Lesson 2: Recognizing Signs and Symptoms of School Refusal

Introduction

Welcome to Lesson 2 of our online course for parents dealing with their child's school refusal. In this lesson, we'll take a deeper dive into some of the concepts from Lesson 1, particularly Operant Conditioning and the four drivers of school refusal. We're doing this because it offers terrific strategies to get your kids back into school.

Understanding Operant Conditioning is crucial for parents because it sheds light on how behaviors are influenced by consequences. It helps parents identify what reinforces or punishes a child's refusal to attend school. This insight enables parents to develop targeted strategies to effectively address school refusal.

Next, we'll examine the mental health continuum in relation to school refusal, figuring out when it's the right time to seek help, where to find external support, and why it's beneficial for both your child and you as a parent.

Lastly, we'll focus on recognizing signs and symptoms of school refusal. So by the end of this lesson,  you'll have a better understanding of what to look for in your child's behavior.

Let's get into it!

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Objectives:

• Have a deeper dive into the four drivers of school refusal
• Identify the behavioral and emotional indicators of school refusal.
• Understand when school refusal becomes a problem using the Mental Health continuum.
• Benefit from some parent tips to create and maintain a happy home.

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Week 1 Recap

In Lesson 1 we suggested that you find the cause of your child's school refusal, because once you've done this it will be easier to work towards a strategy to counter this.

Remember, we spoke about the four drivers of school refusal?  This is based on a Psychological theory called Operant Conditioning - so we're going to get a little deep so you can understand the theory and why it's an important factor in getting your child back to school.  Here's a reminder of the  four drivers (take note of the words in brackets because they're the theory part we're going to work on). Basically, you're doing a bit of Psychology Theory which I think is cool. And it works.

1. AVOIDING situations which evoke negative emotions (Negative reinforcement).

Example: Sarah is being bullied at school, and the negative emotions associated with this situation make her reluctant to attend. Her parents allow her to stay home when she expresses distress about going to school. The removal of the scary stimulus (negative emotions from bullying) reinforces her avoidance behavior, which contributes to the school refusal.

2. ESCAPE from negative social and/or evaluative situations (Negative reinforcement).

Example: Alex is struggling academically, and the fear of judgment from others about their academic performance causes anxiety. When Alex avoids school, he temporarily escapes the negative social and evaluative situations he fear so much. This escape is a negative reinforcement because he avoids the negative evaluation, strengthening the behavior of avoiding school to manage the anxiety.

3. ATTENTION SEEKING (positive reinforcement)

Example: Emily seeks attention by refusing to go to school. When she does so, her mother takes her to Nana's house, where she receives a lot of attention and fuss. The positive attention from her mother and extended family becomes a positive reinforcement for her school refusal behavior, making it more likely that she will repeat the behavior to gain attention.

4. TANGIBLE REWARDS (positive reinforcement)

Example: James refuses to go to school, and as a result, his mother allows him to play video games and takes him out for ice cream. The tangible rewards of playing games and enjoying ice cream become positive reinforcements for James's school refusal behavior. The likelihood of him repeating the behavior increases because of the rewarding consequences.

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Changing behaviors to stop school refusal

Now, let's unpack Operant Conditioning again so you understand why this is one of the key components in winning the School Refusal battle.

Operant Conditioning is a psychological concept that explores how behavior is influenced by its consequences. In the context of school refusal, Operant Conditioning helps us understand how a child's behavior related to attending school can be shaped by the consequences that follow.

Remember to look at these examples and ask:

1. What is the behavior (in most cases in this course the behavior is the school refusal)?

2. Is something being added (positive) or taken away (negative)

3. Is the behavior likely to be continued (reinforcement) or likely to stop (punishment).

Now, let's consider examples of Operant Conditioning in the context of school refusal:

1. Positive Reinforcement for School Attendance: Example: Sarah is anxious about going to school, but when she attends without resistance, her parents praise her and allow her to choose a special activity after school.

Positive reinforcement involves adding something to increase the likelihood of a behavior. In the case of school refusal, if a child attends school without resistance, positive reinforcement could include praising the child, providing small rewards, or acknowledging their effort. Over time, this positive experience can create an association between attending school and positive outcomes.

2. Negative Reinforcement for Avoidance Behavior: Example: Tom experiences anxiety about attending school. When he expresses his reluctance, his parents allow him to stay home, providing relief from the anxiety. This removal of the anxiety reinforces his avoidance behavior.

Negative reinforcement involves removing something to increase the likelihood of a behavior. In the context of school refusal, if a child avoids school due to anxiety, negative reinforcement could occur if the avoidance results in the removal of the anxiety-inducing situation. This removal of the anxiety reinforces the avoidance behavior.

3. Gradual Exposure and Positive Reinforcement: Example: Emily is reluctant to attend school due to social anxiety. Her parents work with her and the school to gradually expose her to social situations. At each step, positive reinforcement, such as praise and encouragement, is provided to build her confidence.

Gradual exposure is a technique where a child is gradually exposed to the feared or avoided situation in manageable steps. Positive reinforcement is applied at each step to encourage the child to tolerate and eventually overcome their anxiety.  (More about creating a plan to do this in a Lesson 3.)

4. Consistent Consequences for Non-Attendance: Example: Jake refuses to go to school, and each time he does, his parents implement a consistent consequence, such as limiting screen time or other preferred activities. The negative consequence is intended to discourage the behavior of school refusal.

Consistent consequences are crucial in Operant Conditioning. If non-attendance is consistently met with negative consequences, it may discourage the behavior. This could involve loss of privileges, additional responsibilities, or other consequences that the child finds undesirable.

Operant conditioning can be valuable in addressing school refusal because it provides a framework for understanding and modifying behaviors based on consequences.

Now, let's unpack the diagram above again to reinforce your learning:

1. AVOIDING situations which evoke negative emotions (Negative Reinforcement):
   • Example: Sarah is being bullied at school, and the negative emotions associated with this situation make her reluctant to attend. Her parents allow her to stay home when she expresses distress about going to school. The removal of the scary stimulus (negative emotions from bullying) reinforces her avoidance behavior, which contributes to the continuation of her school refusal.
2. ESCAPE from negative social and/or evaluative situations (Negative Reinforcement):
   • Example: Alex is struggling academically, and the fear of judgment from others about their academic performance causes anxiety. When Alex avoids school, he temporarily escapes the negative social and evaluative situations he fear so much. This escape is a negative reinforcement because he avoids the negative evaluation, strengthening the behavior of avoiding school to manage the anxiety.
3. ATTENTION SEEKING (Positive Reinforcement):
   • Example: Emily seeks attention by refusing to go to school. When she does so, her mother takes her to Nana's house, where she receives a lot of attention and fuss. The positive attention from her mother and extended family becomes a positive reinforcement for her school refusal behavior, making it more likely that she will repeat the behavior of school refusal to gain attention.
4. TANGIBLE REWARDS (Positive Reinforcement):
   • Example: James refuses to go to school, and as a result, his mother allows him to play video games and takes him out for ice cream. The tangible rewards of playing games and enjoying ice cream become positive reinforcements for James's school refusal behavior. The likelihood of him repeating the behavior of refusing school increases because of the rewarding consequences.

In these examples, you can see how Operant Conditioning principles are at play. The behavior of school refusal is influenced by the consequences that follow - whether it's the removal of an scary stimulus (negative) or the addition of a desirable stimulus (positive). Understanding these dynamics can be key in developing effective interventions to address school refusal and work on practical strategies to reinforce school attendance.

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Practical strategies to reinforce school attendance

Here's some practical examples of strategies that parents can implement using positive and negative reinforcement, as well as positive and negative punishment:

1. Positive Reinforcement:
   • Example: If a child completes their homework without being reminded, parents could offer positive reinforcement by praising the child and giving them extra playtime or a small reward.
2. Negative Reinforcement:
   • Example: If a child consistently follows their morning routine without resistance, parents could remove a daily chore from their responsibilities as a form of negative reinforcement.
3. Positive Punishment:
   • Example: If a child engages in disrespectful behavior, parents might apply positive punishment by assigning an extra chore for a specified period.
4. Negative Punishment:
   • Example: If a child neglects their household duties, parents could implement negative punishment by temporarily restricting their screen time or social privileges.

It's important to note that effective use of these strategies requires careful consideration of the child's personality, age, and the specific behavior being addressed. Additionally, consistency, clear communication, and a focus on promoting positive behaviors are essential elements in the successful implementation of these strategies. Parents should strive to create a supportive and loving environment while providing guidance for their child's behavior.

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Recognizing the pattern of school refusal along with your child's mental health

Not wanting to go to school is a tricky problem that's connected to how a child feels inside. It's like a puzzle where a child's mind and feelings are part of deciding if they go to school or not.

Imagine a line with green on one side and red on the other. Green means feeling good and red means feeling really not good. Everyone's feelings can be anywhere on this line. When a child doesn't want to go to school, it's like their feelings are on this line, and it's important to understand where.

This problem is like mixing two things together: going to school and how a child feels inside. Some kids feel good and can easily go to school (that's in the green zone), but others might feel a bit tough inside, and that makes going to school hard for them (that's in the yellow or red zones).

So, helping a child who doesn't want to go to school isn't just about saying, "Go to school!" It's also about understanding how they feel inside. It's like fixing both parts of the puzzle.

If you found this tricky, it's okay! Going through this again can help, just like figuring out a puzzle step by step. If you feel you're getting it, let's continue to see how we can work on this together for your child.

Using a mental health model, the journey to anxiety-based school refusal often looks like this:

Imagine your child's feelings like colors on a scale. Let's talk about how they might act about going to school in each color:

Green Zone: Feeling Good

In the green zone, a child feeling good mentally would probably go to school regularly and be happy about it. Sometimes, they might be a bit unsure, but it's normal and doesn't become a big problem.

Purple Zone: Reacting

If they're in the purple zone, it's like they're reacting to something bothering them, like stress or challenges. They might sometimes say they don't want to go to school because of these things. At this point, we can help by dealing with what's bothering them.

Yellow Zone: Injured

Moving into the yellow zone, the child's struggle with going to school might get stronger. They could keep saying they're scared or don't want to go. This might be because of mental health issues. Seeing a doctor or a mental health person can help at this stage.

Red Zone: Mentally Unwell

In the red zone, if a child has severe mental health problems, they might really refuse to go to school a lot. They could be very upset, have trouble with schoolwork and friends, and might even think about leaving school completely. If it's been like this for a long time, they might actually drop out.

It's important for parents, teachers, and mental health people to notice if a child's behavior changes. Getting help early, no matter which color, is really important. Help might be talking to someone, working with the school, and making sure the child feels supported with their mental health needs.

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Recognizing Signs and Symptoms of School Refusal

Identifying when your child is struggling with going to school is important. Here are some things to look out for:

Physical Signs:

Repeated complaints about headaches, stomach aches, or feeling unwell, especially on school days.
Unexplained physical symptoms without any underlying medical reasons.

Emotional Changes:

Notice if your child becomes more moody, irritable, or sad.
Look out for signs of anxiety, fear, or panic related to school.
If your child expresses a strong desire to be home schooled or attend a different school.

Behavioral Changes:

Resistance or arguments when it's time to get ready for school.
Withdrawal from social activities or friends.
Loss of interest in hobbies or activities they once enjoyed.
Decreased interest in academics or a drop in school performance.
Frequent absences or tardiness.

Avoidance Strategies:

Pleading to stay home, using excuses like feeling sick.
Trying to delay or avoid going to school through bargaining or negotiation.
Hiding or getting rid of school-related things like backpacks or homework.
Pretending to be asleep or unwell to avoid getting ready for school.
Extreme fear or distress about specific aspects of school, like certain teachers or classmates.

Academic Performance:

Watch for a decline in grades, incomplete assignments, or missed deadlines.
If your child feels overwhelmed or unable to keep up with schoolwork.

Sleep Disturbances:

Changes in sleep patterns, like difficulty falling asleep or frequent nightmares.
Waking up feeling tired and unrested.

Frequent Absences:

Keep track of your child's attendance. Consistent and unexplained absences could be a sign of school refusal.
Pay attention to patterns, like missing school on specific days or after breaks.

If you notice these signs often or if your child seems really distressed, it's a good idea to seek help from a mental health professional or your child's doctor. They can provide guidance on how to best support your child through this challenging time.  Remember if your child is refusing school because of anxiety, it's important that we teach them to be brave to help them through this.  This course is designed to help you along the journey to your child's wellness.

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What sort of professional help?

If your child's refusal to attend school is causing significant distress and your efforts at home haven't worked, seeking professional help is a proactive step. Here are some options to consider:

School Counselor or Psychologist:

Reach out to your child's school counselor or psychologist. They have experience dealing with school refusal and can offer support, strategies, and tailored interventions. It's important that you keep constant communication with the school so they can help you along the way. It's when the communication stops that legal issues may begin.

Child and Adolescent Therapist:

Consult a child and adolescent therapist, like a psychologist or licensed mental health counselor. They can work directly with your child, providing individual therapy sessions to address underlying causes and help develop coping skills.

Pediatrician or Family Doctor:

Your child's pediatrician or family doctor can identify any physical or medical factors contributing to school refusal. They can also refer you to mental health professionals specializing in working with children.

Support Groups:

Join a support group for parents of children with school refusal. These groups offer a safe space to share experiences, gain insights, and receive support from others facing similar challenges. Your child's school or local mental health organizations may help you find relevant groups in your area.
Remember, seeking professional help is a proactive move, not a sign of failure. Professionals will collaborate with you to create an individualized plan for your child's success. This is why we have a forum you can chat on, or you can join our private School Refusal Recovery Facebook page to chat to others who are dealing with the same issues.

It's important to note that not all children will exhibit all these signs and symptoms. Each child is unique, and their experience of school refusal may differ. However, recognizing these common signs can help parents identify when their child may be struggling with school attendance.

That's the end of Lesson 2, and we hope it's been helpful for you.  Over the next week, observe your child's behavior and try out the positive/negative, reinforcement/punishment by adding or taking away things to either reinforce a good behavior, or stopping a bad behavior and let us know how you went in the forum, or on our private Facebook group.  Don't forget to go to our Homework, Tips and Case Studies page for more Week 2 learning.

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Conclusion

Our primary goal in this lesson has been to emphasize the significance of recognizing the signs and symptoms of school refusal. By doing so, we can provide the necessary support and intervention to help these students overcome their difficulties and achieve success in their academic endeavors.

We encourage you to review this lesson if you need a refresher or if you missed any important details. Additionally, we invite you to explore the other lessons in this course, as they cover various aspects of school refusal and offer comprehensive guidance for parents, educators, and students alike.

Remember, by recognizing the signs and symptoms of school refusal, we can ensure that children receive the support they need to thrive academically and personally. Let us work together to create a nurturing and inclusive environment where all students can reach their full potential.

Before you move onto lesson 3, please complete the Home Work for Lesson 2