Introduction
It usually starts with a tummy ache.
Sunday night, just after supper. Then again on Monday morning, worse this time, with tears. You keep them home, because what else do you do with a child who says they feel sick? By ten o’clock they’re fine. Bright, even. By Sunday night it’s back.
The GP finds nothing. The school says they seem happy enough once they’re there. And you’re left standing at the gate at 7:40 with a child clamped to your leg (or a teenager who won’t get out of bed), a boss waiting, and a horrible feeling that whatever you do next is going to be the wrong thing.
If that’s your house, you’re not failing, and your child isn’t simply being difficult. This has a name. It’s called school refusal.
Term 4 starts on Tuesday, 6 October. For most families that means the last push of the year. For some, it means dreading the Monday night before. This post is for them: what school refusal is, what’s usually underneath it, and what actually helps a child back through the gate.
What School Refusal Is (and Isn’t)
School refusal is when a child finds it so distressing to go to school that they can’t, or can only manage it in fits and starts. In the UK it’s now often called emotionally based school avoidance, which describes it rather better. The emotion comes first. The avoidance follows.
It isn’t truancy. A child bunking school usually hides it from you and goes off somewhere more interesting. A child with school refusal is at home, where you can see them, and often badly wants to be the kind of child who just goes. They’re not choosing the easy option. For them, there isn’t one.
It’s also more common than most parents realise. Estimates put it at between 2% and 5% of school-aged children, boys and girls equally. It tends to peak around ages five to six and ten to eleven, and it clusters at the big transitions: starting Grade 1, the move into Grade 8, a new school after a move. It also flares after long breaks, which is why the end of a holiday can be the hardest week of the term.
The body often speaks first. The stomach ache on school mornings, the nausea, the headache that nobody can figure out the cause of. These aren’t invented. Anxiety produces real symptoms, and a child who can’t yet say “I’m frightened” will very often say “I feel sick” instead.
What It Looks Like at Home
It rarely arrives all at once. It builds. Some of the signs parents describe to me:
- physical complaints on school mornings that fade by mid-morning, and don’t appear on weekends or in the holidays
- Sunday-night dread, or a slump in the last few days of every holiday
- clinging, pleading or meltdowns at drop-off, especially in younger children
- phone calls from the sick bay, asking to be fetched
- in teenagers: not getting up, a sleep pattern that’s drifted later and later, “I’ll go tomorrow” (said every day)
- going for part of the day, or only on certain days (often the ones without a particular subject, teacher or break time)
One day off isn’t a pattern. A few weeks of this is.
What’s Usually Underneath
School refusal is a signal, not a diagnosis. The work is finding out what it’s signalling, and it’s often more than one thing.
Anxiety
The most common driver. For younger children it’s often separation anxiety: a fear that something will happen to you, or to them, while they’re apart. For older children and teens it tends to be social anxiety (being looked at, being left out, being asked to speak) or performance anxiety, especially in high-achieving kids for whom a test is a verdict on who they are.
Something happening at school
Bullying, in the corridor or in the class WhatsApp group. A friendship that’s gone wrong. A teacher your child is frightened of. A subject where they’re quietly drowning. Children will often protect you from these, or not have the words for them, so it’s worth asking gently and more than once.
Learning differences and sensory load
For many neurodivergent children, school is simply exhausting. Picture it from the inside: a bell every forty minutes, a quad full of hundreds of shouting children, a humming fluorescent light, a classroom that smells of someone’s lunch. An autistic child may hold it together through all of that, masking all day, then fall apart at home, until one morning they can’t face it at all. ADHD makes the school day a long, uphill slog of being told to sit still and try harder. Undiagnosed learning difficulties do the same, more quietly.
Something at home
A separation or divorce. A parent who’s ill, or struggling. A new baby, a death in the family, a move. Some children stay home because they’re worried about someone there. They want to keep an eye on things. Others are carrying something they can’t yet say, and school is simply one demand too many.
Low mood
In teenagers especially, what looks like refusal can be depression: no energy, no point, no reason to get up. If your teen has lost interest in things they used to love, not just school, take that seriously.
Why Staying Home Makes It Harder
This part is hard to hear, so I’ll say it kindly.
Every day at home brings relief. The tummy ache fades, the dread lifts, everyone breathes out. That relief is real. But the brain learns from it: school is dangerous, home is safe, avoiding it worked. So the next morning, the fear is a little bigger.
Meanwhile, the work piles up. Friendships move on without them. The class has had three weeks of jokes they weren’t there for. Going back now means facing all of that as well as the original fear, so the wall gets higher with every day away.
None of this means you’ve done something wrong by keeping them home. Almost every parent does, at first. It means the aim, gently and gradually, is to get them back.
What Helps
There’s no single fix, and what works for a six-year-old looks different from what works for a sixteen-year-old. But these principles hold across ages.
Take the body seriously, once
Book a proper check-up with your GP to rule out anything physical. Then, once your child has been cleared, stop re-checking every morning. You can be warm about a sore tummy (“I know, that feels horrible”) without turning it into the question of whether they go.
Get curious before you get firm
The school gate is the worst place to find out what’s wrong. Ask at a calm time: in the car, walking the dog, at bedtime when the lights are off. Ask open questions, and be ready for “I don’t know”. That’s often the honest answer. Younger children usually say more through play, drawing or a game than through direct questions.
Keep the morning boring
Same wake-up time, same routine, same calm tone, every school day. Keep goodbyes warm and short. A long, emotional goodbye tells a frightened child that there’s something to be frightened of.
Make home a little less interesting
This isn’t punishment. It’s just that if a day at home means screens, snacks and your undivided attention, it becomes very hard to compete with. During school hours, home can look like school: set work, no gaming, no TV. A child who genuinely can’t go shouldn’t be punished. School hours are still school hours.
Talk to the school early
Contact the class teacher or grade head, and the school counsellor if there is one. Most South African schools also have a school-based support team (SBST) set up for exactly this sort of thing. Ask for specifics: a safe adult your child can go to, a quiet place to take a break, an agreed plan for drop-off, perhaps a softer start to the day. Schools can’t help with what they don’t know.
Go gradually
A child who hasn’t been at school for three weeks is unlikely to manage a full Monday. Break it into steps they can actually take. Driving past on a Sunday. Walking to the gate. Going in for the first two periods. Staying until break. Then longer. Each step is practised until it’s boring, then you move on. The aim is steady progress, not a perfect week.
Look after yourself (and each other)
School-refusal mornings are brutal. They leave parents late, frazzled and often at odds with each other; one of you wants to be firmer, the other wants to be kinder. Try to agree on a plan away from the heat of the morning, then stick to it together. Your child will borrow your calm, or your panic. You’ll need support too.
The Home-Schooling Question
South Africa has seen an explosion in online and home-schooling options, and when mornings are a war zone, they can look like a lifeline.
For some children, a different school, or a different way of schooling, is the right answer. But it’s a decision best made once you understand what’s driving the refusal, not in the grip of it. If the problem is anxiety, it has a way of following a child to the next place. Moving them to learning at the kitchen table can take the pressure off for a while, then leave them more frightened of the outside world than before.
Understand first. Then decide.
When to Get Help
As a rough guide, reach out if your child has missed more than a week or two, if it keeps coming back every term, or if the mornings are already costing your family more than you can carry. The earlier it’s addressed, the easier it tends to be to turn around.
Get help sooner if there’s panic at the gate, if your child seems low or withdrawn for most of the day and not just on school mornings, or if you suspect bullying or something they’re not telling you. And if your child ever talks about not wanting to be alive, or you’re worried about their safety, don’t wait: call SADAG’s suicide crisis line on 0800 567 567, which runs 24 hours a day.
Therapy helps. A review of treatment studies found that children with school refusal who received psychological support, mostly cognitive behavioural therapy, went on to attend school significantly more. Interestingly, their anxiety took longer to settle than their attendance did. That’s worth knowing. Getting back through the gate is a big step, not the finish line, and the work carries on after it.
In my room, that work usually happens on two fronts. With your child, we look at what the fear is made of, and build the skills to face it in small, manageable steps. With you, we make a plan for the mornings that you can both live with, and I’m happy to work alongside the school so everyone is pulling in the same direction.
Conclusion
School refusal can make you feel helpless, as a parent. It can make your child feel like a problem. Neither is true. Your child is struggling with something that feels much bigger than they are, and with patience, a plan and the right support, most children do find their way back.
Providing support for parents and teens is what I do every day, in person in Claremont (close to Rondebosch, Newlands, Kenilworth and Wynberg) and online across South Africa. If this post described your mornings, you’re welcome to get in touch.
The gate will still be there on Tuesday. So will you.
About Me
I’m Paula Marais, a registered specialist wellness counsellor based in Claremont, Cape Town. I hold an Honours in Psychology (Unisa) and a Master’s in Creative Writing (UCT), and I’m registered with the Association for Supportive Counsellors and Holistic Practitioners (ASCHP).
I offer individual and couples counselling, in person in Claremont and online across South Africa. Online sessions are equally as effective as in-person sessions.
There’s no pressure and no judgment. You can reach me at info@paulamaraistherapy.com or on WhatsApp at 072 633 7661.
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