Symptoms and Signs of School Refusal

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/21/2019

Doctor's Notes on School Refusal

School refusal is a psychological symptom that occurs when a student refuses to go to school or regularly experiences severe distress related to school attendance. School refusal can occur at any age but it is most often seen in children 5-7 years of age and 11-14 years of age. Some causes of school refusal may include an earlier history of separation anxiety, social anxiety, or depression; undiagnosed learning disabilities or reading disorders, parental illness, parental marital problems, death in the family, moving, jealousy over a new infant sibling, and bullying.

School refusal is considered more of a symptom than a disorder and can have a number of causes. The child refuses to attend school and experiences significant distress about the idea of attending school. Signs of school refusal may include significant school absence (generally one week or more), significant distress with school attendance, embarrassment or shame at the inability to attend school, crying or protesting every morning before school, missing the bus every day (in adolescents), and regularly developing some type of physical symptom when it is time to go to school.


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.