School Behavior

“Help! My Child Won’t Go to School.”

School refusal impacts up to 28% of children. It often stems from anxiety associated with ADHD and learning challenges. Follow this three-pronged approach to get your child back into the classroom without trauma.

By Alana Cooperman, LCSW Updated on May 7, 2025
Click to Add Comments

For some neurodivergent students, school is not a sanctuary for learning. It’s perceived as a source of constant stress, triggering physical symptoms like stomachaches, headaches, and even nausea. These children may wage a miserable battle to stay home each morning or have trouble remaining in school throughout the day.

This isn’t about playing hooky. School refusal, also called school avoidance, is a serious matter. An acute case can last from two weeks up to a year; a chronic case might persist for a year or two. School refusal may stem from underlying struggles associated with ADHD, learning disorders, or separation or generalized anxiety. A student might be overwhelmed by academic challenges, bullied at school, rejected by peers, and/or troubled by family distress at home.

School refusal has grown worse since the COVID-19 pandemic. When schools reopened and resumed in-person learning, experts say, many students didn’t return to the classroom. Generally, school refusal affects 5 to 28 percent of students at some time in their lives, according to the School Avoidance Alliance.

What School Refusal Looks Like

Elementary-age children cling to their parents and resist entering the school building. At home, they complain of stomachaches, headaches, nausea, or vomiting. They have tantrums when talking about homework or express worry about school. Sometimes, they run away from home to avoid going to school.

A child’s teachers might report a change in their behavior, or their mood might shift unexpectedly in school and at home. The child generally starts to worry about things unrelated to school.

[On-Demand Webinar: School Avoidance & Refusal Strategies for Parents and Educators]

School refusal looks different in adolescents and teens. Many of them leave school early, skip class, or avoid certain parts of the day by going to the nurse. Some have sleep problems and complain of stomachaches and other ailments. Some experience panic attacks.

Older students can’t always communicate their feelings or anxieties. Instead of saying something like, “School is really hard and I’m struggling,” they become defiant, irritable, and angry toward peers and family members. Older kids also become more self-conscious about their academic performance, how they think others perceive them, and their physical appearance.

Identifying Underlying Fears of School

Distractibility, sensory overload, poor working memory, disorganization, and time blindness can make school challenging for students with ADHD. Those with anxiety may seek to escape the pressure of classroom tests, quizzes, and social situations. Others may avoid school to gain access to rewards at home, like video games or screen time.

Addressing school refusal is critical — and achievable. Many therapists recommend cognitive behavioral therapy (CBT) because it can help kids identify their underlying fears and support a gradual shift in their behavior.

Children with ADHD commonly struggle with anxiety, which brings a fight, flight, or freeze response. Avoidance, an example of the flight response, is common for kids who have anxiety and ADHD. To improve anxiety, you must address avoidant behavior.

Think of it this way: A boy is scared of his neighbor’s dog. When he steps out of his house and sees it, his heart races and he thinks, “The dog is going to bite me.” He runs back into his house and calms down, but only temporarily.

When he sees the dog again, his anxiety grows in intensity because avoiding the dog only confirmed his anxiety. His urge to run away is even greater.

[Download: Social Anxiety Facts and Falsehoods]

So how does the child conquer his fear of dogs? By not avoiding them. The more children are exposed to what they fear — in safe, incremental doses — the more they teach their bodies to understand: “I can do this, even though it’s really hard.” This helps build a tolerance for things that are uncomfortable.

This process is called exposure therapy: It means exposing an individual to the fear that triggers their anxiety in gradual, increasingly challenging steps. This is a critical part of the treatment plan for school refusal. When kids confront their fear, and ride the wave of anxiety that builds, crests, and subsides, they learn that their anxiety will pass and that they can tolerate the feeling while it’s happening.

An effective school refusal treatment plan, called a hierarchy, requires a nuanced understanding of a child’s specific situation. The hierarchy should include motivating rewards upon completion of each step. But keep in mind: It’s important to break down the hierarchy into very small steps. Practice the first step until a child’s anxiety level drops from a rating of 8 out of 10 to a 4 or 5. Then move to the next step.

Below is a sample hierarchy plan:

  1. Drive to school
  2. Walk to school door
  3. Walk through school door
  4. Walk to selected location in school
  5. Walk to classroom, sit outside for 5 minutes
  6. Walk to classroom, sit outside with a friend for 10 minutes
  7. Walk into class, sit in“safe spot” for 5 minutes
  8. Stay in school 1 (2, 3, 4) period(s)
  9. Stay in school until lunch
  10. Stay all day

Working with Your Child’s School

An effective partnership between parents, the school, and a therapist may look like this:

  • The child goes to CBT once a week or more. The therapist works on exposure therapy as well as cognitive reframing tools and coping strategies.
  • The child’s parents meet with the therapist regularly to learn how to provide support.
  • The school collaborates with the parents and the therapist on creating and implementing a re-entry plan.

Schools can offer supports and accommodations to ease the intense anxiety caused by attending school. This could include reducing the homework load, changing deadlines, moving the child’s seat, or having the child start their day in the therapist’s office.

If the child’s anxiety is so impairing that none of these interventions help, consider medication, or an alternate school setting, such as a therapeutic school with more robust supports.

[Download: 30 Great Accommodations for Children with ADHD]

Staying Home from School

If you allow your child to stay home from school, consider the following:

  • Keep everything as boring as possible, including meals.
  • Turn off the Internet. Remove devices until after school hours.
  • Direct your child to do schoolwork and chores.
  • Do not allow playdates, outsides activities, or rewards.

Make sure to prepare your child for their return to school the night before and the morning of.

The night before:

  • Help your child engage in a relaxing activity.
  • Use supportive statements and positive self-talk together.
  • Practice strategies that will calm your child.

The morning of:

  • Calmly state that you understand how your child is feeling. Say, “I can see this is really hard for you.”
  • Express confidence in their ability to cope. Say, “I know you can do this.”
  • Review rewards and consequences.
  • Keep calm. Refrain from emotional reactions.

Reader Insights

ADDitude magazine asked readers whether their child ever refused to go to school for an extended period. Forty-three percent responded yes. Of this group, 41% said that school refusal lasted for days, 20% said weeks, 11% said months, and 28% said it lasted for a year or longer. Some shared their experiences.

“In kindergarten, it was hard for my oldest to leave the comfort of home. His ADHD made it hard to adapt to new expectations and routines. He ran away from school often, hid from his teachers, and just plain refused to leave the house in the mornings. When his teacher started preparing a card with a new word and definition for him each morning, inspired by his hyperfixation on words, he suddenly became excited to go to school. He kept those cards in a collection. Now he’s in fifth grade and absolutely loves school and his teacher.”

“It was too hard for my child to sit all day and the teachers didn’t understand. We sent him to a school that understood ADHD better. Now he gets up early and goes happily.”

“My son was willing to go to school, but not to stay in class. Health issues, peer bullying, and lack of educator support made him feel lost in the middle school classroom. We found private tutors who could work with him daily at home to rebuild his academic skills and confidence. After four months, he was ready to return to a new school.”

“My daughter hated middle school. She had a hard time socially, the school felt too big, and one day she announced she was never going back there. But, true to form for ADHD people, she had already thoroughly researched her options and found an online school that would give her academic support while allowing me to be her teacher. The program fit her learning needs, and when high school started, she was ready to return to a conventional school environment. It was a lot of work for me, but I admired her for articulating the problem and finding a reasonable solution on her own at the age of 14.”

School Refusal & Avoidance: Next Steps

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.