September 19, 2022
Cindy Lopez:
Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen. School avoidance has become a major issue among adolescents. Research shows that students who avoid school are significantly more likely to experience numerous problems, including school dropout, mental health issues, and even suicide. So today we talk about school avoidance. What is it? How’s it tied to anxiety? And how does it show up in kids? How can parents effectively support their children who are experiencing school avoidance or refusal? Listen to this conversation with Dr. Jody Miller head of Esther B. Clark schools at CHC. Jody has a wealth of experience and expertise with students around social and emotional issues in school.
Jody Miller:
Hi Cindy.
Cindy Lopez:
Thanks Jody for being here. This is an important topic. When we talk about school avoidance or school refusal because it has become a major issue among our teens, among our adolescents, but before we jump in to discussing what do you do about it, let’s start by defining it. So what is it and how does it show up in kids?
Jody Miller:
Well, it’s kind of exactly how it’s labeled, it’s avoiding school and avoiding school all together, which would be chronic avoidance. Uh, kids are just not going day after day after day. Uh, it could be that kids are experiencing, you know, distress or difficulty in the morning and it takes them a while to actually get to school, maybe they eventually go, but they’ve missed a portion of the day and that continues on a number of days, even longer. It could be that students are at school, but avoiding portions of the school day, maybe leaving a class, trying to avoid something within that class, you know, escaping that particular area. So it could be any of those areas where kids are having difficulty attending.
Cindy Lopez:
So our listeners are probably thinking, oh, what’s the difference? Like they might be familiar with truancy, but not school avoidance, and my understanding with truancy is like that’s more of a legal issue. Would that be accurate?
Jody Miller:
Yeah, I mean truancy is technically in at least in the state of California is missing three days or more of school. So it’s a, it’s a pretty low bar, and I think kind of the approach for students in general education versus the approach for students in special education are very different. Um and for students in special education making sure that there are supports in place so that avoidance of school, whether it be altogether avoidance or portions of the day being avoided, that there are supports in place to kind of motivate kids to return to school. I think there’s less, obviously less support in a general education setting than there would be in a special education setting.
Cindy Lopez:
Yeah, that’s a good point to make the difference between general education and special education as we talk about school avoidance and we are really talking about the kids most likely in special education who are experiencing school refusal or school avoidance. So what are the functions of school avoidance, and why do students refuse to go to school?
Jody Miller:
Yeah, I think, you know, we may wanna explore the reasons why kids are going to school first and there are kind of three motivating factors for kids to attend school other than the fact that it’s required. And I think in the United States most students know that it’s a requirement to attend school, but kids really wanna attend school because they feel good about something there. Uh, whether it’s they’re doing well academically and they’re proud of themselves, and that gives them positive feelings, uh, whether they’re engaged in an extracurricular club, a sports team, and then really the most important piece is whether they’re connecting socially, whether they have a friend or many friends, and those are really the reasons why kids want to attend school. And so when they’re not attending school, it’s really rooted in anxiety around something, but those areas, academic, extracurricular, a friend, those are missing also. And so, kids are increasingly absent because of those three areas are not present for them.
Cindy Lopez:
So when kids aren’t at school, it’s likely they’re not at school because there’s something about school that’s literally stressing them out, right? It’s causing them anxiety and that could be from a number of things that you’ve already mentioned, it could be social, it could be academic, it could be tests or whatever, and there’s also that idea that sometimes it’s kind of nice to stay at home, like the parents reinforce that somehow.
Jody Miller:
Yeah, I mean kids are having difficulty, you know, attending school because there’s something uncomfortable or there’s something distressing about that environment? Uh, it could be that they’re not performing well academically, and they miss school and they return to school maybe, and they’re behind and that cycle continues to repeat. So they feel more and more like a failure. It could be that there is a social anxiety. They’re avoiding some person, it could be a teacher, it could be a peer. It could be that they were bullied. And so they’re trying to avoid those areas or those people, so the school avoidance is really rooted in the student’s feelings of anxiety, and their feeling anxiety about school or something about school, and to avoid those feelings they also want to avoid the environment in which they occur.
Cindy Lopez:
So, as you’re talking, I’m thinking this is probably pretty important to intervene early, right? Because you mentioned that cycle, like once it starts, it’s kind of hard to break it, is that accurate?
Jody Miller:
Yeah, it’s extremely hard. At Esther B. Clark we work with a lot of students that have had difficulty making it to school. Obviously by the time they’re coming to a non-public school it’s a fairly chronic situation. We’ve worked with students that have sometimes been out of school for years. Definitely the pandemic has added to the difficulty of students returning to school. They were out for long periods of time for distance learning. And then, uh, if there is an anxiety about school that was there before, it’s just really enhanced or increased students feelings of anxiety post pandemic in the return to school. So we’re seeing lots of students really struggling. There’s kind of two areas in which we see school avoidance and how it’s been developed over time. The first area is that if parents will think back or school personnel will think back there was early signs of things the student was not doing well, but they kind of made it through, and they’re saying, “well, oh yeah they had difficulty leaving me in the morning, but they were little, and we were able to kind of push through that.” Uh, so there’s, you know, kind of a history of that anxiety that’s been there. Uh, and then there could be an acute situation where some bigger event has occurred, could be a bullying event in school. It could be a death in the family and those are real specific examples that we’ve experienced at Esther B. Clark and those acute situations occur, and students are just having a hard time going to school. There wasn’t previous long history of that, but because of that acute situation, they’re having difficulty attending school.
Cindy Lopez:
So Jody, you just mentioned a few things that parents might be seeing that would cause them to think that they should intervene or could intervene. So what additional things, what are those yellow flags, things that parents might be seeing in their kids?
Jody Miller:
Yeah, one bigger area that we see a lot especially with our kids that are experiencing anxiety, coupled with school avoidance is somatic complaints. So, feelings of sickness and those arise as a result of the feeling of, the anxiety about school, but they’re really real and valid feelings for those students and obviously as a parent you’re listening to your child and you’re saying, “wow, you know, he or she doesn’t feel well.” And so that can begin a cycle of school avoidance as well is those feelings of anxiety, you know, having a tummy ache or a headache and then parents listening to that and thinking there’s something really medically a concern there and then avoiding school and then that cycle continues. So in some situations, parents can also be hindering school attendance for students, uh, because you’re listening and you really want them to feel comfortable and feel well, and they’re telling you they’re not and so you as a parent allow them to not attend school. Some of the other things that contribute would be routines are off at home. Uh, so the morning routine gets really off or specifically the sleep routine. And I work with a lot of students and families where the sleep routine is really off and that’s a big contributor to avoiding school because, you know, they may be staying up late, not able to get up in the morning, then wanting to sleep late. And that sleep routine is really important to have a, you know, very consistent sleep routine and a very consistent morning routine.
Cindy Lopez:
So, there’s sometimes too, I think with kids that I’ve seen in my years in the classroom and in working at schools, kids don’t really have an accurate perception. So, you know, there’s this sense of like doom and gloom and everything’s bad.
Jody Miller:
Mm-hmm.
Cindy Lopez:
All the teachers hate me, kids don’t like me.
And my experience too. I’m sure you’ve experienced it as well, is that as an administrator at school, when you’re trying to talk with parents about these kinds of things, sometimes it’s hard for them to hear it, and it’s hard for them to understand that they might have a part in it. Can you comment on that a little bit more?
Jody Miller:
Yeah, I think that when we’re working with students, especially students in special education there’s an identified disability and sometimes those students need support and work on accurate perception or perspective taking. And like you said Cindy I’ve heard many times that “nobody likes me” or, you know, “the principal or the teacher’s out to get me,” and it really is just talking and being honest with the family about what’s going on, what’s happening, what’s occurring so that they can begin to see kind of the reality of what’s going on and that we can start putting together a plan to help the student have a more accurate perception or perspective of the things that are occurring in school and that is sometimes a contributor to school avoidance. If you don’t feel like you’re liked, whether that’s a true perception or not, you don’t wanna be in that environment.
Cindy Lopez:
So we just mentioned that parents might be contributing to their staying at home, and if parents who are listening are probably saying, “well, what should I do then? How do I support my child?” So what thoughts do you have about that?
Jody Miller:
I think that when it’s starting to be a concern to you as a parent, listen to that, you know, don’t think that this is maybe a phase or this is something that’s gonna pass on its own, that may be true, but not doing anything and it not being true is far more, uh, risky than it would be otherwise. So, listen to yourself, listen to your thoughts about what’s going on with your child, gather information, if you can or if the child can talk to you about other feelings and what’s going on and maybe there are specific events that you don’t know about. Trying to gather as much information as possible, uh, from the child, but also from school, connecting with the teachers, the staff, the principal, the special educators if you are in special education and gathering information from them so that you can begin to put together a plan to address that issue.
Mike:
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Cindy Lopez:
Previously, you talked about routines and establishing routines. So those are a little outta whack it might be good to get routines back on track.
Jody Miller:
Yeah.
So, how can parents effectively support their children? Basically through first gathering as much information as possible, talking to their child, trying to understand where those feelings may be coming from. There may be an underlying anxiety there, but what about school is making them feel that way? Can the student or the child articulate that – that understanding and that information will help guide the parent as to how to address the avoidance.
If the routines are not consistently being followed, uh, morning routines specifically and sleep routines, then looking at that area and seeing where adjustments can be made so that the routines can return to a level of consistency that would allow students to be prepared in the morning to attend school.
I think the other area is if the child is remaining at home, he or she is not able to go to school and you’ve tried everything you can to get them to school uh, there needs to be a expectation set for the home environment while the student is at home. You don’t want to make that environment so reinforcing that the student loves to stay home. When I talk to parents about this particular area of concern, I always let them know we have to make home more boring than school so that there is a motivating factor to attend school and not to remain home. So we start to look at what they’re doing, what are they doing all day while they’re at home and are there, fun activities or motivating activities that we can remove? I also talk to the parents about reducing their attention to the child while they’re at home. So you’re just trying to, you know, shift that motivating factor from, it’s motivating to stay at home to it’s more motivating to attend school.
Cindy Lopez:
Yeah. Yeah. And we talked about early intervention, but I’m wondering, is school refusal an actual diagnosis? Is that something that they would see as specialist for, and they would diagnose it?
Jody Miller:
School refusal is not a diagnosis, but kind of the root of many of the struggles with school attendances and that would be an underlying diagnosis of anxiety. Uh, and yes, I would certainly start to seek out professional advice or support, maybe even beginning with your pediatrician, if you haven’t already began that discussion and you know, could go further into psychotherapy, medication exploration. We have students that even have an emotional support animal. That really is sometimes helpful in having that animal with the student to attend school and then I think that maybe the last area would be in terms of just how to address or how to support the student, does there need to be a home support component? Could there be, you know, added professionals to support the student in the morning? Sometimes that’s done through an IEP, and sometimes that’s done privately by the parent.
Cindy Lopez:
At CHC, we have our clinical services and therapists who are here for those kinds of kids with anxiety and so much anxiety that it keeps them from going to school. Um, and pediatricians uh, Jody just mentioned that too. That’s a good place to start. Your pediatrician hopefully has a good whole picture of your child and if not, you can give them more information and then they could recommend next steps or advise. And then, you know, just the whole COVID thing could be also another excuse not to attend school, like either for parents or the child, right? It’s like, I don’t wanna go to school cause I’m afraid I’m gonna get sick, but there’s a whole list of reasons your kids might not want to go to school and there is treatment as well. So just know that you can reach out, chconline.org.
Jody Miller:
I would say a couple of things about COVID Cindy. We’ve seen it as an increase in student’s anxiety. Like you said, I don’t wanna attend school because I’m scared that I may contract the virus, and we’ve also seen it as a way to avoid school. I have a sore throat or I have a headache or I don’t feel well. And of course with following all the COVID procedures, you know, schools want kids to stay home if they’re feeling sick. So we’ve seen kind of both of those areas coming up within our students. Just to kind of put some of this into perspective, I have two children and I talk about them quite a bit. School avoidance can happen so quickly sometimes and it can be, uh, like I said before, one of those acute situations. My son Nash who was in first grade last year, going into second grade. In May he had a really tough day at school socially. He and one of his friends had a pretty escalated interaction, and I had to go pick him up from school and the next day he didn’t wanna go, and he loves school. He has never said anything like, “I don’t want to go.” He loves it, but that interaction was so devastating to him that he didn’t wanna go to school. And it was kind of a struggle to get him there. Um, and what we did was we reached out to obviously the school personnel, we met with them, we actually reached out to the student, uh, he brought them a gift to kind of, you know, settle the conflict, and he was able to work through that, but you can see that was a very small uh dot on the map for him and he completely wanted to avoid school and that could have really developed into something more had we kind of not addressed it as immediately as possible, but that’s just one example from my own family where, you know, could have been something a little bit further along.
Cindy Lopez:
Yeah. That’s so important. So we talked about kids and teens, but specifically let’s look at middle school for just a minute. Middle school is such a unique time in development and in adolescent development and things tend to erupt during those years. So, what can parents do, especially as we think about their middle schoolers and school avoidance?
Jody Miller:
Middle school for lack of a better word is a beast. It is a very difficult time in a child’s life most often. You know, it’s the time when students are starting to get a sense of who they are. They are starting to understand the social world much better and their emotions. And also it’s a time when they’re beginning to want and they’re getting more autonomy from adults. And so as a student approaches the most kind of difficult time in their schooling, they’re also wanting to avoid more adult support or adult intervention and so that can sometimes be kind of a train wreck. And we do start to see more emotional distress, definitely more school avoidance in the middle school years than, you know, any other time.
Cindy Lopez:
So yeah, middle school is such a unique time and there’s so many great things about it, but there’s a lot of hard things about it too. So this whole topic of school avoidance, it’s such a big issue and we’ve talked a lot about it, and you’ve brought up so many important things that our listeners probably are trying to like think how I’m gonna remember this. So I’m wondering Jody, from your vantage point, what’s the most important thing you want our listeners to remember on this topic?
Jody Miller:
The first one is to stay informed about what’s going on at school. A well informed parent is a prepared parent. Uh, so as much information that you can gather, as many conversations that you can have with your child is the best way to approach just raising a child in general, but also if you’re starting to see difficulty arise. Uh, and then listen to your intuition. If your child is beginning to miss school, refusing school, distressed in the morning, inattention, uh, or thinking that things will improve, or this is a phase, that’s not the approach you wanna have, don’t sit by and hope that things will improve. You have to act.
Cindy Lopez:
Yeah, that’s so important. Thank you for saying that Jody, and to our listeners thank you for joining us today. And if you need some help or want more information on this topic, want to talk to somebody, please call us. You can reach us at 650-688-3625 or you can email the care team at careteam@chconline.org. Jody has been with us today and as we said in the introduction, she is thehead of Esther B. Clark schools at CHC.
Jody Miller:
Esther B. Clark our schools that are in place to support kids that are struggling socially or emotionally and have not been successful in a traditional academic setting.
Cindy Lopez:
And you can find out more about Esther B. Clark School also by calling CHC or, visiting chconline.org. Jody, thank you so much for being with us again today for sharing some of your personal stories and for sharing your expertise, we really appreciate.
Jody Miller:
Thanks Cindy. I enjoyed myself.
Cindy Lopez:
And to our listeners. We hope you’ll join us again next time.
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