School refusal: what to do

School refusal is not about school. It is almost always about something the child cannot yet face, and school is where the something becomes unavoidable. The response that works treats the underlying signal, not the attendance number.

What school refusal is — and what it is not

School refusal is a pattern of intense distress about attending school that is not explained by a specific, identifiable dispute (like a one-off bullying incident or a change of school). It often shows up with strong physical symptoms — tummy aches, headaches, vomiting — that are real and not faked.

It is different from truancy. Truancy is going-somewhere-else avoidance, usually without parental knowledge. School refusal is at-home distress the family is aware of. The response is completely different.

Why it is urgent

The longer a child is out of school, the harder the return becomes. The Australian research is unusually consistent on this: a child out for more than a week typically needs structured support to return, and a child out for more than a term without intervention has a high rate of prolonged disengagement.

This does not mean force them back tomorrow. It means act this week.

Step 1 — Rule out a medical cause (day 1–3)

A GP visit ahead of day three. Not because the tummy aches are probably medical — they usually are not — but because ruling out a physical cause removes one variable and builds trust with the child that you are taking the body seriously.

Step 2 — Call the school, early and collaboratively (day 1–5)

Ask for a meeting with the wellbeing coordinator, classroom teacher, and any relevant specialist staff. Bring a short, factual note of what you are seeing at home. Ask three questions:

• Has anything changed in the classroom — a seating change, a friendship change, a teacher change, a curriculum change?
• Is there any current peer issue, bullying, or social friction the teacher has noticed?
• Can we build a graduated return-to-school plan, together?

A school that responds well to this conversation is a school that is working with you. A school that responds dismissively is a signal worth escalating — to the deputy principal, the principal, or the relevant state education department's student wellbeing line.

Step 3 — Involve a psychologist (within week one)

School refusal is a mental-health presentation, not a discipline one. A GP Mental Health Care Plan (MBS 2715) unlocks up to ten subsidised psychology sessions a year. Ask the GP for a referral to a psychologist with experience in school refusal or anxiety in children.

Waiting weeks for a psychologist appointment is unfortunately normal. If the refusal is severe, the family can escalate through a headspace centre (for 12–25 year olds) or through a paediatrician, and in some states through the public Child and Youth Mental Health Service (CAMHS).

Step 4 — The graduated return plan

A return plan is not 'back to full days from Monday'. It is built in small steps, negotiated with the child, and owned by the school.

1. 1Contact only: a visit to school for ten minutes with no expectation of class attendance. Usually with a trusted staff member.
2. 2Partial attendance: one or two hours, specific lessons the child chooses.
3. 3Half-days, with a clear way out if it is not working (a safe person, a safe space in the school).
4. 4Full days, back-to-back.
5. 5Normal attendance, with ongoing check-ins.

This plan is written down, reviewed weekly, and known to every adult who will touch the child during the week. The child should know exactly what is being asked of them each day.

What is often underneath school refusal

• Anxiety — separation, social, or generalised. The most common underlying presentation.
• Autism — masking at school and exhausting on the commute home, until the masking collapses.
• ADHD — executive function demands of the school day overwhelming a child with insufficient support.
• Bullying or social exclusion — often under-reported by the child.
• A specific learning difficulty that has not been identified — especially around year 2–4 when reading demands accelerate.
• Family change — separation, bereavement, a new sibling, a move.
• A specific incident at school the child is protecting someone from.

Your role, through all of it

You are not the therapist. You are the steady presence. You hold two things at once: the belief that your child can return, and the acknowledgement that they are genuinely struggling. Both are true. Neither negates the other.

The parents who come through this are the ones who stay regulated, who collaborate with the school, who bring in professional help early, and who do not make their child's attendance a referendum on the parent's competence.