School Refusal: When Your Child Won’t Go to School and What Helps

School refusal describes a child who becomes so distressed about going to school that they struggle to get there or stay there, usually with their parents fully aware of the problem. It is not a diagnosis in itself. In most children it is driven by anxiety, and most children do return to regular attendance, particularly when the family, the school and a clinician start working on it early ^[1].

This guide explains how school refusal differs from truancy, the reasons that often sit behind it, what you can do at home this week, how to work with your child’s school in Abu Dhabi, and when to ask for a professional assessment.

What school refusal is, and what it is not

Children who refuse school are usually not trying to get away with something. They are frightened or overwhelmed, and staying at home brings fast relief. Researchers commonly use a set of features first described by Berg: the child is reluctant or refuses to attend, usually stays at home during school hours with the parents’ knowledge, shows emotional distress at the prospect of attending, does not have serious antisocial behaviour, and the parents have made reasonable efforts to get them to school ^[2].

Truancy looks different. A child who is truanting typically hides absences from parents, is not especially anxious about school itself, and spends the time elsewhere. The distinction matters because the two problems respond to different approaches ^[1].

School refusal is reported in roughly 1 to 5 per cent of school-age children. It can appear at any age, but it is seen most often around ages 5 to 7 and again around 11 to 14, when children start school or move into a new stage of education ^[1].

Signs parents often notice

The pattern is usually clearest on school mornings. Common signs include:

• stomach aches, headaches, nausea or feeling faint before school, which tend to ease if the child is allowed to stay home ^[1]
• tears, pleading, anger or tantrums when it is time to leave
• repeated requests to come home, or calls from the school nurse’s room
• worry that builds on Sunday evenings, at the end of a holiday or after a period of illness
• a child who is relaxed and well at weekends and in the holidays

Refusal often begins after a stretch of time at home, such as a holiday or an illness, or after a stressful event like a move, a new school, or a change in the family ^[1].

Rule out physical causes first

Morning symptoms are real, even when they are linked to anxiety. A visit to your child’s doctor is a sensible early step, both to rule out a medical problem and so that everyone can plan with confidence ^[1].

Why a child may refuse school

There is rarely a single reason, and children often find it hard to explain what is wrong. Some of the patterns clinicians look for are below.

Separation anxiety in younger children

In younger children, the most common driver is anxiety about being apart from a parent ^[1]. The child may fear that something will happen to a parent while they are at school. Our guide to separation anxiety at school drop-off covers this in more detail.

New refusal in older children and teenagers

When refusal starts for the first time in an older child or adolescent, it can be a sign of something more specific. Bullying, depression, and learning, medical or developmental conditions that have not yet been identified, including autism and ADHD, are all possibilities that need to be checked ^[1].

Anxiety disorders

In clinic samples, around half of young people with school refusal have a diagnosable anxiety disorder ^[2]. This may be generalised worry, social anxiety, panic, or a specific fear connected to school. Our articles on childhood anxiety disorders and back-to-school anxiety explain how these present.

Why staying at home can make it harder

When a frightened child is allowed to stay home, the relief is immediate. That relief is understandable, but it also teaches the child that avoiding school makes the fear go away. Over time, schoolwork and friendships slip, and the return becomes more daunting. This is one reason professionals stress that earlier help tends to lead to better outcomes ^[1].

None of this means a parent has done anything wrong. Most parents keep a distressed child at home out of care. The aim is to replace that short-term relief with a plan the child can manage.

What parents can do this week

• Talk at a calm moment. Evenings or weekends are often better than school mornings. Ask open questions about what feels hardest: the trip to school, a lesson, a person, lunchtime, or being apart from you.
• Book a check-up. A medical review helps to rule out physical illness and gives you something solid to share with the school ^[1].
• Contact the school early. Ask to meet the class teacher, counsellor or head of year. Share what you are seeing at home and ask what they see at school.
• Keep mornings predictable. Lay out clothes and bags the night before, keep the routine the same each day, and keep goodbyes short and warm.
• Make home on school days less rewarding. If your child is at home during school hours, keep screens and treats for after school time, so that staying home does not feel like a holiday.
• Notice effort. Praise every step towards school, even a partial day.

For many children, a gradual return works better than an all-or-nothing approach. This might begin with a shorter day, or a few lessons, with a named adult at school who checks in with your child on arrival ^[1]. The plan works best when home and school agree on it in advance and stick to it.

Working with your child’s school in Abu Dhabi

Attendance in Abu Dhabi private and charter schools is governed by ADEK policy. Under the version of the Student Administrative Affairs Policy we reviewed (version 1.1, September 2024), absence above 5 per cent of school days is treated as a cause for concern from Grade 1 upwards, and above 10 per cent in kindergarten. The policy expects schools to work with parents on an intervention plan when attendance becomes a concern ^[3].

The same policy lists absences that can be authorised, including illness supported by a parent letter or official documentation, and pre-arranged medical appointments. Students with additional needs may be granted medical or therapeutic leave, and a school may ask for a medical assessment report when planning support ^[3]. ADEK updates its policies from time to time, so ask your school which version and procedures currently apply.

In practice, it helps to:

• keep the school informed rather than reporting each absence as a minor illness
• share relevant professional reports, with your consent, so the school can adjust support
• agree one point of contact at school and a simple way to share progress each week
• ask whether your child’s needs should be reflected in a support or learning plan; our guide to school support plans in Abu Dhabi explains the options

How school refusal is assessed and treated

A good assessment looks at the whole picture. It usually involves talking with the child and parents, gathering information from teachers, and a medical check, so that anxiety, low mood, learning difficulties, bullying and other factors can be understood together ^[1].

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) has the strongest research support for school refusal ^[1]. It helps a child understand the link between thoughts, feelings and avoidance, learn ways to manage anxiety, and return to school in planned steps. Parents and school staff are usually involved.

A 2018 systematic review and meta-analysis of eight studies, involving 435 young people, found that psychosocial treatments, mostly CBT, led to a meaningful improvement in school attendance. The same review did not find a significant reduction in anxiety compared with control conditions, and the authors noted that the studies were small and at some risk of bias ^[2]. In other words, therapy helps children get back to school, but anxiety may need continued attention after attendance improves.

Medication

Medication is sometimes considered alongside therapy, particularly when anxiety or depression is severe, but it is rarely used on its own for school refusal ^[1]. Any decision about medication should follow a full assessment by a child psychiatrist and a conversation with the family about benefits and side effects.

When to seek professional help

Consider booking an assessment if:

• your child has missed several days, or attendance keeps slipping despite your efforts
• refusal keeps returning after holidays or illness
• there are signs of low mood, panic attacks, withdrawal from friends or changes in sleep or eating
• you suspect bullying, a learning difficulty or another unidentified need
• mornings have become a source of conflict that affects the whole family

If your child talks about harming themselves, treat it as urgent and use the emergency numbers above.

How BMMC can help

Beautiful Mind Medical Center’s children’s services include assessment by child and adolescent mental health clinicians, CBT, behavioural therapy and parent support. An initial assessment typically takes one to three sessions and can be carried out in Arabic or English. Parent-only sessions are available if your child is not yet ready to attend. With your consent, the team can provide school reports and work with your child’s school on practical strategies; the school is contacted only with your agreement.

If you would like to talk through your child’s situation, you can call +971 2 621 2230, email info@bmmc.ae, or use the booking form. You can read more about the team on our clinicians page.

This article is for general educational purposes and is not a substitute for an individual assessment, diagnosis, or treatment plan from a qualified healthcare professional. If you are concerned about a child’s or adolescent’s safety, seek urgent professional help.

References

1. American Academy of Child and Adolescent Psychiatry. School Refusal. Facts for Families No. 7. Updated August 2026. aacap.org
2. Maynard BR, et al. Treatment for School Refusal Among Children and Adolescents: A Systematic Review and Meta-Analysis. Research on Social Work Practice. 2018;28(1):56–67. doi:10.1177/1049731515598619. Full text (ERIC)
3. Abu Dhabi Department of Education and Knowledge (ADEK). Student Administrative Affairs Policy, version 1.1, September 2024 (Arabic). adek.gov.ae
4. The UAE Government portal. Handling emergencies. u.ae