073: What to do when your child refuses to go to school

We’re a couple of weeks into the new school year by now and I hope that for most of you the morning drop-offs have gotten a bit easier than they were in the beginning. But some of you may still be struggling with a child who doesn’t want to go to school, who resists you leaving at drop-0ff time, and who might be suddenly suffering from stomachaches and headaches (particularly on Sunday nights or weekday mornings) that had not previously been a problem. Today’s interview with Dr. Jonathan Dalton, director of the Center for Anxiety and Behavioral Change in Rockville, MD is going to help us understand whether our child is having a ‘normal’ amount of difficulty transitioning to school or if they are struggling enough that they might need extra help – and if so, what to do about it.   References Bergin, C., & Bergin, D. (2009). Attachment in the classroom. Educational Psychology Review 21, 141-170. Dalton, J., & Beacon, V. (2018). School refusal. In D. Driver & S.S. Thomas (Eds.), Complex disorders in pediatric psychiatry: A clinician’s guide (pp 11-22). St. Louis, MO: Elsevier. Egger, H.L., Costello, J., & Angold, A. (2003). School refusal and psychiatric disorders: A community study. Journal of the American Academy of Child & Adolescent Psychiatry 42(7), 797-807. Hallinan, M.T. (2008). Teacher influences on students’ attachment to school. Sociology of Education 81, 271-283. Hamre, B.K., & Pianta, R.C. (2001). Early teacher-child relationships and the trajectory of children’s school outcomes through eighth grade. Child Development 72(2), 625-638. Houts, R.M., Caspi, A., Pianta, R.C., Arseneault, L., & Moffitt, T.E. (2010) The challenging pupil in the classroom: The effect of the child on the teacher. Psychological Science 21(12), 1802-1810. Jerome, E.M., Hamre, B.K., & Pianta, R.C. (2009). Teacher-child relationships from kindergarten to sixth grade: Early childhood predictors of teacher-perceived conflict and closeness. Social Development 18(4), 915-945. Kearney, C.A. (2016). Managing school-based absenteeism at multiple tiers: An evidence-based and practical guide for professionals. Oxford, U.K.: Oxford University Press. Kearney, C.A., & Albano, A.M. (2007). When children refuse school: A cognitive-behavioral therapy approach, Therapist guide (2nd Ed.). Oxford, U.K.: Oxford University Press. Kearney, C.A. (2006). Dealing with school refusal behavior: A primer for family physicians. Family Practice 55(8), 685-692. Kearney, C.A. (2002). Identifying the function of school refusal behavior: A revision of the school refusal assessment scale. Journal of Psychopathology and Behavioral Assessment 24(4), 235-245. King, N., Tonge, B.J., Heyne, D., & Ollendick, T.H. (2000). Research on the cognitive-behavioral treatment of school refusal: A review and recommendations. Clinical Psychology Review 20(4), 495-507. Ladd, G.W., & Dinella, L.M. (2009). Continuity and change in early school engagement: Predictive of children’s achievement trajectories from first to eighth grade? Journal of Educational Psychology 101(1), 190-206. Ladd, G.W., & Buhs, E.S., & Seid, M. (2000). Children’s initial sentiments about kindergarten: Is school liking an antecedent of early classroom participation and achievement? Merrill-Palmer Quarterly 46(2), 255-279. Last, C. G., Hansen, C., & Franco, N. (1998). Cognitive-behavioral treatment of school phobia.  Journal of the American Academy of Child and Adolescent Psychiatry 37, 404–411. Pianta, R. C., Belsky, J., Vandergrift, N., Houts, R. M., & Morrison, F. J. (2008). Classroom effects on children’s achievement trajectories in elementary school. American Educational Research Journal 45 (2), 365–397   Read Full Transcript   Transcript Jen:     [00:00:37] Hello and welcome to the Your Parenting Mojo podcast. Today we are going to help a whole lot of parents who are in the middle of a massive transition, and that is the transition to kindergarten or school. Many people, adults included, don’t love change. It’s certainly much easier to keep doing the same things we’ve been doing with the people we know and love than it is to go to a completely new place with people we mostly don’t know whoever new expectations for us that we don’t know if we can meet and we also have to start getting up really early in the mornings, which can introduce all kinds of new power struggles at bed time so we might not be able to solve all of these problems today, but we’re going to take a specific look at what is known as school refusal, which is pretty much what it sounds like when a child says “I don’t want to go to school.” Jen:    [00:01:24] To help us understand this and figure out what to do about it, we’re here today with Dr Jonathan Dalton, who is a licensed psychologist and the Director of the Center for Anxiety and Behavioral change in Rockville, Maryland. He received his BA in psychology from Villanova University an MA in psychology from the Catholic University of America and this PhD in Clinical Psychology from Fordham University. Dr Dalton specializes in treating anxiety and behavioral disorders with particular expertise in the treatment of anxiety-based school refusal. Welcome Dr. Dalton! Dr. Dalton:  [00:01:53] Thank you so much. Dr. Dalton:   [00:01:54] So I wonder…firstly we should probably get clear on some terms that we’re going to use today because when I started reading your work, there were a whole bunch of terms and I want to be sure that we use them clearly. Dr. Dalton:  [00:02:03] Sure. Jen:  [00:02:04] So you use absenteeism and truancy, school refusal, and so can you define these for us and then perhaps also help us understand how common these issues are. Dr. Dalton:   [00:02:12] Sure. Yeah. So just thank you again for inviting me. This is something that I care a great deal about, and I treat many, many kids with these problems. Absenteeism is a global term. It’s an umbrella term that just defines kids who are not in school for any reason. It could be transportation, it could be illness, it could be anything. Truancy is more in line with delinquency; t’s against the law. These are kids who might leave in the morning and then never show up to school because they’re having too much fun in the parking lot or in the woods behind school. Oftentimes that’s more of a criminal justice issue, where school refusal or school avoidance is a more of a psychological development where kids often because of anxiety do not believe they are able to attend school, and so they literally refused to go. It could be kids won’t get out of bed in the morning. I do a lot of home visits for these kids and I’ve seen kids barricaded in bathrooms with their mastiffs guarding them and sending me off with hairspray when I get there and different things so it can be quite significant for some kids. Jen:   [00:03:13] Okay. So in general we’re talking about slightly older children here, right? Because most of the parents who are listening to this are parents who are just sort of in this kindergarten phase, maybe some of them on the high end are in the transition phase. Some of them were toddlers transitioning into preschool for the first time, and this is probably not such a relevant thing for them. Is that right? Dr. Dalton:    [00:03:33] It really depends, because the research says that there’s kind of a two different ages where we most often see the onset and one of them is five and six years of age, so it’s when kids have to first separate from their family and go into a novel circumstance. It is a time when we...