What is School Refusal Behavior?
Many Sufferers Also Have Underlying Anxiety Disorder
The disorder encompasses all forms of problematic absenteeism by students, including tardiness, school phobias, and separation anxiety. Although students of all ages can be affected, the age group most heavily afflicted are children ages 12-18. Stressors such as a family move or a transition to a new chool can also trigger symptoms.
As noted by Christopher Kearney, PhD of the University of Nevada-Las Vegas, an expert on school refusal disorder, this problem affects 5% to 28% of children during their school lives. Kearney outlined these statistics in a 2006 article, "Dealing with school refusal behavior: A primer for family physicians," written for the Journal of Family Practice. In other words, adults probably know or have known someone who has suffered through it.
Symptoms Begin Years Earlier
Students as young as five years of age can have symptoms when they cry or say they have a stomach ache to avoid attending school.
"It begins as soon as they start school, but at that age, parents can pick up a crying child and tell him or her that they are going to school," said Maggie Hahn, Clinical Coordinator of the Adolescent Psychiatric Unit at Northwest Community Hospital in Arlington Heights, IL.
By the time they reach middle school, sufferers can get aggressive with parents and disrupt family life. Grades begin to fall, dropping out of school is a possibility as well as drug and/or alcohol abuse. if the problem is left untreated.
Terrified of School
School refusal behavior is not a matter of students simply not wanting to go to class. Sufferers are terrified of going to school.
“It breaks down into two reasons,” Hahn explained. “Some are terrified of something in school, either taking tests, or thinking that the other kids are laughing at them. Others have actual separation anxiety, and are afraid that something bad will happen at home while they are gone.”
For treatment to be effective, which subvariety of the disorder a student suffers from must first be determined. so treatment and coping mechanisms can be tailored to fit the situation.
Kearney's article in the Journal of Family Practice recommends an entire battery of questions such as "Would you rather be with your family than at school?" or "How often do you stay away from school because it is difficult to speak with other kids?"
Few Treatment Options
Although recognition of the disorder may be made by a family physician or pediatrician one of the difficulties is that resources to treat it are scarce. Hahn believes that Northwest Community Hospital's track is the only in-patient program in the country for school refusal disorder, although a number of hospitals in metropolitan areas have outpatient programs. Compounding the problem is that many sufferers also have underlying anxiety, depression, or other psychological disorders that may need ongoing care.
School Refusal Warning Signs
While one student may complain of headaches or stomachaches, another may refuse to get out of bed, while a third repeatedly gets "sick" and calls home during the school day. Symptoms can run the gamut and may even include combinations of behaviors. Here are some typical warning signs that a child is suffering from school refusal disorder:
- Failing grades
- Frequent physical complaints such as headaches, stomachaches,
- Social problems
- Anxiety or panic attacks
- Depression
- Fatigue
- Risk-taking behavior
- Drug/alcohol use
- Physical Aggression or threats
Many symptoms, particularly physical complaints can mimic other disorders. When these occur in combination with a pattern of not attending school, a through evaluation should be made by qualified professionals to determine whether a student has school refusal disorder or another psychological or possibly even a physical disorder.
Even Ordinary Activities Can Terrify Students
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