Many children and teenagers struggle to get back into the school routine after a long break. They struggle with the change in bedtime routine, the long hours in the classroom and the workload can cause some stress and getting used to. Most children can handle the discomfort and get used to this change in a few days or up to a few weeks, but for some youth the emotional distress can be overwhelming. To relieve this distress, a child or teen may begin to avoid school, in other cases they attend school but with much resistance and stress for the whole family during the morning routines, other youth skips classes, and small children may cry or become clingy when they arrive at school. Anxiety and stress can cause unexplained headaches, stomachaches, and other ailments which may make it hard for children to get to school on time in the morning or make it feel necessary to leave early. 

Why is this happening?
Avoiding or trying to avoid school happens because children and teens don't want to feel the distressing emotions. When we avoid situations that cause the distress, we have immediate short-term relief.  Some common reasons for school refusal are:

• separation anxiety - the child does not want to be away from their parent(s). 
• social stressors - bullying, lack of friends, social anxiety, conflict with peers etc.
• academic concerns - work is difficult/they don't understand it, perfectionism, falling behind, fear of failure, fear of the teacher etc.
•  sensory issues - loud, bright, too much stimulus, classroom chaos, etc.
• fear - of having a panic attack, fear of vomiting, fear of public speaking, etc.

It's normal for the body and the brain to want to avoid stressful, distressing and anxiety provoking situations. We are designed to fight, flee or freeze when faced with something that is dangerous; however, when the brain misinterprets information as being dangerous, the response is still the same. The heart races, breathing quickens, muscles become tense, gastrointestinal sensations, shaky, sweaty; when these physical symptoms persist, it can lead to pain, headaches, vomiting, feelings of dread, tightening across the chest, difficulty with attention/focus/concentration, hyperactivity or fidgeting. These symptoms can be overwhelming, scary and embarrassing for children and youth, and therefore they try to avoid them, or it can cause anger. 

What can you do?
First and foremost, if your child or teen is complaining of aches, pains, stomach issues, heart issues etc. have them seen by a medical professional. If there are no medical causes for the symptoms it might be time to talk to your child. Ask them questions about their day, their thoughts, their feelings about school. Questions like

• "What do you enjoy about school and what do you not enjoy about school?"
• "What do you like about your friends and what do they like about you?"
• "How do people at school show you they care?"
• "What does it sound like in your classroom?"
• "Who can you go to if you have a problem?"
• When it comes to teenagers the conversation might be a bit more directive like: "these symptoms you have might be related to stress or other strong emotions, what do you think?"
• "I get that high school can be stressful or annoying, do you think that things are really bad at school and the emotions are causing physical symptoms?"
• "I know that you might not want to share your problems with me, or you might want to deal with it yourself but getting someone else's perspective might be helpful. I can take you to a therapist if you don't want to talk to me."

You're here because you're educating yourself about this problem, once you have some more information it could be helpful to share what you've learned with your child or teen. When they understand what's going on with them, it can reduce the fear and embarrassment and allow then to consider possible solutions.
Speak to the school if there are things they can do to help.
Finally, introduce coping skills like breathing exercises, mindfulness, movement/exercise, spending time in nature, progressive muscle relaxation, visualization, challenging thoughts, problem solving to name a few. 

If you are doing everything you can to manage this problem and are not finding a lot of progress, reaching out to a local mental health professional for help might be the next step. If you would like to consult with me, feel free to call (905) 464-1029, email ljuba@newdirectionscounselling.ca or use the contact form below.