Does my son/daughter have school refusal?
The answer to this question is in your gut. You know when things are getting out of hand or heading that way. If you are on this site, then you see signs that have led you here.
School Refusal is sometimes also referred to as school avoidance and school phobia. It describes a child's refusal to attend school. It can start as periodically missing school a day here and a day there. It can escalate into missing days of school at a time. It can also lead to children to refuse going to school altogether. Children may refuse school by crying, screaming, hiding or may complain of feeling sick. School refusal is usually related to one or more emotional disorders. It is often seen in conjunction with anxiety, social phobia, depression, and obsessive compulsive disorder. School refusers are not refusing school to be defiant or get attention. There are usually underlying factors and emotional issues causing this behavior.
Living with School Refusal can wreak havoc on a child and their family. It is challenging because the child may not be able to articulate why they are avoiding school. Each day the child misses school work, the more work has to be made up and this creates even more stress. Additionally, some school districts do not understand school refusal. The district can and end up blaming the parents for not getting their child to school. Sometimes the school personnel will say the child is being manipulative and defiant. Also, the child may feel embarrassed by their school refusal and avoid their friends and create more isolation.
School Refusal is often accompanied by one or more of the following:
Anxiety (General Anxiety Disorder, Social Anxiety Disorder, Separation Anxiety)
Obsessive Compulsive Disorder
Mary B. Wimmer, PhD School Psychologist from Wisconsin and School Refusal Expert goes on further to explain the “CHARACTERISTICS OF STUDENTS WITH SCHOOL REFUSAL”
“Anxiety, depression, and physical complaints are frequently associated with school refusal. Anxiety Students with school refusal often exhibit separation, social/performance, or more generalized anxiety reactions as well as other anxiety disorders. Separation anxiety. Students with separation anxiety, which is most common in younger children, become preoccupied with thoughts of harm befalling a loved one and are overly dependent on parents and other caregivers. They may cry, kick, or run away to avoid coming to school. Many young children experience separation anxiety in preschool or when starting kindergarten. However, if the behavior continues for weeks or even months, it is more serious and needs to be promptly addressed.
Social/performance anxiety. Students with social/performance anxiety worry about what others think, are concerned about how they will be judged, and fear humiliation. They may have intense anticipatory anxiety about giving speeches, taking tests, or participating in sports.
Generalized anxiety disorder. Students with generalized anxiety disorder (GAD) have excessive anxiety and worry about any number of situations and events. These students are concerned about their competence, unsure of themselves, and perfectionist about their schoolwork. They tend to perceive the world as threatening and may experience anxiety about situations such as war or catastrophic events like tornados and hurricanes. Their anxiety interferes with school performance and can cause fatigue, restlessness, difficulty concentrating, irritability, sleep disturbance, and muscle tension.
Other anxiety disorders, such as obsessive compulsive disorder (OCD), posttraumatic stress disorder (PTSD), panic attacks, and agoraphobia, can be associated with school refusal.
Depression may be the cause of school refusal behavior for some students. Common characteristics of depression in children and adolescents include depressed mood, lack of interest in activities, irritability, difficulty getting along with others, rebellious or risk-taking behavior, sleep difficulties, physical complaints, fatigue or lethargy, feelings of inadequacy or excessive guilt, difficulty concentrating or indecisiveness, and thoughts of death or suicide. For students who refuse to go to school, the presence of depression is associated with more severe symptoms than for those students with anxiety alone. Many students suffer from both anxiety and depression, two disorders that often occur together”
Dr Chris Kearny from UNLV is a leading researcher of school refusal. He devised the following categories to illustrate school avoidance causes.
School Refusal: Categorical-Dimensional Approach Based on Function
• to avoid school-based stimuli that provoke a sense of negative affectivity, or combined anxiety and depression; examples of key stimuli include teachers, peers, bus, cafeteria, classroom, and transitions between classes
• to escape aversive social or evaluative situations such as conversing or otherwise interacting with others or performing before others as in class presentations
• to pursue attention from significant others, such as wanting to stay home or go to work with parents
• to pursue tangible reinforcers outside of school, such as sleeping late, watching television, playing with friends, or engaging
The following is the School Refusal Assessment Scale-Revised (SRAS-R), developed by Christopher Kearney and Wendy Silverman. It is a psychological assessment tool designed to evaluate school refusal disorder symptoms in children and identify their reasons for avoiding school.
Scoring and interpretation of the SRAS-R
Scoring the SRAS-R is based on a 0-6 scale, with each question being scored as follows based on participant response:
0 points: 0, meaning “never”
1 point: 1, meaning “seldom”
2 points: 2, meaning “sometimes”
3 points: 3, meaning “half the time”
4 points: 4, meaning “usually”
5 points: 5, meaning “almost always”
6 points: 6, meaning “always”
Each item in the question set contributes to a different function which may be contributing to the child's school refusal behavior. Total scores may be computed by adding the scores of each of four functions on both the parent and child versions. These function scores are each divided by 6 (the number of scores in each set). Parent and child function scores are then summed and divided by 2 to determine the mean function score. The function with the highest mean score is considered the primary cause of the child’s school avoidance. The function divisions are as follows:
Function one ("avoidance of stimuli provoking negative affectivity"): items 1, 5, 9, 13, 17, and 21
Function two ("escape from aversive social and/or evaluative situations"): items 2, 6, 10, 14, 18, and 22
Function three ("attention seeking"): items 3, 7, 11, 15, 19, and 23
Function four ("tangible rewards": items 4, 8, 12, 16, 20, and 24
Scores within 0.50 points of one another are considered equivalent.