Managing School Refusal in Children with ASD

Communication between parents and teachers is key in identifying complex issues as well as potential strategies to manage school refusal in children with ASD.

What is school refusal?

School refusal refers to the constant and outright rejection of attending school. In such situations, the children usually do not want to or cannot go for many reasons. Common causes listed by the National University Hospital (2019) include social problems, anxiety, depression, academic difficulties, and family problems. In addition, going to school may particularly be challenging for children with ASD as they have more difficulties with sensory processing, social interactions, and changes in routines in an environment that is typically disordered and noisy (National Autistic Society, 2020). Understandably, it can get overwhelming for children with ASD as they struggle to cope, which may lead to a strong aversion to leaving the comforts of their home to go to school, where most things are unpredictable.

What are the signs of school refusal?

Such anxieties and avoidance can manifest in many ways. Signs of school refusal tend to include hiding or refusing to move, low moods, feeling unwell (i.e., physical symptoms), having more difficulty sleeping at night, having intense meltdowns, and even increase in aggressive behaviors, especially when the child is older (Raising Children Network Australia, 2020).

How do I manage school refusal?

The effectiveness of strategies to tackle school refusal would depend on the root of the child’s anxieties (Raising Children Network Australia, 2020). Thus, it is crucial to first identify the trigger of such an amplified negative response to school (National Autistic Society, 2020). If the child can express themselves, encourage them to communicate what is troubling them. Empathize and acknowledge your child’s emotions, as it can be very difficult for them to verbalize their experiences and motives. The use of visual aids may also support this process. For instance, it may be helpful to get your child to rate events or places at school on a scale suited to their level of understanding (e.g., not scary to very scary, very bad to very good, don’t like to like very much). However, as we know, individuals with ASD display a wide range of abilities, and many cannot communicate why they are distressed. Therefore, regardless of their level of functioning, it is imperative that parents also collaborate and discuss with the child’s school. As mentioned, the problems may stem from the school environment (e.g., too loud), feelings of alienation from peers, or complex timetables (e.g., issues with transitions), and they may each require different strategies (National Autistic Society, 2020). Of note, it is also likely that a combination of challenges contributes to making school feel unbearable for children with ASD.

Sensory issues created by the school environment can result in sensory discomfort and barriers to learning (National Autistic Society, 2020). Thus, it may be helpful to set up a calm and safe space for the child to take a break when they get overstimulated or to focus on completing their work. Further, parents may also consider using ear defenders for children who may be sensitive to certain noises. The school can also try providing the child with more breaks in between activities to prevent things from becoming too overwhelming for them at a time.

If it is identified that the child is struggling with social issues in school, start by supporting their learning of social skills (Raising Children Network Australia, 2020). This can be done through role-playing scenarios that may occur during unpredictable times, such as during lunch and playtime. Videos and social stories may also aid their learning. Exposure to different situations and practicing various ways to manage them can help to build the child’s confidence in coping with such unpredictability. Further, promote relationship building by organizing play dates for the younger ones and encouraging the older children to join school activities that interest them to meet like-minded peers. Teachers would also play a crucial role in facilitating social interaction in the classrooms where possible, and also intervening when the child is observed to be bullied or rejected.

The complex timetables that keep changing throughout the day may also contribute to a child’s difficulties in school. Specifically, it is common that a child may need support transitioning between activities or lessons. In such cases, collaborate with the school to make reasonable adjustments, such as using visual aids or a schedule to prepare the child for the sequence of activities. The use of reward systems with reinforcers, such as stickers, toys, or playtime, in school or at home can also be considered. Further, establish and stick to a morning and evening routine (e.g., prepare uniform, pack school bag) and include details (e.g., what time to leave and reach, which room they will go to first, what will happen next). This can help to build confidence as the child can feel more secure about what to expect during the day.

Other strategies that may be effective include collaborating with the school to incorporate the child’s interests in learning (e.g., topics such as transportation). This can promote rapport between teachers and the child with ASD while also increasing engagement at the same time. The use of reward systems, with reinforcers such as stickers, toys, or snacks, may also be considered. For example, teachers can use it to reward small achievements and encourage participation in schools, while parents can introduce it to improve school attendance and reduce avoidance.

Finally, it should be reiterated that the experiences of those with ASD in schools are unique to each child. The reasons for school refusal tend to be complicated and may require many forms of intervention. Therefore, seeking professional help and intervention is encouraged. As school refusal is unlikely to fade away without intervention, it is pertinent to take the initiative to discuss with stakeholders and implement an action plan quickly.

In short, it is first essential that the main issues are identified through discussions and observations. Then, continue to collaborate with the school to figure out practical plans and solutions to implement. An established routine and relevant support (e.g., visual aids, reward systems) can then promote more positive associations, which can help to reduce stress levels and increase self-esteem. As school refusal can be very difficult to handle, it is crucial to continually seek support and be patient.

Written by: Shariffah

References:

National Autistic Society (2020, August 26). What can I do if my child won’t go to school? https://www.autism.org.uk/advice-and-guidance/topics/education/attendance-problems/parents

National University Hospital (2019). School refusal. https://www.nuh.com.sg/our-services/Specialties/Psychological-Medicine/Documents/School%20Refusal.pdf

Raising Children Network Australia (2020, November 25). School refusal: Autistic children and teenagers. https://raisingchildren.net.au/autism/school-play-work/school/school-refusal-autistic-children-and-teenagers