Source: Raising Children (Australia)

KEY POINTS
• School refusal is when children get very upset about going to school and won’t or can’t go.
• Autistic children might refuse to go to school because they’re worried about something at school or they don’t want to leave home.
• Working as a team with your child’s school is the best way to help with school refusal.
• It’s good to acknowledge your child’s feelings about school, but let your child know that you expect them to go back to school.

SCHOOL REFUSAL: WHAT IS IT?

School refusal is when children get extremely distressed at the thought of going to school. This distress doesn’t go away.

School refusal can range from being reluctant to go to school to not being able to leave home or go to school at all. It can mean that children miss some or all of the school day.

With school refusal, parents usually know what’s happening and try to get their children to go to school.

School refusal is different from truancy or ‘wagging’. Parents usually don’t know about wagging.

School refusal is not a formal psychiatric diagnosis. It’s a name for an emotional and/or behavior problem.

SIGNS AND SYMPTOMS OF SCHOOL REFUSAL IN AUTISTIC CHILDREN

Autistic children show many of the same signs of school refusal as typically developing children. Getting ready for school in the mornings or even the mention of school can be difficult. Children might:
• hide under the bed covers and refuse to move
• beg or plead not to have to go
• have more trouble sleeping the night before a school day
• complain of feeling sick and unwell before school, which generally gets better if they’re allowed to stay at home.

You autistic child might also:
• show high levels of anxiety – for example, your child might rely more on obsessions, routines and rituals, like lining up or spinning objects, or they might stim by rocking, spinning or flapping their hands.
• have more meltdowns or more aggressive behavior, especially if your child is older.

These signs and symptoms might be worse when your child is going back to school at the start of a new school year, after the holidays, or after a long period away from school.

CAUSES OF SCHOOL REFUSAL IN AUTISTIC CHILDREN

Autistic children might refuse to go to school because they’re trying to:
• avoid something at school that makes them feel anxious, worried or overwhelmed
• stay at home.

Avoiding something at school
Your child might be feeling anxious, worried or overwhelmed by something at school, including:
• conflict with peers, teasing or bullying
• problems with a teacher – for example, being told off because they were unintentionally rude
• changes in the classroom or a change of a teacher
• a complex timetable
• unpredictable social situations like lunch breaks
• unfinished homework
• particular classes or activities
• a crowded assembly or noisy journeys on public transport or school buses.

Trying to stay at home
Your child might want to stay at home because home is where they:
• feel safe, comfortable and relaxed.
• can be close to, or look after, a family member or pet, particularly if the family member or pet is unwell
• do the things they like best, like technology or computer games.

UNDERSTANDING YOUR CHILD’S SCHOOL REFUSAL

The first step to working on your child’s school refusal is trying to understand the issue from your child’s point of view. This means you can go to the school with useful information.

Identifying why your child is having trouble going to school
• Ask your child why they don’t want to go to school. Ask whether your child is experiencing any difficulties with peers or teachers, or whether there’s something they’re trying to avoid. For example, ‘If you could change one thing about school, what would it be?’
• If your child finds it hard to identify or talk about the problem, ask your child to rate each part of the school day – for example, the bus ride, classroom, specialist classes, teacher, peers, recess and lunch breaks. You could use pictures for each part of the day. Your child could use 1 for ‘I don’t like’ and 5 for ‘really like’, a sad face and a smiley face, or a thumbs down and thumbs up.
• Think about whether there’s anything happening at home that’s making it difficult for your child to leave home and go to school. For example, have you had a death in the family or recently moved house? Is your child worried about someone at home, or is your dog unwell?

Finding solutions to school refusal
• Help your child to problem solve any obstacles about leaving home or going to school. Clearly define the issue, then brainstorm possible solutions. Choose the option that has the best possible outcome. Autistic children can struggle to think of alternative solutions to problems, so it’s OK to come up with solutions yourself.
• Tell your child that you’re going to work together with their school or counselor to help them go to school.

WORKING WITH YOUR CHILD’S SCHOOL ON SCHOOL REFUSAL

It’s important to act quickly on signs that your child is refusing to go to school. This will make it easier for your child to go back to school. And getting back to school as soon as possible will help your child keep up with schoolwork and friendships.

School refusal is unlikely to go away on its own. The best way to support your child to go back to school and stay at school is by working as a team with your child and your child’s school.

Before term starts
If you think your child might struggle going back to school after the holidays or at the start of the new school year, your child might be able to visit the school a few days before term starts. This can help your child get familiar with key staff and the school environment.

Communicating with your child’s school
After the school year or term has started, regular communication with your child’s school is key to helping with your child’s school refusal:
• Have an early conversation with your child’s class or homeroom teacher, or your child’s education assistant or student support group, if your child has one. Let them know that you’re having problems getting your child to school and share what’s happening for your child. The teacher might be able to refer you and your child to other support staff, like the student welfare coordinator, school psychologist or counselor.
• If your child is experiencing bullying, set up a meeting with your child’s teacher, or the school welfare coordinator, or specialist support staff. You can talk about how the issues are affecting your child and find out about the school’s strategies for managing and preventing bullying. Then you can work together on a plan for managing the situation and helping your child develop healthy friendships at school.

Ongoing support from the school
If your child needs ongoing support to stay engaged in school, these ideas can help:
• Ask the school about forming an attendance student support group. This group can work with you on the best ways to support your child’s attendance.
• Set up regular appointments with your primary contact at the school – class or homeroom teacher, principal, aide, student support group, counselor or welfare coordinator. This will help you and the school check on your child’s progress and ongoing support needs.
• Keep in contact with teachers. They can give your child schoolwork to do at home while your child isn’t getting to school.

Practical measures at school
If your child is finding the school environment overwhelming, there are some practical things you could ask the school about:
• If your child has been off school for a long time, could your child return to school gradually? For example, your child might be able to start with a shorter school day or just go in for their favorite subjects and build up from there.
• Is there a quiet space your child could go to if they feel anxious or upset?
• Could your child use help cards? These are visual reminders to your child to ask an adult for help when they need it. For example, your child could show it to the teacher when they need to go to a quiet space.
• Could your child arrive or leave before or after other children?
• Could your child take a favorite comfort object into school – for example, a soft toy or favorite book?
• Could your child do a special lunchtime activity that builds on their interests?

WORKING ON SCHOOL REFUSAL AT HOME: PRACTICAL STRATEGIES

There are some practical things you can do at home to help your child get back to school.

Acknowledging your child’s feelings
• Show your child that you understand their feelings about going to school. For example, you could say, ‘I can see you’re worried about going to school. I know it’s hard, but you need to go because it’s important for your learning and friendships. Your teacher and I will help you.
• If the problem is mainly about leaving home, explain and reassure your child that things will be OK at home. For example, ‘You don’t need to worry about Nanna, because I’m here to look after her’.
• Remind your child of the things they can do to feel calm, like breathing deeply, listening to a mindfulness app on the way to school, or using a fidget toy. You could use visual supports to remind your child of what to do – for example, you could use pictures of these activities.

Supporting your child to build relationships
• Use role-play to help your child with social skills. For example, you could role-play how to ask someone to play during lunch. Practicing what to say and how to say it builds your child’s confidence to manage the situation on their own. You could also use video modeling.
• Organize playdates for a younger child or encourage a teenage child to invite friends over. Building stronger relationships with peers at school can help your child go to school.

Preparing your child for the school day
• Plan for a calm start to the day by establishing morning and evening routines. For example, get uniforms, lunches and school bags ready the night before, and get your child to have a shower or bath in the evening.
• Help your child stick to a bedtime routine. It will be easier to get your child to go to school if they’re not tired.
• Use clear, calm statements to let your child know that you expect them to go to school. Say ‘when’ rather than ‘if’. For example, you can say, ‘When you’re at school tomorrow …’ instead of ‘If you make it to school tomorrow …’.
• Use direct statements that don’t give your child the chance to say ‘No!’ For example, ‘It’s time to get out of bed’.
• Ask your child what activities they like at school and talk about how they’ll be able to do them when they’re at school. For example, you could show your child a photo of a chicken and say, ‘You love feeding the school chickens. You can do that at school today.

Sticking to school routines at home
• Make your home ‘boring’ during school hours so that you don’t accidentally reward your child for not going to school. This means little or no TV, computer games, leisure activities, internet use and so on.
• Make sure any visitors, like grandparents, know what you’re doing so they don’t make it too fun to be at home.
• Get your child to do work provided by the school while at home. This will help to make sure your child doesn’t fall behind.

Going to school
• Get someone else to take your child to school, if you can. Children often cope better with separation at home rather than at the school gate.
• Praise and reward your child for going to school. For example, your child could earn ‘bonus time’ on technology for regular attendance, a special outing with a parent to their favorite park, or their favorite meal for dinner.

After a long break from school, a social story can help your child get used to the idea of going back to school. It could include pictures of key people and places at the school. Or you could help your child get familiar with their timetable. For example, you could add pictures of classrooms or color code the different classes.

GETTING PROFESSIONAL HELP FOR SCHOOL REFUSAL

You can get professional help with managing school refusal and sorting out the problems behind it.

If your child is saying they feel sick, make an appointment with your GP to check it out.

If there are no physical reasons for your child feeling sick, your GP might refer you to a pediatrician, psychiatrist, or psychologist. If your child already sees one or more of these professionals, make an appointment to see them.

A psychiatrist or psychologist will usually do an assessment to see whether the school refusal is linked to issues like anxiety or depression. Therapies and support for school refusal will probably work better if your child is also getting help for anxiety or depression.

If your child is working with a psychiatrist or psychologist, it’s important that the therapists and school staff communicate with each other. It’s a good idea to set up a meeting between them.

Your child can get Medicare rebates for several sessions with a mental health professional if your child has a mental health treatment plan from their GP. You can also get Medicare rebates for visits to a pediatrician or psychiatrist. If your child has a NDIS plan, you could check whether the cost of psychologist sessions can be covered using your child’s NDIS funding.

LOOKING AFTER YOURSELF

School refusal can be hard to handle, and it can be very worrying. Looking after yourself with healthy food, regular exercise and enough rest is good for your health and wellbeing. And when you’re healthy and well, you’ll be better able to support your child to go to school. Getting support from