School Refusal: What do I do when my child won’t go to school?

School refusal is the emotional distress faced by children, with and without an ASD, in response to the idea of going to school. Refusal to go to school is common among students who are just starting school or are in a time of transition, such as starting high school. Regardless of how or when your child is showing you that he or she does not want to go to school, it is important to find out why this is the case. Only then can you provide your child with effective strategies for coping with the aspects of school that he or she finds overwhelming.

Figuring out the 'why'

In order to help your child manage anxiety toward school it is important to consider the function of his or her school refusal behaviour. Like other problem behaviour, school refusal has two main functions: attention and escape/avoidance. For example, younger children may refuse to go to school to gain parental attention (Kearney, Pursell, & Alvarez, 2001). Older students may seek to avoid social or academic situations. For students who do stay home, school refusal may be positively reinforced by alternatives, such as playing with preferred objects at home or spending the day with mom or dad (Heyne & King, 2004). Play detective and find out what function your son’s or daughter’s school refusal behaviour is serving.

Fear Ladders

For refusal that is functioning as an escape or avoidance of school, try using a fear ladder (see below). Fear ladders help children identify the level of anxiety experienced at each step involved in going to school (e.g., riding the bus, walking through the hallway, etc.). As such, they help children identify which parts of school they can cope with and which components of school they find overwhelming.

Fear LadderFear hierarchy for school refusal (Peacock & Collett, 2010

Depending on your child’s age, reading level, and language use, you may choose to use a fear ladder that is based on pictures rather than words. Guidelines for introducing fear ladders, as well as student examples, can be found at anxietybc.com.

Coping strategies

For those aspects of school that your child finds overwhelming and has difficulty coping with, teach them calm-down strategies, such as progressive muscle relaxation and deep breathing. Strategies such as these will help your child control his or her anxiety in situations he or she finds difficult, and are commonly taught to students as a means of self-regulation or coping in a variety of situations. During progressive muscle relaxation, children are taught to recognize the difference between when their muscles are tense and when they are relaxed and practice relaxing through tense-release exercises of the major muscle groups (Wimmer, 2003). Several scripts have been developed for progressive muscle relaxation; guided imagery may also be incorporated for younger students, such as “squeezing lemons” when tensing their muscles (Heyne & King, 2004).

Gradual exposure

Exposure is a key component for students who exhibit school refusal behaviours, as the ultimate goal is to have them attend school willingly and on a full-time basis. The first step is engaging your child and his or her teachers in conversations about going back to school and determining which coping strategies (described above) your child can use in situations he or she finds overwhelming. Be sure to begin exposure with situations that are “just a little scary” to ensure that that your child experiences success (Peacock & Collett, 2010). Next, try a step-by-step approach, in which your child attends school in steps, for example, attending one class the first day, two the next, etc. For each level of exposure, children are taught a strategy (e.g., deep breathing) to cope with the situation and calm themselves down. It is also important to ensure that a parent, teacher, or support worker is with the student to provide coaching when distress is experienced to help the student successfully retrieve relaxation techniques (Peackock & Collett, 2010). As your child becomes better practiced at retrieving these strategies, fade adult support to foster independence in each situation.

Social skills instruction

Many students with ASD have some component of social skills instruction at school. This area of focus will be particularly important for students who identify social situations at school as those they find really scary. Talk to the school counsellor or your child’s case manager about the opportunity for social skills instruction focused on the “really scary” situations identified by your son or daughter. Instruction should involve modeling of the desired social behaviours, rehearsal through role-play, and corrective feedback and reinforcement.

Take Home Message

School refusal is a common problem among students, both with ASD and without. Often times, students refuse to go to school as a result of distress or anxiety experienced in particular situations at school. We can help children self-manage in these situations by teaching coping strategies, teaching social skills, and exposing them to school gradually. It is essential that home and school work together to coach, model and prompt these strategies.

References

http://www.myaspergerschild.com/2011/08/dealing-with-aspergers-children-...
Peacock, G.G. & Collett, B.R. (2010). Collaborative Home/School Interventions: Evidence-Based Solutions for Emotional, Behavioral, and Academic Problems. New York, NY: The Guilford Press
Heyne, D., King, N.J., Tonge, B.J., Rollings, S., Young, D., Pritchard, M., & Ollendick, T.H. (2002). Evaluation of child therapy and caregiver training in the treatment of school refusal. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 687-695. doi:10.1097/00004583-200206000-00008
Wimmer, M.B. (2003). School refusal: Assessment and intervention within school settings. The National Association of School Psychologists