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School avoidance (sometimes called school refusal) occurs when a child regularly refuses to attend school for all or part of the school day (Sewell, 2008). This may include leaving early, coming to school late, or spending all or part of the day in only certain locations in the school in which a child feels safe, such as the nurse’s office, or main office.  A child may show significant distress and emotionality, such as crying, hiding or refusing to leave their house.  A child may show panic symptoms, including temper tantrums, threats, fear, bodily symptoms that present when it is time for school but improve if the child stays home (Kaswar et al, 2022).

 School refusal affects 5-28% of school-aged children at one time or another and is distributed fairly equally among racial, gender, ethnic and income groups (Kearny, 2001). School refusal is more common in students entering a school building for the first time, such as with kindergarteners, and students just entering middle and high school (Hansen, et al, 1998). 

A child may avoid school for multiple reasons and it may or may not be related to a mental health diagnosis, however, it is often comorbid with separation anxiety, generalized anxiety, specific phobias, major depression, oppositional defiant disorder, post-traumatic stress disorder or another mental health concern (Kaswar et al, 2022, Kearny & Albano, 2004). It may or may not be related to learning difficulties. 

A child’s social environment may have an impact as well; factors such as social skill development, family factors, bullying and relationships may play a role.   Developing a successful plan to treat school avoidance begins with a comprehensive functional assessment (Kearny, 2004). 

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School avoidance is a common concern among our clients. At Morningstar Behavioral Services, our treatment of school avoidance begins with a functional behavior assessment of the school avoidance behavior, which includes an assessment of psychoeducational variables and in-home observations.  This assessment then drives the treatment plan. As board certified behavior analysts and school psychologists, we focus exclusively on educational interventions, parent training and behavioral intervention. 

We work collaboratively with schools and families to develop educational and behavioral interventions. We train parents and school staff to implement behavioral interventions confidently.  Our behavioral intervention plans for school avoidance are individualized based on the results of the functional behavior assessment for each student and focus on what both families and schools can do to help their child come to school each day and experience success.