School Refusal Hope

School Refusal 101


 

Does my son/daughter have school refusal?

School Refusal is also referred to as school avoidance and school phobia. Although, school phobia is an antiquated term and isn’t really used in professional circles. It describes a child's refusal to attend school. It can start out periodically by missing a day of school here and there. It can escalate into missing days, weeks or months of school at a time. Estimates citing the prevalence of school avoidance put the figure at 2-5% . However, these numbers are based on older research. School and mental health professionals say that they have seen a rise in school refusal cases over the past few years. So, the actual current numbers may very well be greater.

Children may refuse school by crying, screaming, hiding or may complain of feeling sick. School refusal is often seen in conjunction with one or more emotional disorders. According to a 2015 research study by Dr. Brandy Maynard, a leading school refusal researcher and professor at Saint Louis University; “the emotional distress associated with school refusal is often in the form of fear or anxiety. it is commonly found that around 50% of participants have an anxiety disorder. A broad range of anxiety disorders has been observed, including separation anxiety disorder, specific phobia, social anxiety, generalized anxiety disorder, and panic disorder with agoraphobia”. Kids who refuse school are not refusing to be defiant or get attention. Many kid’s can’t even explain themselves why school is causing them distress. And then it gets complicated by the negative consequences such as social alienation, an overwhelming backlog of missed work, declining grades, conflicting parental views, and possible legal trouble due to the excessive absenteeism.

So, 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. Don’t delay getting help.


 

7 Things You Can Do if Your Child Is Showing Signs Of School Refusal

1.    Call your school and ask to speak to the school psychologist. They are usually part of the Child Study Team (aka: Student Support Team or other like terms). This group of school professionals is in charge of special services (aka special education services). Most families don’t realize that special education in school covers emotional disorders also, not just learning, developmental and physical disabilities. Tell them what is going on and ask for their assistance. They should be willing to work with you on a plan to help your child get into school even if it is for a reduced day. 

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2.    Find a an experienced mental health professional such as a psychologist or psychiatrist. Ask if they have experience with school refusal kids or at least anxious kids. Have them evaluate your child to see if he is dealing with an emotional disorder such as anxiety. Consider using your out-of-network health insurance benefits if you cannot find a suitable professional in your network. Click here to learn about evidence based treatments for school refusal kids. 

3.    Look into your community mental health resources. The federal and state government provide funding to support local mental health services. Some services that may be available are 24/7 crisis response hotlines (some counties will send someone to your house to assess the situation and offer help), low-cost mental health organizations that provide outpatient therapy, psychiatrists, group therapy and community support organizations. To find these services, just google your county name and “mental health services”. If your county resources are thin, then google your state’s mental health services.

4.    Try your hardest not to yell or berate your child. They are not doing this on purpose. They are suffering in some way and it is showing itself in the school refusing behavior. I know this is very hard to do as this is a very frustrating situation.

5.    Find comfort and support from other parents who are dealing with mental health problems in their family. There are a number of national mental health non-profits that provide local support groups and mental health education workshops. Three organizations that do a great job are; the National Alliance on Mental Illness (NAMI), Mental Health America (MHA) and Depression and Bipolar Support Alliance (DBSA). I see that DBSA just started online communities for support, which is awesome. People who you meet through these organizations know exactly how you feel and will be happy to provide support and share resources.

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 6.    Listen to your gut. As parents, we know our kids best. Sometimes we forget that and defer to the professionals even though our gut is telling us that something isn’t right. I often hear stories from parents about how they knew better and should have done what they initially thought was best for their child.

 7.    Take care of yourself and try not to let the school refusal consume you. I know this is extremely difficult, but you are the key to finding the right help for your child. Keep yourself busy and don’t let your mind wander to a million “what if” scenarios.  Go to the gym and try to eat well so you can keep up with your mental strength. Consider speaking to your own mental health professional for support and guidance. 

This is a difficult time in your life, but it will not always be this way.  Stay hopeful and determined and keep fighting for your child’s recovery.

The School Refusal Assessment Scale -Revised (SRAS-R)

The SRAS-R is a psychological assessment tool designed to evaluate school refusal disorder symptoms in children and identify their reasons for avoiding school. It was created by Dr. Chris Kearney who is a leading school refusal researcher from the University of Nevada, Las Vegas.

Dr. Kearney created the Categorical-Dimensional Approach Based on Function , which identifies four possible functions that cause school refusal behavior.

  1. 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

  2. To escape aversive social or evaluative situations such as conversing or otherwise interacting with others or performing before others as in class presentations

  3. To pursue attention from significant others, such as wanting to stay home or go to work with parents

  4. To pursue tangible reinforcers outside of school, such as sleeping late, watching television, playing with friends, or engaging

 

You can click-through this image of the SRAS-R Parent Edition (below) to see the whole form and fill it out. After you score it, the results will show which of the four categories (reasons) are contributing to your child’s school refusal behavior.

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 four 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.

 
 

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, & 21

  • Function two ("escape from aversive social and/or evaluative situations"): items 2, 6, 10, 14, 18, & 22

  • Function three ("attention seeking"): items 3, 7, 11, 15, 19, & 23

  • Function four ("tangible rewards": items 4, 8, 12, 16, 20, & 24

  • Scores within 0.50 points of one another are considered equivalent.

If Your Child Has School Refusal