🚸 What Is School Refusal?

School refusal refers to a persistent difficulty attending school due to emotional distress—not laziness or defiance.

In autistic children, it often starts subtly:

“He had a stomach ache every morning.”
“She cried during uniform time.”
“He begs to be home-schooled.”

This is not just school avoidance—it’s often a reflection of unmet sensory, social, or emotional needs.

🧠 Why Do Autistic Children Refuse School?

1. Sensory Overload

• Crowded classrooms, harsh lighting, loud bells, scratchy uniforms

• Noisy school buses or assemblies

• Constant stimulation leads to anxiety, meltdowns, and shutdowns

2. Social Anxiety and Bullying

• Difficulty interpreting social cues

• Being teased or isolated

• Fear of group activities or oral presentations

3. Rigid Thinking and Transitions

• Sudden changes in timetable

• Inconsistent teachers or rules

• Difficulty moving between activities

4. Academic Pressure

• Learning differences not addressed

• Understood as “lazy” or “slow” despite trying hard

• Perfectionism leading to panic

5. Separation Anxiety

Especially in younger children, or those with limited verbal skills, school refusal may reflect inability to express distress.

🔍 How to Identify School Refusal in Autism

• Frequent physical complaints (headache, stomach pain) before school

• Refusal to get dressed or board the bus

• Meltdowns every morning or late-night anxiety

• Enjoys weekends but deteriorates Sunday night

• Drop in grades or behavior at school

🛠️ What Can Be Done?

✅ 1. Collaborate with School

• Share diagnosis and triggers with teachers

• Create an Individualized Education Plan (IEP) with accommodations

• Provide a sensory toolkit (headphones, fidget tools, calm space access)

✅ 2. Gradual Reintegration Plan

• Start with 1 hour a day or part-time attendance

• Slowly increase based on child’s comfort

• Use visual schedules, not just verbal commands

✅ 3. Therapeutic Support

• CBT for anxiety in verbal children

• Play therapy, occupational therapy, and parent coaching

• Address coexisting conditions like ADHD, OCD, or sleep disturbances

✅ 4. Home Strategies

• Morning routine chart

• Preview the school day the night before

• Emotional vocabulary training (“I feel scared… noisy… tired”)

• Reinforce each successful attempt—even if it’s just entering the school gate

💬 Real-Life Example

Ishaan, age 9, would cling to his mother every morning. After assessment, sensory overload and anxiety were identified. With a shorter school day, noise-canceling headphones, and a teacher buddy, Ishaan now attends regularly and is regaining confidence.

📍 Dr. Srinivas Rajkumar T
Consultant Psychiatrist – Child, Adolescent & Geriatric Psychiatry
Apollo Clinics Velachery & Tambaram | Mind & Memory Lab
🌐 www.srinivasaiims.com | 📞 +91 85951 55808
Specialized in managing school anxiety, academic stress, and behavioral plans for neurodiverse children.