ABSTRACT
School refusal is not a psychiatric diagnosis; rather it is a description of behaviour. School refusal can occur throughout the entire range of school years, but tends to peak at key transition times, that is, at ages 5–6 and 10–11 and 14. Several diagnostic studies have examined the prevalence of various psychiatric disorders among school refusers. Although theoretically any severe psychiatric disorder may be associated with school refusal, the commonest disorders encountered are separation anxiety and social phobia. School refusal is a prominent feature of the disorder in middle childhood. An alternative conceptualisation of school refusal is to approach it from a behavioural perspective and examine the motivation and function of the behaviour. The early detection of anxious school refusal is of utmost importance in order to achieve successful outcomes. The chances of return to school are inversely proportional to the length of period away from school.
