School Refusal and the Power of Social Engagement

*Updated June 2023

Eight-year-old Charlise struggled to get through nearly every day of third grade. She refused to go to school so often that her mother had to physically escort her into the car, and then into the classroom each day. All week, she complained of stomach aches brought on by anxiety. But at home on the weekend, she was a different girl: carefree, pain-free and happy.

Eager to help, her teacher developed a support plan, offering positive reinforcement to Charlise for successfully engaging in classroom activities without fussing or crying. She also seated Charlise at a desk near the front so the teacher could monitor and support the girl.

Those changes might have proved effective for some students. But for Charlise, the approach fell short. Why? First, nobody bothered to investigate exactly why Charlise was struggling at school. We often assume that a child dealing with school refusal is anxious. But what’s causing the anxiety? Our education systems generally lack an appreciation for individual differences—and methods to determine how and why particular students are having challenges. Furthermore, the solutions generally boil down to reinforcement schedules, as they did for Charlise.

A New Paradigm

To help guide her parents and teachers in a different direction, I shared my approach. Influenced by an understanding of the autonomic nervous system (the ANS), I explained the benefits of utilizing Personalized Attunement—that is, deciphering precisely what a child needs to help her nervous system perceive safety rather than threat. Children experiencing school refusal often do so because their brain-body connections sense threat or danger, even when the child is physically safe. The child’s negative feelings result from the activation of the sympathetic nervous system, so she cannot simply talk herself out of her feelings.

The key to helping Charlise was to develop a plan to help her unique body-brain connection detect safety rather than threat. First, her parents met privately with her teacher and explained that Charlise was a perfectionist and feared disapproval from adults. So by complimenting her only for not fussing or crying, her teacher was inadvertently adding to her stress, rather than alleviating it. And since Charlise was so sensitive to her surroundings, sitting close to the teacher (instead of a friend she had chosen to be near) made her feel self-conscious, especially when she couldn’t control her own tears.

We shifted from assuming that Charlise’s behaviors were amenable to reinforcement schedules to recognizing that they were stress responses. The remedy, then, was not to reinforce Charlise’s “good” behaviors but to find ways to increase her neural receptivity, understanding that Charlise wasn’t choosing to act in certain ways, but rather exhibiting behaviors characteristic of a vulnerable nervous system.

After she and the rest of the team heard my suggestions, Charlise’s teacher came up with a creative idea. She knew that when Charlise was calm, she loved holding imaginary tea parties with friends. So the teacher invited the girl and a friend to stay after school and enjoy some real tea with her. The teacher even brought in a tea set from home and served Oreos. The goal was simply to have fun together.

The tea party proved a great success, marking the beginning of a new understanding that the key to helping Charlise was the teacher’s warmly engaged relationship with her, not social reinforcement schedules. The teacher invited the girls to return early the following morning to help her set up the classroom. Another success. On the third morning, Charlise willingly went to school without protest. Her mom told me later that it made her heart soar to see Charlise so receptive to going to school.

Of course, every child is different and will have their own unique responses to support/interventions, and Charlise responded very quickly, which is not often the case. Additionally, not all teachers have the time or resources to individualize a student’s care to the degree that Charlise’s teacher did. Still, the aim when working with a child coping with school refusal is figuring out how to help the child’s nervous system to detect safety in the school setting. For many children, the best way to manage school refusal is to provide social cues that increase a student’s individual perception of safety through social engagement and playful interactions. Following these techniques—which unfortunately aren’t yet part of the traditional educational lexicon but are backed by neuroscience—will lead to more compassion and creativity in solving the challenge of school refusal.

I share more about how to identify and support children’s stress responses in Brain-Body Parenting and Beyond Behaviors.

I also host an online Parenting Community with a library of resources for parents.