School refusal is a condition characterised by reluctance and often outright refusal to go to school in a child who:

• seeks the comfort and security of the home
• displays evidence of emotional upset when faced with the prospect of having to attend school

Features

• Young childest most likely affected
• Most likely to affect teenagers transitioning from primary to secondary school
• A frequent disorder linked to school refusal is seperation anxiety disorder - may also be depression, social anxiety disorder, agoraphobia
• Physical symptoms that are manifestations of emotional upset - tummy ache, micturition, anorexia, diarrhoea, pallor, headache

Diagnosis

• clearly defined when school refusal is present along with symptoms of anxiety and depression

Management

• Patient and parent education - early return to school will improve matters
• Any physical investigations required to exclude a physical cause for symptoms should be speedily completed and the family encouraged not to pursue the search for physical illness as an explanation for the problem
• If return to school cannot be achieved - refer to child mental health services