Understanding School Refusal
School refusal can be more than just a child’s hesitation to attend school. It may be a means of expressing underlying needs that are impacting on school engagement, for example requiring more support to process sensory environments, regulate emotions or navigate social situations. Understanding and implementing appropriate supports can enable children to feel more comfortable and confident engaging with daily routines and school tasks. Addressing potential barriers to school engagement can also support in creating more positive school experiences for children to thrive in supportive environments that foster the development of social-emotional skills and provide opportunities for children to demonstrate their academic potential.
Role of OT in addressing school refusal
Paediatric OTs can support in addressing school refusal by working collaboratively with children, families, and schools to explore the sensory, emotional, and environmental factors that may contribute to a child’s difficulties with school attendance. OTs focus on understanding each child’s unique needs and empower them to develop strategies to cope with challenges they face in the school environment.
One key area OTs address is sensory regulation. Sensory processing challenges can impact on lack of engagement or overwhelm in school environments which can contribute to school refusal. OTs can assess children’s unique sensory profiles to understand their sensory needs and its functional impacts, such as engagement in the classroom. Using these insights, they create tailored strategies to support children to have their sensory needs met and promote better regulation and attention in sensory rich environments. Through school visits and classroom observations, OTs identify barriers to engagement and work with teachers and families to implement appropriate supports like sensory breaks, environmental modifications or tools to foster regulation and engagement in school.
OTs also focus on emotional regulation to support children in developing tools to recognise and respond to emotions within the classroom environment. OTs work with children, families and school staff to develop regulation strategies such as working with children to establish structured routines that provide predictability and reduce uncertainty about transitions, helping children to feel a sense of control and security. Additionally, developing school-related skills including fine motor, self-care and executive functioning skills can support in building up children’s confidence, resilience and capacity to engage in school tasks. This enables more positive experiences within the school environment and can help in improving children’s motivation to attend school.
Practical Strategies for Parents and Caregivers
Establishing predictable routines
Create routines that offer consistency and structure. Predictable morning and evening routines can help reduce stress and create a sense of stability for children. Using visual schedules can reduce uncertainty and help children anticipate what comes next.
Gradual re-engagement with school
Consider starting with small steps to gently reintroduce the school environment. This might involve brief, positive visits to the school, or meeting with familiar staff members in a low-pressure setting, like a teacher or learning support staff.
Building coping strategies
Teach your child calming techniques such as deep breathing, mindfulness, or sensory breaks. Children may benefit from using stress-relief tools (e.g., fidget toys or weighted items) to manage overwhelming emotions. Offer positive reinforcement for small successes, celebrating their bravery in facing their challenges and acknowledging their efforts.
Open communication with the school
Work with school staff to create a flexible, supportive environment for your child. This might include allowing breaks when needed, adjusting expectations to match your child’s current abilities, or providing quiet and safe spaces where they can regroup when they feel overwhelmed.
When to Seek Professional Support
If your child’s refusal to attend school persists and begins to affect their emotional or academic well-being, it may be time to seek professional help. Paediatric OTs can work with the child, family and school to address underlying needs to support children in their sensory processing, emotional regulation or executive functioning within the school environment. With specific strategies, we can help your child build confidence to gradually re-engage with school routines. Addressing the factors contributing to school refusal early can make a significant difference in supporting your child’s engagement with school.
If you would like to learn more about how we can help your child, please call us on 9913 3823 or email hello@occupationaltherapy.com.au.
