Student Well-Being Q&A

What Educators Need to Know About the Intense Anxiety That Keeps Students Home From School

By Evie Blad — September 08, 2023 5 min read
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As schools deal with surges in chronic absenteeism, many educators say an increase in anxiety and mental health concerns have contributed to the problem—and those factors can be difficult to address.

Psychologists use the term “school avoidance,” also known as school refusal, to describe a fear or anxiety that makes it emotionally difficult for students to attend school or to remain there for a complete day of classes. In some cases, students may have panic attacks as they get ready or refuse to leave a vehicle in the drop-off line, said Jayne Demsky, the founder of the School Avoidance Alliance.

After her own son struggled with school avoidance, Demsky created the organization, which focuses on providing resources for parents and professional development for schools. He later attended a therapeutic boarding school to aid in his recovery.

Since the school interruptions of the COVID-19 pandemic, Demsky has seen more concern about school avoidance. For both schools and parents, early intervention, good communication, and understanding are key to tackling the issue, she told Education Week.

This interview has been edited for length and clarity.

What is school avoidance? How would you explain it to someone who isn’t familiar with it?

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School avoidance or school refusal is when a kid has severe discomfort and fear about going to school. Kids might tantrum cry, they might hide under their covers, or hold on to their bedroom door or bed if a parent is trying to get them out.

It could start with a day [of absence] here and there and then gradually builds. It’s not like, “Mommy, I have a stomach ache and don’t want to go to school today.” It is really severe and disconcerting for parents—so much so that you would have to almost drag your kid out of the house to get them to go to school.

People who are unfamiliar with school avoidance might say it’s not uncommon for kids to want to play hooky occasionally. Is there a lot of misunderstanding about this condition?

Yes. I started this because I went through it with my son. You think that, for kids, their job is to go to school and, for parents, it’s like a given that your kid goes to school. No one really understood school refusal back then—and they still don’t.

We couldn’t tell people. They’d be like, “What’s wrong with you? You are weak. Send that kid to my house, and I will get him [to] school.” It’s not so simple. It really isn’t.

The kids are really suffering. It’s really scary the way they feel. When you deal with a kid like this, they almost feel like they’re going to die. They’re just so scared. And as a parent, you feel helpless.

Were there warning signs with your son that you recognize in hindsight?

My son started having anxiety early on in kindergarten, 1st grade, 2nd grade, but I didn’t recognize it. Kids don’t present classically. It’s not like sweaty palms and trouble breathing. He would have problems doing homework, running circles around the room, and having tantrums.

It grew to where a few times in 4th and 5th grade, he wouldn’t get into the car [to go to school]. In 6th grade, he would forget to bring his books home, and he stopped going more and more. The school didn’t know what was going on. They thought he was being lazy, and no one recognized it as anxiety. They treated it like a behavioral issue, like defiance.

It can be very isolating because people don’t understand.

And school avoidance is not a primary diagnosis, right? Does it relate to other issues?

Yes, they say it’s a symptom of [a] greater issue.

There are four functions of school avoidance. Two of them relate to avoiding things [distress from issues in the environment, like bullying, or fears of poor performance on tasks, like reading out loud]. The other two relate to seeking tangible rewards [receiving time with, or recognition, from a parent or remaining in the comfort of home].

Research shows there are two main factors for what helps improve outcomes. One is in school collaboration. Of course, schools are going to say they want to work with parents, but the problem is that sometimes we get into the blame game. The school doesn’t understand what’s really going on at home. Parents are doing whatever they can to get their kids to school, but they aren’t sharing everything that’s going on with the schools.

Schools are really pressured by compulsory-attendance laws. They are under pressure to get these kids back in their seats. Attendance letters are often the first interaction [a parent dealing with school avoidance] may have with their school district. Your home is in shambles, and your first interaction from your school is: “You’re going to truancy court if you don’t come back to school.”

Schools do care, and they are recognizing more and more that mental health is important, and they want to support it. But parents don’t know about student-support teams. They don’t know their school’s social workers, psychologists, and counselors. Schools should have this on their website. And schools should educate parents that there is such a thing as school refusal so they can tell you what’s going on, rather than hiding it from you.

And what’s the other factor that improves outcomes?

Early intervention, which is a ubiquitous term in education. It’s easy to say and hard to achieve. Because schools are overwhelmed, they have a million things going on, they often start [addressing absences] with threats or punitive responses.

Many schools have teams like response to intervention, or RTI, teams. We say, “Make sure there are a few people on that team who understand school avoidance.” We also work with principals and superintendents who really inform policy.

School leaders reading this would probably tell you they are pretty overwhelmed. What’s a good starting point for addressing student anxiety in a school?

They should do a school climate survey if they have not. These surveys go out to students, families, and staff to determine what is going on in a school from a child’s point of view. That should really tell schools a lot about what they should be addressing.

In terms of absence, I would really work on educating families on anxiety. A lot of schools do focus on educating families, but they focus on the value of education. But usually parents of kids with school refusal already value school; they want their kids to go. So schools are missing the mark with those people.

I would also tell principals and superintendents to reevaluate their communications with parents. Let’s make sure that attendance letter is not the first intervention.

A version of this article appeared in the September 27, 2023 edition of Education Week as What Educators Need to Know About the Intense Anxiety That Keeps Students Home


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