COLUMBUS, Ohio – Parents and caregivers often hear a child say, "I don't want to go to school." But when this becomes a regular occurrence, it may be a sign of school avoidance, also known as school refusal- which may be a sign of emotional distress. A new national survey conducted by Ipsos on behalf of The Kids Mental Health Foundation , founded by Nationwide Children's Hospital , reveals nearly a third of parents (30%) whose child missed school due to fear or anxiety last year report their child missed more than a week of school.
The national survey of more than 1,000 parents across the United States also reveals roughly two out of five students who missed school (42%) say they don't feel physically well enough to attend, and one in five say they are too exhausted to attend (20%).
"It's important to recognize that there are a lot of physical symptoms that manifest in kids that are really related to mental health," said Kelley McChristy, a mom of two boys in Columbus, Ohio, who has experienced school avoidance. "When a child says, 'I'm sick, I'm not feeling well,' and you can't find a reason for it, it could be related to anxiety."
According to the National Institutes of Health (NIH), as many as 28% of children experience school avoidance – most commonly among 10–13-year-olds and children transitioning to different schools.
"School avoidance can happen for multiple reasons. Kids may have social concerns, like bullying or feeling like they do not fit in. They could be worried about test taking or having to speak in front of the class," said Ariana Hoet , executive clinical director of The Kids Mental Health Foundation and a pediatric psychologist at Nationwide Children's. "Or sometimes kids don't want to go to school because they have an undiagnosed learning disability, making school stressful for them."
The Kids Mental Health Foundation offers free, evidence-informed resources to help parents and caregivers understand the signs of school avoidance and gives them the tools to help navigate it. Dr. Hoet says having conversations with kids about why they don't want to go to school is crucial in helping them cope with their strong emotions.
"I see this clinically all the time. Kids feel anxious. They don't want to go. They're in distress. And as parents, we want to protect them. We don't want our kids to be in distress, and so the parent decides to keep them home," said Dr. Hoet. "The problem with that is the more we avoid things that make us anxious, the bigger the anxiety gets. And so, a parent feels like they're doing the right thing by giving their child a mental health day or keeping them home, but really that's just going to make the anxiety grow."
And McChristy says knowing what resources are available is key so parents can proactively help their kids address concerns about school avoidance.
"That would be my first piece of advice — to know about resources and help ahead of time and be proactive instead of reactive because I think I was more reactive. And if I could switch that, I would," said McChristy. "I have been shocked by the amount of people that I've talked to whose children are going through the same thing."
If a school avoidance situation worsens when a child refuses to leave their home and it continues for multiple days in a row, a therapist may help. Cognitive behavioral therapy (CBT) may help decrease anxiety and increase school attendance. Therapy may help a child understand they're able to do things that make them anxious, and facing their fears will increase confidence over time.
