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Writer's pictureNirmalya Saha™

School refusal.

A very common problem for every 2nd or 3rd family that their kid doesn't want to go to school or reacts peculiarly when asked to go to school. Although many children feel some digree of fear or anxiety about school, some children experience such excessive anxiety that they refuse to attend school at all. This can be a serious problem because it not only causes much distress to the child bur it also interferes with his/her social or educational development. School refusal also cause distress to parents & teachers.


If it's left untreated, kids with severe symptoms are at increased risk of problems with anxiety & depression ina adulthood as well as difficulties in social adjustments & employment. It means that early identification & treatment is essential. School refusal is not a DSM diagnostic category. But instead it's a symptom that may be related to a number of possible diagnoses or school or social problems. Research has highlighted 3 important aspects of treatment; (1) graduated in vivo exposure in school setting, (2) teaching children specific coping sills, (3) encouraging them to talk about their fears.




School refusal is different from school truancy. Children who are habitually truant from school, tend to have problems of antisocial behavior. Kids who are given the diagnoses of school refusal show signs of anxiety or even panic when pressure is placed on them to attend school, but they show no antisocial behavior. They usually show marked physiological changes like muscle tension or irregular breathing. They are also likely to appear pale because of a high level of arousal of their sympathetic nervous system.


Research on school refusal has emphasized 2 aspects to the disorder; (1) factors that contribute to or related with, (2) its treatment. Many researchers believe that a biological predisposition to emotional problems is important. Stress as a result of new school setting or because of some family issues often trigger school refusal. It's most often treated with CBT that focuses both on the child & on training the parents & teacher in child behavior management skills because kids use verbal protests, temper tantrums & whining as strategies.


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