Every parent faces the occasional “I don’t want to go to school” morning. But when it becomes a pattern, tears at the door, sudden stomach aches, or a child clinging desperately to you, it’s no longer about laziness or stubbornness. It’s a deeper emotional signal, and one that needs gentle attention rather than pressure.

Dr Samant Darshi, Interventional Psychiatrist, Yatharth Hospitals, Noida & Director, Psymate Healthcare, spoke to us to highlight the importance of the matter. School refusal sits at the intersection of psychology, behaviour, and fear. Unlike truancy, where a child actively avoids school for thrill or rebellion, school refusal is rooted in genuine distress. As Dr Samant Darshi explains, it’s “a reaction to emotional disturbance, usually anxiety, fear, or stress, not mischief.” Understanding this difference is the first step toward supporting your child. 

Signs and symptoms parents must not overlook

Dr Darshi notes that the body often expresses anxiety long before children find the words for it. Common indicators include:

• Frequent morning headaches, stomach aches, or throat pain.
• Crying, meltdowns, or clinging to a parent during school time.
• Repeated complaints about attending school.
• Avoiding days with tests, group activities or presentations.
• Spending long hours in the school nurse’s room with vague symptoms.
• Excessive concern about the safety of their parents while they’re away.

A crucial clue: these symptoms usually disappear once the child stays home, only to return the next morning.

Why does school refusal happen? The emotional roots

According to Dr Darshi, school refusal is rarely about one single cause. It generally emanates from a combination of psychological and environmental stimuli.

The four major reasons

• Avoiding negative feelings like anxiety, panic, depression, or learning difficulties.
• Avoiding certain situations, such as bullying, tests, public speaking, or group work.
• It is mainly attention-seeking or reassurance, particularly among children with separation anxiety.
• Preferring comforting alternatives like staying home to play, rest, or pursue hobbies.

Other triggers include:

• Social phobia or extreme shyness
• Family stress (illness, conflict, addiction, or financial strain)
• Fear of emergency drills, fights at school, or sudden stressful events

Dr Darshi emphasises that school refusal often appears during transitions, new grades, new schools, or major life changes.

How psychologists identify school refusal

A proper evaluation goes beyond simple observation because anxiety is internal and easily masked. Diagnosis typically includes:

• Standard anxiety and behaviour questionnaires
• Clinical interviews with parents and children
• Teacher observations and academic history
• Ruling out medical conditions

What parents can do right now

• Rule out illness first. Visit a doctor to ensure symptoms aren’t physical.
• Work with teachers and school counsellors. They can spot triggers you may not see at home.
• Encourage gradual attendance. The longer a child stays away, the harder the return.
• Stay calm and empathetic. Avoid punishment, as it can worsen anxiety.
• Create predictable morning routines. Structure reduces fear.

Small steps, a supportive conversation, a shorter school day, or a familiar adult at drop-off can make a significant difference.

When should you seek professional help?

Dr Darshi recommends mental health support if:

• Symptoms persist for more than two weeks.
• The child refuses, despite family efforts.
• You notice signs of anxiety, depression, trauma, or withdrawal
• The child voices thoughts of self-harm or hopelessness

Early intervention not only helps resolve school refusal, but it also prevents long-term emotional challenges.

School refusal affects approximately 1 in 20 children, particularly during big school transitions. With patience, empathy, and structured support, most children go back to school with renewed confidence. Children don't need pressure; they need understanding. When their fears are heard and dealt with, healing commences.