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When You Think Your Child Is Faking an Illness

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When Your Child Refuses to Go to School

It's Monday morning, time to get moving, but instead of getting ready for school your child is complaining about a stomachache, a headache, dizziness, or something similar. 

Is your child sick, or are they afraid to go to school? 

School avoidance syndrome is one of the most common causes of vague, unverifiable symptoms in school-age children. This syndrome may be triggered by stress. 

How does a parent distinguish between a real illness and anxiety? Ask yourself the following questions: 

Does the child have a fever? Was he or she vomiting? Did the child have diarrhea? What was their condition the night before?"  

If no physical factors are involved, and this has happened several times before, consult your child's doctor to rule out a medical problem.

It's also important to ask the child about what's happening at school.  The American Academy of Pediatrics (AAP) stresses that children may have a difficult time explaining what worries them. The AAP and American Academy of Family Physicians (AAFP) identify the following situations as school avoidance triggers:

  • Teasing by other children, such as being called "ugly" or "fat"

  • Fear of failure

  • Threats of physical harm from a school bully

  • Actual physical harm

  • Anxiety over using a public bathroom

  • Major changes at home, such as a divorce, death of a family member or pet, moving to a new home 

The AAP stresses that the first step in managing school avoidance is to have the child checked by a doctor so that actual physical problems are ruled out. Vision and hearing problems, for example, may cause high levels of school-related anxiety for a child. If no physical problems are found, the doctor can help you understand the child's anxiety and develop a plan to get the child back to school. 

Go, they must, but be understanding

Once physical problems are ruled out, take the time to talk and listen to your child. Be calm and sympathetic. List all of the possible reasons they might be feeling school-related anxiety and listen to your child's response. Watch for the nonverbal behavior. Insist your child go to school, but be understanding. The longer your child stays home, the more difficult it will be for them to go back to school. Your child may pressure you to stay home, but be firm. 

Emotional concerns

Explain to your child that they are in good health and their symptoms are most likely because of the concerns he or she has expressed to you. 

Get support

Enlist the help of the school staff, including the teacher, principal, and school nurse. If you make them aware of the situation, they can help encourage your child and ease their anxieties. Discuss your plan for having your child return to school and work with the school personnel to try and resolve the stressful situations your child identifies. 

A bully problem

If the problem is a bully or unreasonable teacher, talk to the teacher or principal. He or she may be able to make changes to lessen the pressure on your child. Be an advocate for your child. 

Stand your ground

Make a commitment to be firm on school mornings when your child complains, but also make certain the child isn't really ill. The lack of recognizable symptoms (see below) is one of your best ways to evaluate their complaints. 

Clubs and sports

Help your child develop independence by encouraging activities such as clubs or sports that include other children outside the home. The development of friendships and positive interests can be of great help in decreasing a child's anxieties and fears.

Recognizable Symptoms: When your child should be at home

There will be times your child is ill and must stay at home. Your child may need to see a doctor if they have vomiting, diarrhea, a temperature of 101 degrees or higher, a rash, earache, toothache, or a hacking cough. These problems have recognizable symptoms that should keep a child out of school. If your child is ill, be certain they are safe and comfortable, but don't make the sick day a holiday. If they are ill, the child should stay in bed with no special snacks or visitors. They should always be supervised.

If school avoidance lasts for more than one week, you should seek the help of your pediatrician and school personnel. If the combination of physical and emotional issues is limiting your child's ability to function, your pediatrician may suggest that you consult with a child psychologist for additional help and support.

School avoidance is difficult for both the child and the parent. However, quick, supportive action by the parent and the appropriate use of health and school professionals can make the issue manageable.