Autism and school refusal

School can be a challenging environment for many children, but for those with autism, it can be incredibly overwhelming, putting them at greater risk of experiencing school refusal.

There can be many reasons why a child refuses school, and taking time to understand why your child is struggling and building a positive partnership with your child’s school can help them return to their education. 

Signs of school refusal in autistic children

Recognising the signs of school refusal in autistic children early is very important:

• Trouble sleeping, especially the night before school.
• Difficulties waking up and getting out of bed, particularly on school days. Some children may hide under covers, refuse to leave their bed or avoid their morning routine (e.g., get dressed). 
• Consistently pleads or begs parents/carers to be allowed to stay home.
• Frequent, vague complaints of illness such as headaches or stomachaches that suddenly improve if the child doesn’t go to school. 
• Heightened anxiety and more reliance on routines, rituals, or specific behaviours (such as lining up objects, spinning, or hand-flapping) to cope with the stress of school.
• More frequent meltdowns, aggressive behaviour or a general increase in emotional distress, especially in older children, particularly in times of transition like the start of a new school year or after the holidays.

Causes of school refusal

Autistic children often experience more challenges at school than their neurotypical peers, which can lead to school refusal. Whether refusing to enter the classroom, leaving the car to go to school or leaving the house in the morning, school refusal is a serious issue that requires support from a child’s family and school. 

Understanding the triggers for school refusal for autistic students is an important first step in addressing it:

Academic pressures

The general academic demands of school, including complex instructions, frequent transitions to different tasks, and the need for sustained attention, can be challenging for children who have different learning styles that aren’t accommodated. Autistic children may feel embarrassed if they are struggling academically or may not be encouraged to ask for support.

Social skills and friendships

Autistic children may struggle to develop social skills at the same pace as their neurotypical peers. They might struggle to initiate and maintain conversations, misinterpret social cues or jokes or respond inappropriately in social situations. This makes forming and keeping friendships challenging, which can cause isolation and loneliness at school. 

Sensory sensitivities

Schools are busy places filled with loud noises, bright lights, and crowds of people. Many autistic individuals experience sensory sensitivities, which can make school overwhelming. Without accommodations and support in place (e.g., noise-cancelling headphones to manage loud noises or a quiet location to take breaks), students can experience sensory overload or even meltdowns, which can cause them to avoid school out of fear and discomfort. 

Ability to adapt to change

Sudden changes to routines or unexpected transitions, such as casual teachers or deviating from a lesson plan, can be particularly stressful for autistic students who rely on predictability to feel comfortable. Unstructured parts of the school day, such as recess and lunchtime, can also be stressful for autistic students, as social interactions and break time activities are usually different every day. 

Relationship with authority

Autistic students may experience conflict with teachers and other authority figures, particularly if these school staff have a limited awareness of autism. Struggles with social skills, managing academic pressure and being unsupported in the classroom can all contribute to this.  

Cognitive challenges

Autistic students might find it challenging to process verbal and written information. This can affect their understanding of questions, instructions, and learning materials, making the curriculum inaccessible or more overwhelming than it is for their peers.

Many autistic students also struggle with executive functioning skills, such as organising and prioritising tasks. In high school, this can make reading a school timetable overwhelming and lead to difficulties completing assignments on time.

Bullying and social vulnerability

Unfortunately, the social difficulties faced by autistic students can make them targets for bullying. Whether through misunderstanding their interactions or being perceived as different, these children are at a greater risk of being bullied, which can cause mental ill-health, social isolation and reluctance to attend school.

Anxiety and perfectionism

A common trait among some autistic students is a strong desire for perfection in their work. This can lead to stress and anxiety if they feel they are falling short of their own high standards. Anxiety about being separated from family or the familiar routines of home can also affect autistic students.

Addressing school refusal in autistic children

Once you’ve defined what aspect/s of school your child finds challenging, you can begin considering actions to address the issues at hand. Speaking to your child about these challenges is key, but if they’re struggling to identify them on their own, parents/carers may need to determine them through observation and discussions with the child’s school. 

Tell your child that you will work together with their school or counsellor to address these issues. By encouraging collaboration between your child, the school and yourself, your child will feel reassured that they are being supported and that they are not alone. 

Addressing school refusal requires support across all areas of a child’s life:

At home 

Create a consistent daily routine that includes preparing school materials the night before and a calming bedtime routine to help reduce morning stress. Use positive and direct statements about school attendance (e.g., "When you go to school tomorrow..." instead of "If you go to school..."). 

Limit access to TV, video games, and other leisure activities during school hours to make your home less entertaining. However, it’s important to remember that some autistic children may not be deterred by a lack of entertainment options at home. 

Use role-play to help your child enhance their social skills. Encourage them to invite friends over or arrange playdates to strengthen their relationships with peers and reduce their social isolation, which can worsen anxiety and other mental health challenges.

At school 

A child’s school must be willing and proactive about addressing school for a child’s attendance to improve. Speak to your child’s school about the need for customised support that reflects their specific needs, such as sensory accommodations or assistance during transitions.

Suggest using your child’s interests to support their learning and participation. For example, if your child loves dinosaurs, incorporating them into a creative writing activity could increase engagement. Consider creating visual supports that your child can use to communicate their needs discreetly, such as needing to take a break from an activity. Depending on your child’s needs, ask about the availability of a quiet space that your child could use when overwhelmed. 

Ask if the school can accommodate early or late arrivals and departures to transition your child back to school or make trips to and from school less overwhelming from a sensory perspective.

If your child has been away from school for a prolonged period, discuss the possibility of a phased return to school. This might include starting with half-days or attending only their favourite classes.

Encourage the school to organise autism awareness training for all staff members. This training can create a more supportive and understanding environment school-wide and ensure all staff are equipped with the awareness and strategies they need to support autistic students. 

If your child shows signs of school refusal before a new school year or term, arrange for your child to visit the school a few days before the term starts. Familiarising them with the school environment, staff, and routines at their own pace can reduce anxiety. Establish a communication line with your child’s teachers and support staff right from the start; share your concerns and the specific challenges your child faces and ask what they will do to support you.

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School refusal and bullying

If your child is refusing to attend school because of bullying, set up a meeting with relevant school staff as soon as possible. Create a plan to support your child with reporting bullying when it happens and developing healthy friendships with other students.

Professional help for school refusal

Professional support could help you address the cause of your child’s school refusal. Ensure that there is active communication between your child’s therapists and school staff, particularly around a plan to return to school full-time. 

If your child complains of being sick to avoid school, consult with your GP to rule out any medical causes. If mental ill-health concerns like anxiety or depression are identified, consider referrals to specialists like psychiatrists or psychologists.

Legal considerations

It's important for parents to understand their legal responsibilities regarding their child’s education. Regular attendance is crucial, but if an autistic child is unable to attend school due to stress or other related conditions, steps should be taken to address this. Obtaining a medical certificate and communicating with the school and local education authorities can ensure that the child’s educational needs continue to be met while they aren’t attending school, possibly through alternative education arrangements if necessary.

For families experiencing legal issues around their child’s school attendance, there are a range of disability advocacy organisations that can help. 

Leaving the school

Sometimes, families may feel that their only option is to leave the school that their child is refusing to attend. Perhaps the school is not assisting the child in returning to school (e.g., refusing to make accommodations), or is not communicating adequately about the child’s progress with attendance goals. 

Moving to a new school is a significant change and can often increase the anxiety and behavioural issues an autistic student might be demonstrating. It’s not a decision to be made lightly, as your child might also refuse to attend their new school as well. Moving to another school should only be considered when your child’s school will not address the cause of their school refusal or make this issue worse.