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School refusal is a term originally used in the United Kingdom to describe refusal to attend school, due to emotional distress. School refusal differs from truancy in that children with school refusal feel anxiety or fear towards school, whereas truant children generally have no feelings of fear towards school, often feeling angry or bored with it instead. The term was coined as a more general alternative to school phobia, which can be used to describe school refusal caused by separation anxiety.

Approximately 1 to 5% of school-aged children have school refusal, though it is most common in children aged five, six, ten and eleven. The rate is similar within both genders, and there are no known socioeconomic differences.

Children and adolescents with school refusal sometimes suffer from other problems such as mood disorders, social phobia or clinical depression. The longer a child stays out of school the harder it is for them to go back, so some[citation needed] believe it is best to try to get the child back into school as quickly as possible. However, it may be hard to accomplish as when forced they are prone to temper tantrums, crying spells, psychosomatic or panic symptoms and threats of self-harm. These problems quickly fade if the child is allowed to stay home.

Whereas some cases of school refusal can be resolved by gradual re-introduction to the school environment, some others may need to be treated with some form of psychodynamic or cognitive-behaviour therapy. Some families have sought alternative education for school refusers which has also proved to be effective. In extreme cases, some form of medication is sometimes prescribed but none of these have stood out prominently as solutions to the problem.

A medical condition often mistaken for school refusal is delayed sleep phase syndrome (DSPS). DSPS is a circadian rhythm sleep disorder which causes difficulty falling asleep at night and waking in the morning.

Factors that cause school refusal behavior

Factors that cause reluctance to attend school, can be divided into four categories. This distinction has been developed, based on studies in the United States under the leadership of Professor Christopher Kearney.

It is possible that the child wants to avoid school-related issues and situations that cause unpleasant feelings in him, such as anxiety, depression, or psychosomatic symptoms. The reluctance to attend school is one symptom among many in a large number of trouble, such as anxiety disorder, depression, separation anxiety and panic disorder.

It may also be that the child wants to avoid the tests, presentations, group work, specific lessons, or interaction with other children. As well can a child want attention from outside the school, significant people, such as parents or older acquintances.

On the other hand it may be that the child wants to do something more comfortable just experienced her outside of school, like play computer, watch movies, ride with your friends, or use drugs. Some of the children and young people there may be several factors at once.

School refusal untreated, would lead more than half the school refusal child and adolescent to problems which may arise later, such as adult depression, anxiety disorders, under-performance, economic problems, difficulties at work and possibly crime.[1]


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