School avoidance linked to emotional distress in children, survey finds

School avoidance linked to emotional distress in children, survey finds | Image Credit: © EduLife Photos - stock.adobe.com.

A new national survey conducted by Ipsos on behalf of The Kids Mental Health Foundation, founded by Nationwide Children’s Hospital, indicated that school avoidance, also known as school refusal, may be a sign of emotional distress in children. The survey, which included responses from more than 1,000 parents across the United States, found that nearly one-third of parents (30%) whose child missed school due to fear or anxiety in the past year reported their child missed more than a week of school.¹

Among students who missed school, 42% said they did not feel physically well enough to attend, while 20% reported being too exhausted to go to school. Kelley McChristy, a parent from Columbus, Ohio, who has experienced school avoidance with her own children, said, “It’s important to recognize that there are a lot of physical symptoms that manifest in kids that are really related to mental health. When a child says, ‘I’m sick, I’m not feeling well,’ and you can’t find a reason for it, it could be related to anxiety.”

According to the 2023 study, as many as 28% of children experience school avoidance, most often between the ages of 10 and 13 years or during transitions to new schools.²

Ariana Hoet, PhD, executive clinical director of The Kids Mental Health Foundation and a pediatric psychologist at Nationwide Children’s Hospital, noted that school avoidance can occur for a variety of reasons. “Kids may have social concerns, like bullying or feeling like they do not fit in. They could be worried about test taking or having to speak in front of the class. Or sometimes kids don’t want to go to school because they have an undiagnosed learning disability, making school stressful for them,” she said.

The Kids Mental Health Foundation offers free, evidence-informed resources to help parents and caregivers identify signs of school avoidance and address them. Hoet emphasized the importance of talking with children about why they do not want to attend school. “I see this clinically all the time. Kids feel anxious. They don’t want to go. They’re in distress. And as parents, we want to protect them. We don’t want our kids to be in distress, and so the parent decides to keep them home. The problem with that is the more we avoid things that make us anxious, the bigger the anxiety gets,” she said. “A parent feels like they’re doing the right thing by giving their child a mental health day or keeping them home, but really that’s just going to make the anxiety grow.”

McChristy advised parents to be proactive. “That would be my first piece of advice — to know about resources and help ahead of time and be proactive instead of reactive because I think I was more reactive. And if I could switch that, I would. I have been shocked by the amount of people that I’ve talked to whose children are going through the same thing,” she said.

If school avoidance worsens to the point that a child refuses to leave home for multiple consecutive days, mental health intervention may be warranted. Cognitive behavioral therapy (CBT) may be beneficial in decreasing anxiety and improving attendance. Therapy can help children understand they can engage in activities that make them anxious and that confronting fears can build confidence over time.

References:

1. Nationwide Children's Hospital. New survey reveals top reasons why kids avoid going to school. Eurekalert. August 12, 2025. Accessed August 14, 2025. https://www.eurekalert.org/news-releases/1094323
2. Williamson MLC, Roberman S, Sopchak K, Mosley TM. School avoidance: How to help when a child refuses to go. J Fam Pract. 2023;72(7):304-307. doi:10.12788/jfp.0653