. But it can take place in older children also, and may come on more insidiously.

Efforts to reduce family or school tensions and anxieties must be made. Taking a firm stand is essential. Psychological counselling may be necessary, and a sedative may be prescribed.