As the summer draws to a close, the upcoming school year often brings with it a wave of excitement, as well as anticipation and nervousness for children. As a child psychiatrist, I have witnessed firsthand the impact that back to school anxiety can have on kids and their families, especially following the COVID pandemic when we were all at home for varying amounts of time. A 2023 study from Nemours Children’s Health found that 86 percent of school-aged children reported worrying at least some of the time, and that more than 1 in 3 children ages 9-13 worry at least once a week. The biggest worries that children had were about school (64 percent), which matches what I’ve seen in patients and my own children.

School avoidance, also known as school refusal, is a phenomenon characterized by a child's reluctance or refusal to attend school. By understanding the specific fears and concerns driving a child’s avoidance, parents can develop effective strategies to address and alleviate their child's anxiety.

While school avoidance can be seen at any point during the year, as we approach the first day of school and are thinking about how to best prepare our children for a successful school year, it is an opportune time to explore the causes behind school avoidance, its association with anxiety, and provide strategies for parents to support their children in overcoming these challenges.

Differentiate Anxiety in Your Teens and Younger Children: Teenagers experiencing school avoidance often grapple with worries about their social standing, fear of embarrassment, or feeling singled out by their peers. Social situations that involve larger groups or public areas within the school, such as navigating hallways or eating lunch in the cafeteria, can trigger significant anxiety for them. On the other hand, younger children tend to worry more about being away from their parents or caregivers. Their concerns revolve around "what if" scenarios, such as something happening to their loved ones while they are at school, if someone will forget to pick them up or if someone won’t play with them on the playground. It is crucial for parents to identify and acknowledge these specific fears in order to provide targeted support and reassurance.

Be Proactive: While intervention strategies are vital, prevention also plays a significant role in managing school avoidance. If parents are aware of their child's previous struggles with anxiety and school avoidance, they can implement a preemptive exposure and anxiety reduction plan. This plan should be initiated 2-4 weeks before the start of the new school year. Activities such as visiting the school, locating their locker, meeting their teacher, or having lunch in the cafeteria can help familiarize the child with the school environment and get them ready for that first day. By proactively addressing anxiety and establishing a reward system for attending and staying in school, parents can create a positive association with the school experience.

Talk About It: Be open and honest with your child about your own struggles with anxiety. Did you have a hard time going back to school as a kid? Do you have a hard time preparing yourself for a first day at a new job? In the same study I mention above, researchers found that 67 percent of kids will go to advice from their parents on the topic of school anxiety, so if parents can talk openly about their own struggles with anxiety, past or present, it can help a child feel less alone and more open to expressing their concerns with you when they arise.

Be Thoughtful About Reentry: If a child or teenager remains out of school for an extended period, reintegration can become increasingly challenging. To address this issue head on, proactive communication with your school is important. I highly recommend that parents initiate conversations with a principal, teacher, or counselor to devise a personalized "re-entry plan." This usually involves exposing the student to school gradually, say coming to the school office or going in on a weekend or evening when fewer people are around. They can then work up to half days until finally the student feels they have mastered their fears and are more confident and competent to return full-time. I have seen this gradual exposure technique work, especially when coupled with support and rewards.

Seek Professional Support: In some cases, the anxiety and school avoidance experienced by a child may require additional assistance. Parents should consider involving a mental health professional who can provide specialized support and guidance. SonderMind providers often work with parents throughout the school year on these sorts of issues. A professional can help identify and address the underlying causes of anxiety, develop tailored anxiety management techniques, and collaborate with the school to create an individualized plan for the child's success.

As the world navigates the continued challenges of a post-COVID era, it is essential for us as parents to be attuned to our child's anxiety around returning to school, whether that be on the first day or mid-year. By understanding the distinct fears experienced by teenagers and younger children, parents can implement targeted, thoughtful strategies to alleviate anxiety and encourage regular, uninterrupted school attendance.

About the author

Dr. Douglas Newton is Chief Medical Officer at SonderMind.