School refusal occurs when a student will not go to school or frequently experiences severe distress related to school attendance. Comprehensive treatment of school refusal, including psychiatric and medical evaluation when appropriate, is important because studies show that psychiatric disorders are the cause for up to 46% of students who fail to complete high school in the United States. Parents can do several things to help their child who refuses to attend school and treatment may be necessary. With treatment, the rate of remission is excellent; approximately 83% of children with school refusal who were treated with cognitive therapy were attending school at 1-year follow-up. School refusal is considered more of a symptom than a disorder and can have various causes.
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According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), separation anxiety is a fairly common anxiety disorder that consists of excessive anxiety beyond that expected for the child's developmental level related to separation or impending separation from the attachment figure (eg, primary caretaker, close family member) occurring in children younger than 18 years and lasting for at least 4 weeks.
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