Research Paper, 2022-23

School refusal

Author

Dr Shannon Clark

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Executive summary

School refusal is a type of school attendance problem characterised by a child or young person’s emotional distress at attending school.[1] It differs from other forms of school attendance problems in terms of the distress experienced, and in that parents and carers typically know about their child’s absence from school and have tried to get them to attend.[2] This distinguishes school refusal from truancy (where parents or carers are often unaware of their child’s absence), school withdrawal (where parents may support or encourage their child to stay home), and school exclusion (which stems from school-based decisions).[3]

Estimates of the prevalence of school refusal in Australian and international literature are between 1% to 5% of all students.[4] Its prevalence is higher among students with autism spectrum disorders and attention‑deficit/hyperactivity disorder.[5] Across the world, there have been reports of growing rates of school refusal following the COVID-19 pandemic.[6] In Australia, school staff, parents and support services report that the incidence of school refusal has increased following COVID-19 school disruptions.[7]

In Australia, school attendance has been trending downwards over a number of years and there was a marked decrease in 2022.[8] In 2022 in Australian schools, the student attendance rate—the percentage of possible days that students in Years 1–10 attend school—was 86.5% while the attendance level—the proportion of students in Years 1–10 whose attendance rate is equal to or greater than 90%—was 49.9%. This is a sizeable drop from 2021, when the attendance rate was 90.9% and the attendance level was 71.2%. These measures do not identify different reasons for non-attendance. In international literature, missing 10% or more of available school days is a common cut-off point for chronic absenteeism.[9]

A number of complex factors can contribute to school refusal. These include stressful life events, problems at school with peers or a teacher, academic difficulties, bullying, illness, and transitions such as starting or moving school.[10] Young people with school refusal are often diagnosed with anxiety disorders.[11]

School refusal can negatively impact students’ learning and achievement and place them at risk of leaving school early.[12] School refusal can also have longer term impacts on children and young people’s social and emotional development and mental health into adulthood.[13] Dealing with a child or young person’s school refusal can be a source of stress and conflict for families.[14]

Introduction

Following disruptions to schooling from the COVID-19 pandemic, there have been increasing concerns about the rising incidence of school refusal among Australian students.[15] School refusal is characterised by a child or young person experiencing significant emotional distress at the idea of going to, or staying at, school.[16] As well as being distressing for the child or young person themselves, it is also stressful and disruptive for families, teachers and school staff.

This paper discusses school refusal and how it differs from other types of school attendance problems drawing on international and Australian literature. It considers its prevalence, as well as the national data on school attendance available in Australia. School refusal is a complex and multifaceted problem that can occur for a range of different reasons. Different factors that can contribute to school refusal are discussed as well as approaches to address school refusal and absenteeism. Finally, the paper considers the impacts of school refusal on children and young people in the short term and longer term, as well as impacts on the classroom more broadly.

What is school refusal?

School refusal is a type of school attendance problem based on a student’s emotional distress at attending school.[17] Although there are variations in definitions, features of school refusal include:

  • reluctance or refusal to attend school, often resulting in extended school non-attendance (some definitions include absence thresholds)
  • severe emotional upset, which can take various forms, including fear, anxiety, depression, anger, determined resistance, somatic health complaints (such as headaches, stomach aches), and sleep disturbance
  • staying at home with parents’ or carers’ knowledge
  • parental attempts to secure their child’s attendance at school
  • absence of significant anti-social disorders.[18]

These features distinguish school refusal from other types of school attendance problems, such as:

  • truancy, whereby children and young people are absent from school or class without permission, they generally conceal their absences from their parents, and may show antisocial behaviours
  • school withdrawal, whereby absenteeism is mainly motivated by parent factors, with parents not attempting to get their child to attend school, or encouraging them not to attend
  • school exclusion, which is problematic absenteeism stemming from school-based decisions, for example, relating to disciplinary measures, resource allocation, or for school-based performance requirements.[19]

There can be overlaps between the types of school attendance problems, and children and young people may experience different types of absenteeism at different times.

There is a spectrum of school refusal behaviour, reflecting different levels and kinds of absenteeism (Figure 1):

Figure 1    Spectrum of school refusal behaviour

Spectrum of school refusal behaviour

Source: Christopher Kearney, Helping School Refusing Children and Their Parents: A Guide for School-Based Professionals, (New York: Oxford University Press, 2018), 8.

School refusal typically develops along a continuum, with different expressions over time.[20] Early identification and intervention is crucial, as the more school a student misses, the harder it is to return to school and the more likely it will be that they will stay out of school entirely.[21]

School refusal is also sometimes referred to, or used interchangeably with, terms including ‘School Can’t’, problematic absenteeism, school avoidance, school reluctance, school phobia and emotion(ally) based school avoidance (EBSA).[22]

Prevalence

Estimates of the prevalence of school refusal cited in Australian and international literature are generally between 1% to 5% of all students.[23] However, there are difficulties capturing school refusal data given the range of school refusal behaviours (for example, somatic symptoms, lateness, partial or complete absences), as well as different definitions and different ways of tracking school absences.[24]

School refusal can occur throughout the range of school years; however, there tend to be peaks around certain ages (usually between 5–6 years and 10–11 years) and transitions (such as starting primary school or high school, or moving schools).[25]

Students with autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD) are at higher risk of school refusal. For example, a study of students in the UK with ASD found that 43% of students had persistent non-attendance (absent for more than 10% of available sessions), and that school refusal accounted for 43% of non-attendance.[26] An Australian study examined reasons for school non-attendance for children on the autism spectrum and found that 72.6% of responders had persistent absences (3 or more days in a 20-day period), with school reluctance/refusal responsible for the highest number of half and full days missed in total.[27]

Increased school refusal and the COVID-19 pandemic

Schools, parents and those treating students, such as psychologists and social workers, report that there have been increases in the prevalence of school refusal in Australia following disruptions to schooling due to the COVID-19 pandemic.[28] For example:

Bayside School Refusal Clinic director John Chellew said he had noticed a "significant increase" in referrals since the COVID-19 lockdowns in Melbourne last year.

"Statistics were saying between 2 and 5 per cent of children, up until last year, were school refusing. That then doubled last year," Mr Chellew said.

"Anecdotally, now we are thinking about the statistics trebling."[29]

Trends of increasing school refusal following the COVID-19 pandemic have also been reported in other countries.[30] For example, a short report published by the United Kingdom Office for Standards in Education, Children’s Services and Skills (Ofsted) in February 2022 examined aspects of school attendance and how schools approach challenges of persistent absence.[31] The report noted that many schools were experiencing higher than average absences due to COVID-19, both directly—for example, due to student illness—and indirectly—for example, due to parents’ and students’ anxieties. Successive national lockdowns had contributed to social anxiety for some.[32]

On 27 October 2022, the Australian Senate referred the issue of the national trend of school refusal and related matters to the Education and Employment References Committee for inquiry and report.[33] Following an extension of the Committee’s reporting date, the Committee is due to report by 21 June 2023.[34]

School attendance in Australia

In Australia, school attendance is compulsory, typically from the age of 5–6 until age 17.[35] State and territory legislation sets out age ranges for compulsory schooling, as well as attendance requirements for students of compulsory school age.

School attendance for Australian students in Years 1–10 is reported by the Australian Curriculum, Assessment and Reporting Authority (ACARA) via the National Report on Schooling in Australia—Data Portal. The Key Performance Measures (KPMs) for attendance, as specified in the Measurement Framework for Schooling in Australia, are ‘attendance rate’ and ‘attendance level’:

Key Performance Measure 1(b) Attendance rate. The number of actual full-time equivalent student-days attended by full-time students in Years 1-10 in Semester 1 as a percentage of the total number of possible student-days attended in Semester 1.

Key Performance Measure 1(c) Attendance level. The proportion of full time students in Years 1-10 whose attendance rate in Semester 1 is equal to or greater than 90 per cent.[36]

The measures do not differentiate reasons for non-attendance. Furthermore, these figures do not include the number of ‘detached students’, young people of compulsory school age who are not enrolled in a formal education program of any type. A 2019 report estimated conservatively that the number of detached students across Australia was 50,000.[37]

Chronic absenteeism occurs when students miss too much school.[38] A common cut-off point in international literature for chronic absenteeism is 10%; that is, students with attendance rates below 90% for any reason are considered as chronically absent.[39] In Australia, this equates to approximately 20 or more days absent in a year.[40] The KPMs reflect this cut-off.

In 2022 in Australian schools, the student attendance rate was 86.5% while the attendance level was 49.9%.[41] This is a sizeable drop from 2021, when the attendance rate was 90.9% and the attendance level was 71.2%. Attendance data for 2020 was not published due to inconsistencies in the data relating to the COVID-19 pandemic.

ACARA’s data portal notes that:

Attendance rates in Semester 1 2022 declined due to the impact of the COVID-19 Omicron variant and high Influenza season outbreaks and floods in certain regions experienced across Australia at that time.[42]

The following figures show time series student attendance rates and attendance levels from 2014 and 2015 to 2022.

Figure 2    Student attendance rate for Years 1–10 students in all schools in Australia, time series

Student attendance rate for Years 1–10 students in all schools in Australia, time series

Source: Australian Curriculum, Assessment and Reporting Authority (ACARA), ‘Student Attendance’, National Report on Schooling in Australia—Data Portal, Time Series.

 

Figure 3    Student attendance level for Years 1–10 students in all schools in Australia, time series

Student attendance level for Years 1–10 students in all schools in Australia, time series

Source: ACARA, ‘Student Attendance’, National Report on Schooling in Australia—Data Portal, Time Series.

Attendance trends

Attendance tends to vary across years of schooling, with schools experiencing a drop in attendance as students advance through the years from Year 3 to Year 10.[43] The biggest drops occur between years 7 and 10. In 2022:

  • the attendance rate was 87.3% for Year 7 students, falling to 82.9% for Year 10 students
  • the attendance level was 52.7% for Year 7 students, falling to 41.6% for Year 10 students.[44]

Attendance also differs by location, with school attendance declining as geographical remoteness increases.[45] In 2022:

  • the attendance rate for students in Years 1–10 in major cities was 87.5% compared with 63.1% in very remote areas
  • the attendance level for students in Years 1–10 in major cities was 52.4% compared with only 19.7% for students in very remote areas.[46]

There is also a gap in school attendance between Indigenous and non-Indigenous students in Australia.[47] In 2022:

  • the attendance rate for Aboriginal and Torres Strait Islander students across Australia was 74.5% compared with 87.4% for non-Indigenous students
  • the attendance level for Aboriginal and Torres Strait Islander students was 26.6% compared with 51.5% for non-Indigenous students.[48]

There are also differences in school attendance across Australia by school sector, with independent schools tending to have the highest attendance rates and levels and government schools the lowest. In 2022 for students in Years 1–10:

  • government schools had an attendance rate of 85.6% and an attendance level of 48.2%
  • Catholic schools had an attendance rate of 87.9% and an attendance level of 50.5%
  • independent schools had an attendance rate of 88.8% and an attendance level of 55.6%.[49]

However, there is variation across the states and territories (see Figures 4 and 5). For example, in 2022 for students in Years 1–10:

  • the attendance level for Catholic schools in WA (60.0%) was the highest of the sectors while it was the lowest of the sectors in the ACT (33.8%) and NT (35.4%)
  • the attendance level for government schools in Victoria (54.4%) was the second highest of the sectors in the state and 10.1 percentage points higher than government schools in NSW (with a larger gap for ACT and NT government schools).
Figure 4    Student attendance rate by state/territory for Years 1–10, 2022

Student attendance rate by state/territory for Years 1–10, 2022

Source: ACARA, ‘Student Attendance’, National Report on Schooling in Australia—Data Portal, School Sector by State/Territory.

 

Figure 5    Student attendance level by state/territory for Years 1–10, 2022

Student attendance level by state/territory for Years 1–10, 2022

Source: ACARA, ‘Student Attendance’, National Report on Schooling in Australia—Data Portal, School Sector by State/Territory.

Drivers of school refusal

School refusal is complex and multifactorial. It is associated with a range of risk factors, including individual traits, socio-economic conditions, family structure, the school environment and society more broadly. Factors that can contribute to school refusal include:

  • stressful life events
  • major transitions such as starting primary or secondary school
  • moving or other big change
  • fear of harm coming to a parent
  • illness in the family
  • separation and divorce
  • academic problems
  • overprotective parenting
  • friendship difficulties
  • separation anxiety.[50]

There are different conceptualisations of school refusal. For example, school refusal can be understood as a symptom of an underlying mental illness or disorder. Young people exhibiting school refusal are often diagnosed with anxiety disorders, such as generalised anxiety disorder, separation anxiety disorder, panic disorders and/or social anxiety, with 50% to 80% of children or young people with school refusal meeting criteria for one or more such disorders.[51] 

School refusal has also been characterised in terms of underlying motivations. For example, school refusal can be understood as being driven by negative reinforcement whereby students avoid situations that prompt unpleasant or anxious feelings (such as separation from caregivers, social interactions or academic requirements like a test or presentation), or aversive situations (such as bullying).[52] On the other hand, school refusal can also be understood as being driven by positive reinforcement, whereby students are motivated to stay home to get attention from parents, or to do activities at home that they find more enjoyable, such as watching television, social media or sleeping. School refusal can be motivated by a mixture of both positive and negative reinforcement.[53]

A criticism of bio-medical models is that they tend to locate school refusal and distress as problems with individual students and families and can reinforce negative stereotypes and deficit perceptions.[54] Increasingly, the importance of factors relating to young people’s life experiences and school factors are being recognised, with school refusal seen ‘as signals that all is not well in the young person’s world’.[55]

Research literature often groups drivers or risk factors for school attendance/absence into 4 domains: the individual, the family, the school and the broader community. A summary of these groupings as outlined in Problematic School Absenteeism—Improving Systems and Tools (a collaborative Nordic project funded by the European Union’s Erasmus+) is provided below:

Individual factors

  • psychological problems, for example, anxiety or depression
  • developmental disorders, such as ASD or ADHD
  • physical health, such as chronic illness
  • substance abuse
  • (undetected) learning disabilities.

Family factors

  • family structure, functioning and parenting style
  • socio-economic disadvantage
  • parental physical or mental health problems
  • low parental involvement in schooling
  • overprotective parenting style.

School factors

  • poor classroom management, for example, lack of classroom order and poor structuring of instruction and/or of social interactions between students
  • failure to prevent or manage bullying, social isolation, unpredictability at school
  • school transitions, for example, due to changes between schools, starting a new school year or returning after a holiday period
  • changes in pedagogical practices, for example, going from one primary teacher to subject‑specific teaching.

Community factors

  • society-wide pressure on students to achieve academically
  • perceptions of threats, such as school shootings or terrorism
  • neighbourhood characteristics, such as poverty, and structural barriers, such as lack of transport infrastructure or living in remote locations.[56]

Consequences of long-term infrequent school attendance

Schools are important for students’ development socially and academically. As such, school absences can have short and long-term negative impacts on children and young people’s essential competencies, including socio-emotional competences, and literacy and numeracy skills.[57]

Without treatment, school refusal can have negative impacts on students’ learning and achievement, as well as placing these students at risk of dropping out of school early.[58] Students refusing school are also more likely to experience problems in social adjustment and to have ongoing mental health problems in late adolescence and adulthood.[59]

The crisis-like presentation of school refusal can cause distress for parents and family conflict as they manage the challenge.[60] School refusal may also negatively impact on teaching and school staff due to stress and uncertainty in how to manage the problem and in strained relationships with families.[61]

International literature has also highlighted negative effects associated with school non‑attendance over the longer term. For example, various forms of school attendance problems have been associated with poor health outcomes, marital and psychiatric problems, non-violent crime and substance use, and occupational problems and economic deprivation later in life.[62]

Impact of school absences on academic performance

A report commissioned by the Australian Government Department of Education, Employment and Workplace Relations (DEEWR) in 2012 examined the relationship between school attendance and students’ academic performance. The study used data collected about students in government schools in Western Australia, including attendance records and results from the National Assessment Program—Literacy and Numeracy (NAPLAN). It found:

average academic achievement on NAPLAN tests declined with any absence from school and continued to decline as absence rates increased. The nature of the relationship between absence from school and achievement, across all sub-groups of students strongly suggests that every day of attendance in school contributes towards a child’s learning, and that academic outcomes are enhanced by maximising attendance in school. There is no “safe” threshold.[63]

The report noted that the effects of absences accumulate over time.

The study found that unauthorised absences (absences that are unexplained or where the reason is not deemed acceptable by the school principal) had a significantly stronger association with achievement than authorised absences (absences for which a legitimate reason for the absence is given, such as illness), with even small amounts of unauthorised absence associated with substantial falls in average NAPLAN test scores. The authors suggested that unauthorised absences could reflect possible behavioural and school engagement issues, rather than just time away from school.[64]

The report observed some students were more adversely affected by absences than others, with gaps in achievement evident for students depending on where they live, their socio-economic status, and Indigenous status at all levels of attendance.[65] More advantaged students had relatively high levels of achievement irrespective of their levels of school attendance.[66]

Impact of school refusal on the classroom

The negative impacts of school absenteeism and school refusal are predominantly discussed in terms of impacts on the child or young person themselves. However, school refusal and chronic absenteeism can have spillover effects on other students’ academic achievement and can negatively affect teachers and school staff. This section discusses secondary impacts of school refusal and chronic absenteeism.

Chronic absenteeism not only affects the student who misses school but can potentially reduce outcomes for classmates. A study of student results from an urban elementary school in the US examined the spillover effects of chronic absenteeism on classmates’ achievement.[67] The author hypothesised that extreme rates of absenteeism could slow the regular pace of classroom instruction as highly absent students would require significant remediation efforts and classroom management efforts from teachers when returning to class. The study found evidence that having a greater proportion of chronically absent classmates was associated with lower achievement across reading and mathematics.

School refusal can cause stress for teachers and school staff and can have a negative impact on relationships between teachers and students and families. Teachers and principals interviewed as part of a qualitative study from Ireland reported feeling responsible for assisting students who had been absent to catch up, which took time away from other students in the class.[68] Teachers felt stress and frustration at the disruption to class dynamics of students returning and pressure to see students complete project components or examinations.

Cases of school refusal may also require school staff to liaise with a diverse array of support services, such as child protection and family support services, social work and psychological services.[69] This can be a source of stress as participants negotiate what the role and duty of schools should be, and what should be the responsibility of other services and providers.[70]

Addressing school refusal and absenteeism

Given the complex nature of school refusal, approaches aimed at assisting children and young people to return to school need to be multilayered and flexible.[71] Identifying the factors contributing to a student’s school refusal is important for determining the resources that might be employed to address the problem.

The resources that are available to a child or young person to address school refusal may not be equally accessible. Although school refusal cuts across social class divides, families with ‘greater social, cultural, financial capital tend to have the necessary resources to manage the situation and ensure a positive outcome’.[72] Families from higher socio-economic backgrounds may have more choice in accessing assessment services and therapeutic supports.[73]

Federalism may also pose complications for developing national approaches to school refusal in Australia. States and territories have overarching responsibility for schools in their jurisdictions. While the Australian Government plays a role in providing funding for schools and participating in national policy decisions with states and territories, it does not own or manage any schools.[74]

This section discusses multitiered approaches to addressing school attendance and briefly considers the (in)effectiveness of punitive approaches.

Multitiered approach to absenteeism

Many resources on addressing school refusal and student absenteeism advocate for a multitiered approach.[75] Christopher Kearney’s 2016 book, Managing School Absenteeism at Multiple Tiers: An Evidence-Based and Practical Guide for Professionals, outlines strategies for addressing problematic absenteeism organised into 3 tiers (see Figure 6 below). The tiers represent increasing severity of absenteeism and intervention:

  • Tier 1: universal prevention—approaches focus on functioning and school-wide attendance and on preventing absenteeism for all students
  • Tier 2: targeted early intervention—approaches focus on addressing students with emerging, acute, or mild to moderate school absenteeism
  • Tier 3: intensive later intervention—approaches focus on addressing students with chronic and severe school absenteeism.
Figure 6    A multitier model for problematic school absenteeism

A multitier model for problematic school absenteeism

Source: Christopher Kearney, Managing School Absenteeism at Multiple Tiers: An Evidence-Based and Practical Guide for Professionals, (New York: Oxford University Press, 2016), 16.

 

Implementing strategies to improve attendance requires adequate resourcing and system supports (see Figure 7).

Figure 7    Enablers for implementing strategies to improve attendance and establish a positive attendance culture in schools

Enablers for implementing strategies to improve attendance and establish a positive attendance culture in schools

Source: CESE, Understanding Attendance, 36.

Recent media articles on school refusal have reported the challenges schools face in managing students refusing school, including shortages of specialist knowledge, allied health, and psychological and counselling services.[76] For example, media articles have reported shortages of school counsellors and psychologists in schools, such as an October 2022 report in The Guardian of a ‘dire shortage’ of school counsellors in NSW, with figures obtained showing that there was one counsellor for every 650 students across the state.[77]

The Australian Psychological Society’s framework for the provision of effective psychological services in schools recommends a ratio of one psychologist to 500 students, based on data from United Nations countries and best practice.[78] The 2021 Gallop inquiry, commissioned by the NSW Teachers Federation, recommended providing school counsellors:

on the basis of at least 1:500 students and a corresponding increase in senior psychologists [sic] education by 2023 to address the significant increase in student mental health issues[79]

Punitive approaches

Research does not indicate that punitive approaches to school attendance are effective in improving attendance as they do not address the root cause of attendance problems.[80] As school attendance is compulsory in Australia, not attending school can result in legal penalties for families, and/or the possible involvement of child protection services.[81] However, there is no evidence to suggest that fines or court orders improve attendance for individual students.[82]

At the family level, some have argued for parents to employ a stricter disciplinary approach to dealing with their child’s school refusal. For example, Victorian Shadow Minister for Education Matthew Bach stated in an opinion piece:

School refusal stems from anxiety, which – as we know – is a serious mental health condition. And because of this, parents naturally empathise deeply with their children. Yet what the growing number of children who refuse to attend school need most is tough love. Going to school must simply be non‑negotiable.[83]

However, authoritarian approaches can negatively impact children refusing to go to school.[84] Negative family processes, including intrusive and constraining parental control and harsh and corporal punishment, increase the likelihood of school absenteeism and dropout, while positive family processes, including parental support and monitoring, acceptance, clear boundaries and granting of autonomy decrease the likelihood of school absenteeism and dropout.[85] As such, interventions aimed at increasing positive family process, particularly in primary school, and decreasing negative family processes, particularly in secondary school, may be beneficial to address school absenteeism.[86]

Conclusion

COVID-19 caused massive social disruptions across the world. In Australia, governments and school systems responded to the unfolding pandemic by introducing measures such as school closures, pupil free days, remote learning, and relaxing attendance requirements.[87] In addition to the pandemic, many students across Australia have been impacted in the last few years by natural disasters, including bushfires and floods. These situations have created contexts rich in the risk factors identified as contributing to school refusal, such as stressful life events or big changes, school transitions, family illness or fear of harm coming to a parent, and friendship difficulties.

While there are increasing concerns about the rising incidence of school refusal, there are challenges in understanding the extent of the problem. Across Australia, the national attendance rate and attendance level have been trending downwards for a number of years, with a particularly noticeable decline in both measures in 2022. In 2022, less than half of students attended school for 90% or more of available school days in Semester 1. Put another way, more than half of students across Australia were chronically absent from school in 2022. The national data also show differences in attendance according to years of schooling, geography, indigeneity, and school sectors. There is also substantial variation across the states and territories in terms of attendance. While these figures do not provide insight into the reasons for school non-attendance, such as school refusal, they do point to wider problems of absenteeism.

Greater understanding of the reasons for student absenteeism may allow school communities to better address the needs of students who are refusing school, or who are otherwise disengaged or at risk of disengaging. At a broader level, research into the reasons for variation between the states and territories may also shed light on factors contributing to higher or lower school attendance. In February 2023, Education Ministers commissioned the Australian Education Research Organisation to investigate the causes of declining attendance and provide advice to Ministers on evidence-based approaches that support attendance.[88] It will also be vital to ensure that schools have the resources available to assist students’ return to the classroom, to support student wellbeing and mental health, and to ensure that there are avenues to enable students to continue to learn.