What does school avoidance look like?
  • Complaints of not feeling well, with vague, unexplainable symptoms
  • Anxiety-related symptoms such as headaches, stomach aches, hyperventilation, nausea, or dizziness
  • Symptoms often occur on school days and are usually absent on weekends
What could be causing your child's anxiety?
When to seek help
  • While you might try to manage school refusal on your own, if your child's school avoidance lasts more than one week, you and your child may need professional assistance to deal with it.

  • First, your child should be examined by your pediatrician. If your child's school refusal persists, or if they have chronic or intermittent signs of separation difficulties when going to school – in combination with physical symptoms that are interfering with functioning – your doctor may recommend a consultation with a child psychiatrist or psychologist.

  • Even if your child denies having negative experiences at school or with other children, their unexplainable physical symptoms should motivate you to schedule a medical evaluation.
Steering your child back to school: Tips for concerned family members
  • First, have your child examined by a doctor who can rule out physical illness and assist you in designing a plan of treatment. Once physical illness has been eliminated as a cause of symptoms, your efforts should be directed not only at understanding the pressures your child is experiencing but also at getting your child back in school.

  • Talk with your child about the reasons why they do not want to go to school. Consider all the possibilities and state them. Be sympathetic, supportive, and understanding of why your child is upset. Try to resolve any stressful situations the two of you identify as causing worries or symptoms.

  • Acknowledge that you understand your child's concerns, but focus on their return to school. The longer your child stays home, the more difficult their eventual return will be. Explain that they are in good health and their physical symptoms are due to other things – perhaps grades, homework, relationships with teachers, anxieties over social pressure or legitimate fears of violence at school. Let your child know that school attendance is required by law. They will continue to exert some pressure upon you to stay home, but you must remain determined to get your child back in school.

  • Communicate and collaborate with the school staff, including the teacher, principal, school nurse, school guidance counselor, psychologist, or social worker to share what you know about why your child is struggling to attend school. The more information the school has about why school avoidance is occurring, the better they will be able to help you. Share with them your plans for your child's return to school and enlist their support and assistance.

  • Make a commitment to be extra firm on school mornings, when children complain most about their symptoms. Keep discussions about physical symptoms or anxieties to a minimum. For example, do not ask your child how he or she feels. If they are well enough to be up and around the house, then he or she is well enough to attend school. 

  • If your child's anxieties are severe, they might benefit from a step-wise return to school. For example: On day one, they might get up in the morning and get dressed, and then you might drive them by the school so they can get some feel for it before you finally return home together. On day two, your child might go to school for just half a day, or for only a favorite class or two. On day three, your child can finally return for a full day of school.

  • Your pediatrician might help ease your child's transition back to school by writing a note verifying that he or she had some symptoms keeping them from attending school, but though the symptoms might persist, they are now able to return to class. This can keep your child from feeling embarrassed or humiliated.

  • If a problem like a school bully or an unreasonable teacher is the cause of your child's anxiety, become an advocate for your child and discuss these problems with the school staff. The teacher or principal may need to make some adjustments to relieve the pressure on your child in the classroom or on the playground.

  • If your child stays home, be sure they are safe and comfortable, but do not give them any special treatment. Your child's symptoms should be treated with consideration and understanding. If your child's complaints warrant it, they should stay in bed. However, your child's day should not be a holiday. There should be no special snacks and no visitors, and they should be supervised.

  • Your child may need to see a doctor when they stay home because of a physical illness. Reasons to remain home might include not just complaints of discomfort but recognizable symptoms: a temperature greater than 101 degrees, vomiting, diarrhea, a rash, a hacking cough, an earache or a toothache. 

  • Help your child develop independence by encouraging activities with other children outside the home. These can include clubs, sports activities, and overnights with friends.
IEP and 504 plan accommodations to share with your child's teacher
Classroom and environment accommodations examples

  • “Cool down passes” to take a break from the classroom. Examples might include a walk down the hallway, getting water, standing outside the classroom door for a few minutes, completing coloring pages in the back of the room, or using a mindfulness app with headphones.

  • Provide positive reinforcement, like stickers, extended computer time, or a special activity when a child tolerates a feared situation.

  • When a child has concerns about getting the directions wrong, try signaling the class first when giving directions (flashing lights, clapping hands). When possible, have the directions written on the board or elsewhere. It may help assure anxious children that they have understood the directions.

  • Provide a consistent, predictable schedule. Post in a visible place for the child’s reference.

  • Allow breaks as necessary and offer opportunities for action. For instance, pacing without disturbing others, running an errand, handing out papers, or using a soft squeeze ball.

  • Identify one adult at school to seek help from when feeling anxious (school counselor, if available)

  • Buddy system: Pair student with a peer to aid with transitions to lunch and recess (these less structured situations can trigger anxious feelings)

  • Extra time and warnings before transitions.

  • Preferential seating (near the door, near the front of the room, near the teacher’s desk).

Homework and test accommodations examples

  • Extended time on tests will ease the pressure on anxious children. Testing in an alternate, quiet place is preferable for some children. Consider the use of word banks, equation sheets, to cue children whose anxiety may make them “blank out” on the rote material.

  • Clearly stated and written expectations (behavioral and academic)

  • Frequent check-ins for understanding, prompted by the teacher.

  • Modify assignments; have the child complete only odd-numbered problems, allow them the use of a word processor, or give an oral exam instead of a high-pressure, written exam.

  • Allow extra time on quizzes, exams, and in-class assignments.

  • Consider having the child present to the teacher alone, or have the child audiotape or videotape the presentation at home.

  • Record class lectures or use a scribe for notes

Other Accommodations for Anxiety

  • Preferential group (teacher or adult child knows well) for field trips

  • Help after illness: Missed work can spike anxious feelings. Providing class notes and exempting students from missed homework can help.

  • Assign a responsible buddy to copy notes and share handouts.

  • If tests are given the day of the child’s return, give them the option to take the test at another time and use the test-time to make up any other missing work.

  • Substitute teachers: Letting the child or family know when a substitute will be in the classroom can help the child prepare.

  • Determine the child’s comfort with either closed-ended questions (requiring a yes or no) or with opinion questions. Start with whichever is easiest.

  • Use a signal to let the child know that their turn is coming.

  • Provide opportunities for the child to share knowledge on topics in which they are most confident.

  • Fire and safety drills-While these drills are necessary, anxious children can becvery distressed by imagining these events. If there is an opportunity, signal the child in person just before the alarm sounds. This may buffer the surprise of the drill and allow children to mobilize with less distress.

Adapted from A Day in our Shoes
Anxiety and School Avoidance Webinar
February 19, 2020, 12:00-1:00pm

Is getting your child to school a struggle?

Anxiety is a natural part of childhood, but when anxiety impedes on your child’s ability to learn, you may need support and services through the Committee on Special Education. Learn how to collaborate with your child’s school and what supports and services are available through school when your child has anxiety.

This webinar will not be broadcast in our office. To participate, you must have access to a computer at another location – your home, office, or other facility.

REGISTRATION IS REQUIRED. To register, please use this link –

Additional Resources