School refusal is a child-motivated refusal to attend school or difficulty remaining in class for the full day. Child-motivated absenteeism occurs autonomously, by the volition of the child. This behavior is differentiated from non-child-motivated absences in which parents withdraw children from school or are unable to bring their children to school for circumstances such as homelessness. School refusal is characterized by avoidance and/or emotional distress at the time of attending school.
Assessment
Because school refusal behavior is a multifaceted issue, there is not a single valid measure or assessment method for diagnosis. Assessment first involves measuring and evaluating the number of days the child is absent, late, or leaving school early. Parent reports and self-reports from the child regarding emotional distress and resistance towards attendance are taken into account.
Researchers are motivated to assess and treat this behavior because of its prevalence and potential negative consequences. Short-term negative consequences of school refusal for the child include distress, social alienation, and declining grades. Familial conflict and legal trouble may also result.
The onset of school refusal can be sudden or gradual. In cases of sudden onset, refusal often begins after a period of legitimate absence. The problem may start following vacations, school holidays, or brief illness. It can also occur after a stressful event, such as moving to a new house, or the death of a pet or relative.
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! colspan="4" |Risk Factors for School Refusal Behavior Negative reinforcement school refusal behavior is associated with anxiety-related disorders, such as generalized anxiety disorder. Attention-seeking school refusal behavior is associated with separation-anxiety disorder. School refusal classified by the pursuit of tangible reinforcement is associated with conduct disorder and oppositional defiant disorder. Some scholars also emphasize the importance of helping the child manage social, emotional, and behavioral problems that are the result of prolonged school nonattendance.
History
There has been little consensus on the best method for organizing and classifying children demonstrating school refusal behavior. School refusal was initially termed psychoneurotic truancy and characterized as a school phobia. The terms fear‐based school phobia, anxiety‐based school refusal, and delinquent‐based truancy were commonly described as school refusal behavior. These criteria were later declared inadequate in capturing the full range of school refusal behavior.