Start by asking: “What is making school difficult?

When a child or teenager is struggling to attend school, it can be tempting to focus on the attendance itself.

But school attendance difficulties can have many contributing factors, and anxiety is only one possibility.

A young person may be finding school difficult because of:

• Anxiety or feeling overwhelmed
• Learning difficulties or academic demands
• Sensory overload
• Bullying, exclusion or friendship difficulties
• Communication differences
• Autism, ADHD or other neurodivergent needs
• Emotional regulation difficulties
• Changes at home or family circumstances
• Physical health or fatigue
• The school environment
• Transitions, unpredictability or changes in routine
• Difficulty eating or drinking adequately during the school day
• Insufficient sleep or difficulty recovering between school days

It can also be helpful to look beyond the school gate.
Is the young person eating and drinking adequately at school?
Are they getting enough sleep?
How much energy are they using to manage the school day?
Do they have enough time to decompress, play, unwind and recover before doing it all again the next day?

Rather than beginning with:
“How do we get them back to school?”
start by asking:
“What is making school difficult for this child?”

Understanding the underlying barriers can help families, schools and professionals identify supports that are better matched to the young person's individual needs and circumstances.

Not every school attendance difficulty has the same cause, and not every child needs the same solution.

Is Your Child Getting Enough Recovery Across the School Week?

When a child or teenager is finding school increasingly difficult, it can help to look beyond what happens at the school gate.

A school day can involve significant learning, social, sensory, communication, emotional and organisational demands. Eating and drinking adequately, getting sufficient sleep and having opportunities to decompress and recover can all influence how much capacity a young person has available to manage those demands.

It can be helpful for families to consider what is happening across the child's whole school day and the time between school days.

Are They Eating Enough During the School Day?
​
Some children and teenagers eat very little at school, even when food is packed for them.

There can be many reasons for this, including:

• Reduced appetite when anxious or overwhelmed
• Sensory preferences or sensitivities around food
• Busy, noisy or uncomfortable eating environments
• Social concerns about eating around other people
• Not having enough time to eat
• Difficulty opening packaging or managing lunch independently
• Medication-related appetite changes
• Becoming distracted during break times
• Preferring to use breaks for other activities

​Rather than assuming a child has eaten because their lunchbox went to school, it can be useful to understand whether they are actually eating during the school day and whether something about the school environment is making eating difficult.

Persistent concerns about eating, appetite, nutrition or growth should be discussed with an appropriate health professional.

Are They Drinking Enough During the Day?
Some children and teenagers may also drink very little while at school.
They may:

• Forget to drink
• Become absorbed in activities
• Dislike the available water
• Find accessing their drink bottle difficult
• Avoid using school toilets
• Have difficulty recognising or responding to thirst

It can be useful to consider whether the young person has easy and acceptable access to fluids throughout the school day and whether there are barriers making drinking more difficult.

Are They Getting Enough Sleep?

Sleep provides an important opportunity for children and teenagers to recover from the demands of their day.

When a young person isn't getting sufficient or restorative sleep, they may have less capacity available for:

• Learning and concentration
• Emotional regulation
• Social interaction
• Managing frustration
• Sensory demands
• Transitions
• Problem-solving
• Managing everyday school expectations

It can therefore be useful to consider not only what time the child goes to bed, but how well they are sleeping, whether they appear rested and whether they are getting enough opportunity to recover before the next school day.

Persistent sleep difficulties, significant daytime sleepiness, snoring or other concerns about sleep should be discussed with a GP or appropriate health professional.

Do They Have Time to Decompress After School?
Children and teenagers can have very full days.
​
After school there may be:
Homework → therapy → sport → appointments → chores → dinner → preparation for tomorrow

For some young people, particularly those using substantial energy to manage academic, social, sensory, communication or emotional demands throughout the school day, having lower-demand time after school can be important.

This doesn't need to look the same for every child.
It might involve:

• Outdoor or imaginative play
• Drawing, craft or building
• Physical activity
• Spending time with pets
• Listening to music
• Reading
• Quiet time
• Connecting with family
• Engaging in a favourite hobby or interest
• Simply having some time without another scheduled activity

What About Devices and Downtime?
After a busy school day, children and teenagers may need time to decompress, recover and transition out of the demands of school.

Devices, gaming and online activities can be enjoyable and relaxing for some young people. However, it can also be helpful to create regular opportunities for device-free, lower-demand and unstructured time.

Depending on the child, this might include:

• Outdoor or imaginative play
• Drawing, craft or building
• Physical activity
• Spending time with pets
• Listening to music
• Quiet time
• Connecting with family
• Engaging in a favourite hobby or interest
• Simply having time without another scheduled activity

Unstructured downtime can give children space to slow down after a demanding day rather than moving immediately from:
School → devices → homework → activities → bedtime

The goal isn't necessarily to remove devices altogether. Instead, consider the overall balance:
“Does our child have enough time and space in their day to play, unwind and recover in ways that work for them?”

Look at the Whole Day, Not Just School Attendance

When school attendance becomes difficult, it can be tempting to focus primarily on getting the child through the school gate.

But attendance is only one part of the picture.
Consider:
What is the school day asking of this child?
Are they eating and drinking adequately while they're there?
How much energy are they using to manage learning, sensory, social and communication demands?
Are they getting enough sleep?
Do they have opportunities to decompress and recover before doing it all again the next day?

Looking at the young person's whole day and overall capacity can help families, schools and professionals better understand what may be contributing to school attendance difficulties and what changes or supports may be helpful.

What Is School Anxiety?

School anxiety is a broad term used to describe anxiety or significant worry connected with school or aspects of the school experience.
A child may be anxious about:

• Entering the classroom
• Separating from a parent or caregiver
• Speaking in front of the class
• Making mistakes
• Tests or assignments
• Being judged
• Friendship difficulties
• Bullying
• Particular teachers or classmates
• Toileting at school
• Lunchtime or recess
• Sport
• Changing classrooms
• Unstructured activities
• Getting into trouble
• Not understanding schoolwork
• Sensory experiences
• Travelling to school
• Something happening to a parent while they are away

Some children can explain exactly what worries them.

Others may simply say:
“I don't want to go.”

That doesn't necessarily mean there isn't an underlying reason.

---

What Is School Avoidance?

School avoidance describes a pattern in which a child or teenager increasingly avoids attending school or particular parts of the school day.
It might begin with:

• Occasional absences
• Requests to stay home
• Late arrivals
• Leaving early

and gradually progress to:

• Missing particular classes
• Missing certain days
• Attending only part of the day
• Remaining in the car at drop-off
• Significant distress when school is discussed
• Extended periods away from school

The term describes what is happening.

It doesn't tell us why it is happening.

That distinction is important.

---

School Refusal, School Avoidance or School Attendance Difficulty?

Families may encounter several different terms when looking for information, including:

• School refusal
• School avoidance
• School anxiety
• School attendance difficulties
• School attendance problems
• Emotionally based school avoidance

You may also hear other terminology used by schools or professionals.

At Belong Health, we generally prefer language that encourages curiosity about the barriers to attendance rather than implying that a child is simply choosing not to cooperate.

For that reason, terms such as school attendance difficulty or difficulty attending school can sometimes be more useful.

The language should not distract from the most important question:
What is making school difficult for this particular child?

Signs Your Child May Be Finding School Difficult

School attendance difficulties don't always begin with complete refusal to attend.
Early signs may include:

• Increasing complaints about school
• Difficulty getting out of bed on school mornings
• Taking much longer to get ready
• Frequent lateness
• Asking repeatedly whether they can stay home
• Becoming distressed during the trip to school
• Difficulty separating at drop-off
• Crying before school
• Refusing to get out of the car
• Frequent physical complaints
• Regular requests to go home
• Avoiding particular classes
• Increased irritability after school
• Significant exhaustion after school
• Emotional escalations at home
• Increased anxiety on Sunday evenings
• Sleep difficulties before school days
• Reduced attendance over time

Recognising changes early can provide an opportunity to investigate what has changed before the pattern becomes more established.

---

Physical Symptoms Before School

Children and teenagers experiencing distress about school may report physical symptoms such as:

• Stomach aches
• Headaches
• Nausea
• Feeling shaky
• Racing heart
• Dizziness
• Feeling hot
• Tiredness
• Muscle tension
• Needing the toilet frequently
• Difficulty eating breakfast

These symptoms should not automatically be dismissed as “just anxiety”.

Physical symptoms can have medical causes.

If symptoms are persistent, significant, new or unexplained, speak with your child's GP or another appropriate health professional.

---

Why Might a Child Avoid School?

There is rarely one universal explanation.

For some children, anxiety is the main barrier.

For others, anxiety develops because another aspect of school is genuinely difficult.

Several factors may also occur together.

---

Anxiety & Worry

A child may worry about:

• Being separated from caregivers
• Making mistakes
• Being embarrassed
• Being judged
• Tests
• Presentations
• Social situations
• Getting into trouble
• Something bad happening
• Uncertainty or unexpected changes

Avoiding school may reduce anxiety temporarily.

However, where anxiety is the primary barrier, repeated avoidance can sometimes make returning feel increasingly difficult.
Explore Anxiety Counselling & Support

---

Learning Difficulties

Consider what school might feel like if reading, writing, spelling or mathematics consistently required much more effort than it appeared to require for classmates.

A child may say:
“School is boring.”
“I hate maths.”
“I'm not going.”

But underneath that response might be:
“I don't understand what we're doing.”
“Everyone finishes before me.”
“I'm embarrassed to ask for help.”
“I feel stupid.”

​Possible areas of difficulty can include:

• Reading
• Spelling
• Written expression
• Mathematics
• Working memory
• Processing information
• Attention
• Language
• Organisation

Where persistent learning difficulties are suspected, further assessment may help identify the child's strengths and areas requiring support.
Explore Psychology Assessments

---

Autism & School Attendance Difficulties

Autistic children and teenagers may experience school differently from their peers.
Potential barriers can include:

• Sensory overload
• Unpredictability
• Changes to routine
• Social demands
• Communication demands
• Unstructured periods
• Classroom noise
• Crowded environments
• Transitions between activities
• Difficulty understanding expectations
• Masking
• Bullying
• Feeling misunderstood
• Exhaustion from navigating the school day

It is important not to assume that an autistic child struggling with school simply needs greater tolerance of the environment.

Sometimes the environment itself needs to change.
Support may involve understanding the child's:

• Sensory needs
• Communication preferences
• Predictability needs
• Regulation
• learning profile
• Social experiences
• Strengths
• Interests
• Environmental barriers

Explore Autism Support & Resources

---

ADHD & School Difficulties

Children and teenagers with ADHD may experience difficulties involving:

• Sustained attention
• Starting tasks
• Organisation
• Working memory
• Time management
• Following multi-step instructions
• Managing belongings
• Completing work
• Sitting through lengthy activities
• Emotional regulation
• Transitions

A child may repeatedly receive feedback such as:
“Pay attention.”
“You forgot again.”
“Stop talking.”
“You need to try harder.”

Over time, school can become associated with frustration, criticism or feeling unsuccessful.

Understanding the child's executive functioning needs can be more useful than assuming a lack of motivation.
Explore ADHD Support & Resources

---

Sensory Overload at School

Schools are complex sensory environments.
A school day may involve:

• Bells
• Chairs scraping
• Multiple conversations
• Bright lighting
• Crowded corridors
• Assemblies
• Busy playgrounds
• Strong smells
• Physical proximity to others
• Uniforms
• Heat
• Toilets
• Sudden noises

For some children, these experiences can be uncomfortable or overwhelming.
A child may not say:
“The sensory environment is overwhelming.”

They may say:
“I hate school.”

Where sensory processing or functional participation appears to be contributing, Paediatric Occupational Therapy may be worth exploring.

---

Bullying, Friendship & Social Difficulties

Sometimes the reason a child doesn't want to attend school is straight forward:
​
Something difficult is happening there.
This might involve:

• Bullying
• Exclusion
• Friendship breakdown
• Conflict
• Teasing
• Feeling isolated
• Difficulty joining groups
• Fear of particular students
• Social misunderstandings
• Online conflict affecting school relationships

A child may be reluctant to disclose bullying because they:

• Feel embarrassed
• Fear retaliation
• Don't want adults involved
• Believe nothing will change
• Worry they will be blamed
• Don't know how to explain what is happening

Counselling can support the child's emotional wellbeing, but counselling should not replace appropriate action by adults when bullying or an unsafe environment is contributing.

Friendship, Bullying & Social Difficulties

Friendship conflict, exclusion, bullying and feeling socially unsafe can make attending school increasingly difficult for some children and teenagers. Understanding what is happening socially can be an important part of identifying what is making school difficult.

Learn more: Friendship, Bullying & Social Difficulties in Children & Teenagers

---

Communication Difficulties

Communication demands occur throughout the school day.
Children need to:

• Understand instructions
• Express ideas
• Ask for help
• Follow conversations
• Interpret social information
• Participate in groups
• Understand classroom language
• Navigate misunderstandings

Communication difficulties can sometimes look like:

• Withdrawal
• Avoidance
• Behavioural responses
• Not following instructions
• Social difficulties
• Reduced participation

Where speech, language, communication or social communication is contributing, Speech Pathology may be relevant.

---

Emotional Regulation & School

Some children manage throughout the school day and then become highly distressed once they get home.
Parents may see:

• Crying
• Anger
• Withdrawal
• Irritability
• Exhaustion
• Emotional escalations
• A strong need to be alone
• Difficulty tolerating ordinary demands

This doesn't necessarily mean the child was coping comfortably at school.

They may have been using substantial effort to manage throughout the day.

Rather than focusing only on the behaviour that occurs afterwards, consider:
“What demands has this child been managing all day?”

​Explore Emotional Regulation & Dysregulation

---

Stress, Overwhelm & Academic Pressure

Older children and teenagers may experience increasing pressure relating to:

• Homework
• Assignments
• Tests
• Exams
• Grades
• Subject choices
• University pathways
• Expectations
• Balancing school and work
• Extracurricular commitments
• Social relationships

​A teenager who feels overwhelmed may begin avoiding the environment associated with that pressure.

​Support may involve looking not only at coping strategies but also at whether the current demands are realistic and sustainable.
Explore Stress, Overwhelm & Burnout Support

---

Confidence, Self-Esteem & School

Repeated difficulties at school can affect how a child sees themselves.

​They may begin thinking:
“I'm stupid.”
“I'm bad at school.”
“Everyone else can do this except me.”
“Nobody likes me.”
“I always get things wrong.”
This is another reason why identifying the underlying barrier matters.

If a child has a learning difficulty, communication difference, executive functioning difficulty or sensory need, repeatedly framing the problem as effort or behaviour may reinforce an inaccurate and damaging view of themselves.
Explore Confidence, Self-Esteem & Identity Support

---

Family Changes & Adjustment

School attendance may also become more difficult during periods of significant change.
Examples can include:

• Moving house
• Changing schools
• Parental separation
• Family conflict
• Bereavement
• Illness within the family
• A new sibling
• Changes in caregiving arrangements
• Returning after an extended absence
• Transitioning between primary and secondary school

Sometimes school difficulty is one part of a broader adjustment response.

---

When Family Changes Affect School

Changes at home can sometimes affect sleep, routines, emotional wellbeing and school participation. If school attendance becomes more difficult after a significant family change, it can help to consider both what is happening at home and any barriers within the school environment.

Related resource: Family Changes & Adjustment in Children & Teenagers

---

Physical Health, Chronic Illness & Fatigue

Physical health should remain part of the picture.
School participation may be affected by:

• Chronic illness
• Pain
• Fatigue
• Sleep difficulties
• Medication effects
• Gastrointestinal symptoms
• Headaches
• Other health concerns

A child with genuine physical symptoms should not have those experiences dismissed simply because school anxiety is also being considered.

Medical concerns should be discussed with an appropriate health professional.

---

Is My Child Being Defiant?

This is an important question.

A child refusing to put on their uniform, leave the house or get out of the car can look oppositional from the outside.

But behaviour tells us what happened, not necessarily why it happened.

Consider the difference between:
“They won't go to school.”
and:
“Something is making it difficult for them to go to school.”

That change in perspective encourages investigation rather than immediate judgement.

It does not mean there should never be expectations or boundaries.
​
It means expectations work better when we understand the barriers the child is experiencing.

---

Should I Force My Child to Go to School?

There isn't one answer that is appropriate for every child.

School attendance is important, but simply increasing pressure without understanding the underlying barriers may not address the actual problem and can sometimes increase distress.
​
At the same time, avoiding school indefinitely may create additional academic, social and emotional difficulties.
The appropriate approach depends on factors such as:

• Why attendance is difficult
• How severe the distress is
• How long it has been occurring
• The child's age
• Physical and mental health
• Safety
• Learning needs
• Neurodevelopmental needs
• What support the school can provide
• What professional support is already involved

For significant or persistent attendance difficulties, families may benefit from working collaboratively with the school, GP and relevant health or allied health professionals.

What Parents Can Do

1. Become Curious Before Becoming Corrective
Instead of starting with:
“You have to go.”
try to understand:
“What part of school feels hardest at the moment?”
The child may not immediately know.
That is okay.

2. Look for Patterns
Consider:

• Is one day harder than another?
• Is one class consistently avoided?
• Are Mondays particularly difficult?
• Does distress increase around tests?
• Is lunchtime difficult?
• Did something change recently?
• Are mornings harder after poor sleep?
• Is attendance worse following particular social situations?

Patterns can provide clues.

3. Talk With the School
Ask what staff are observing.
Useful questions might include:

• Has anything changed?
• How does my child appear during class?
• Are there particular subjects they avoid?
• What happens during recess and lunch?
• Have friendship dynamics changed?
• Are there learning concerns?
• Are there sensory or environmental triggers?
• Does my child ask to leave class?
• Are they participating?
• Do they appear distressed or unusually quiet?

Parents and schools may see very different parts of the picture.
Both perspectives matter.

4. Take Your Child's Experience Seriously
Taking a child's concerns seriously doesn't mean automatically agreeing with every conclusion they reach.
It means communicating:
“I believe that this feels difficult for you, and I want to understand why.”
That can be very different from:
“There's nothing wrong with school.”

5. Break the Problem Into Smaller Parts
“School” is enormous.
Instead ask:
Which part of school?
The difficulty might be:

• Getting ready
• Leaving home
• Travelling
• Entering the gate
• Entering the classroom
• A particular lesson
• Lunchtime
• Sport
• Social interaction
• Academic work
• Toileting
• Assemblies
• Going home

The more precisely the barrier can be identified, the more targeted support can become.

6. Consider the Environment
Don't focus only on changing the child.
Ask whether the environment could also change.
Possible adjustments might involve:

• Predictable routines
• Clear instructions
• A quieter workspace
• Sensory accommodations
• Alternative transition arrangements
• Access to a safe or quiet space
• Support during unstructured times
• Learning adjustments
• Communication supports

Appropriate adjustments should be individualised and discussed with the school and relevant professionals.

7. Seek Support Early
You don't necessarily need to wait until a child has stopped attending completely.
Consider seeking support when:

• Distress is increasing
• Attendance is declining
• Physical symptoms are frequent
• Family conflict around school is escalating
• The child appears exhausted
• Anxiety is interfering with daily life
• Bullying is suspected
• Learning difficulties are suspected
• The child is becoming increasingly withdrawn
• The situation isn't improving

---

Returning to School After an Extended Absence

For some children, returning after a significant absence can itself become difficult.
The return may need to consider:

• What caused the absence
• What has changed
• Current anxiety or distress
• Learning demands
• Peer relationships
• Sensory needs
• The child's confidence
• Appropriate school adjustments
• Communication between family and school

Depending on the individual situation, a collaborative and gradual approach may sometimes be appropriate.

The goal should be sustainable participation, rather than simply achieving one successful day of attendance.

---

How Can Counselling Help With School Anxiety?

Counselling may be helpful when emotional factors are contributing to school difficulties.
Depending on the child or teenager, counselling may involve:

• Understanding worries
• Identifying triggers
• Exploring thoughts and beliefs
• Developing emotional awareness
• Building coping strategies
• Supporting confidence
• Exploring friendships
• Processing bullying or difficult experiences
• Supporting adjustment
• Developing self-advocacy
• Exploring perfectionism
• Supporting communication about needs
• Developing problem-solving strategies

Counselling should be adapted to the child's age, communication preferences, developmental needs and goals.

---

CBT-Informed Support for School Anxiety

Cognitive Behavioural Therapy-informed strategies may be used where appropriate to explore relationships between:
situations → thoughts → emotions → behaviour

For example:
Situation: Giving a presentation at school tomorrow.
Thought: “Everyone will laugh at me.”
Emotion: Anxiety.
Behaviour: Trying to stay home.

Support might involve exploring the thought, understanding the fear and developing strategies for approaching the situation.

However, not every difficult school experience is based on an inaccurate thought.

If the child is genuinely being bullied, doesn't understand the schoolwork or is experiencing sensory overload, those barriers also need to be addressed.

This distinction is important.

---

Neurodiversity-Affirming Support

For neurodivergent children and teenagers, support shouldn't focus on making them appear more neurotypical simply so they can tolerate an environment that isn't meeting their needs.

A neurodiversity-affirming approach may consider:

• Sensory needs
• Communication preferences
• Executive functioning
• Predictability
• Autonomy
• Regulation
• Interests and strengths
• Social experiences
• Masking
• Environmental demands
• Appropriate accommodations

The question isn't simply:
“How do we make this child cope with school?”

It may also be:
“What does this child need to participate more safely and sustainably?”

---

When Might Occupational Therapy Help?

Occupational Therapy may be relevant where school participation difficulties involve:

• Sensory processing
• Emotional regulation
• Executive functioning
• Organisation
• Motor skills
• Handwriting
• Daily routines
• Functional participation
• Environmental demands

​An Occupational Therapist may help identify functional barriers and strategies or adjustments that support participation.
Explore Paediatric Occupational Therapy

---

When Might Speech Pathology Help?

Speech Pathology may be relevant when school difficulties involve:

• Understanding language
• Expressing thoughts
• Following instructions
• Social communication
• Conversation
• Communication breakdowns
• Speech or language difficulties

Communication demands can contribute significantly to school participation and social experiences.
Explore Speech Pathology for Children

---

When Might a Psychology Assessment Help?

A Psychology Assessment may be worth considering when school difficulties occur alongside questions about:

• Autism
• ADHD
• Learning difficulties
• Intellectual functioning
• Cognitive functioning

Assessment and counselling serve different purposes.

An assessment may help investigate why particular aspects of school are difficult, while counselling may support emotional wellbeing, adjustment and coping where appropriate.

---

When Should I Speak With My Child's GP?

Consider speaking with your child's GP when:

• Anxiety or distress is significant
• Attendance is substantially affected
• Physical symptoms are frequent
• Sleep or appetite has changed
• Low mood is persistent
• Your child appears increasingly withdrawn
• There are significant mental health concerns
• You are unsure whether symptoms have a physical or psychological cause

Your GP can assess your child's overall health and advise whether additional support or referral may be appropriate.

---

Working With Your Child's School

School attendance difficulties are often best approached collaboratively.
Depending on the circumstances, this may involve:

• Parents or caregivers
• The child or teenager
• Teachers
• School leadership
• Student services
• School psychologists
• GPs
• Counsellors
• Occupational Therapists
• Speech Pathologists
• Psychologists
• Other relevant professionals

The exact team will depend on the child's needs.

Where possible, everyone should work toward a shared understanding of:
What are the barriers, and what might make participation more manageable?

---

School Anxiety Counselling for Children & Teenagers

Belong Health provides counselling for children aged 7+ and teenagers.
Support may be appropriate where school difficulties involve concerns such as:

• Anxiety
• Stress
• Feeling overwhelmed
• Emotional regulation
• Friendship difficulties
• Bullying
• Adjustment
• Confidence
• Self-esteem
• Life changes

Counselling is not a substitute for appropriate educational, medical or safeguarding responses where those are required.
Explore Child & Teen Counselling

---

Counselling in Falcon & Mandurah

In-clinic counselling is currently available at:

Belong Health
13 Littleton Street
Falcon WA 6211

Our Falcon clinic provides a local counselling option for children aged 7+ and teenagers from Mandurah, Falcon and surrounding Peel areas.
Enquire With Belong Health

---

Telehealth Counselling Across Perth & Western Australia

Where clinically appropriate, counselling may also be available via telehealth across Perth and Western Australia.
Telehealth may be useful for some families who:

• Live elsewhere in Perth
• Live regionally or remotely
• Have difficulty travelling
• Need greater flexibility
• Prefer accessing support from home

Telehealth suitability is considered individually, particularly for children and teenagers.
Explore Telehealth Counselling

---

Free 20-Minute Meet & Greet

Where available, Belong Health offers a free 20-minute Meet & Greet with a Counsellor.
This provides an opportunity for families to:

• Meet the Counsellor
• Briefly discuss the concerns
• Ask questions
• Learn about the Counsellor's approach
• Discuss whether counselling may be suitable
• Decide whether the Counsellor feels like an appropriate fit

There is no obligation to continue after the Meet & Greet.
Book a Free Meet & Greet

---

Related Support & Resources

You may also find these Belong Health pages helpful:
Child & Teen Counselling
Anxiety Counselling & Support
Stress, Feeling Overwhelmed & Burnout Support
Confidence, Self-Esteem & Identity Support
Emotional Regulation & Dysregulation
Autism Support & Resources
ADHD Support & Resources
Paediatric Occupational Therapy
Speech Pathology for Children
Psychology Assessments
Explore the Belong Health Resource Hub

Frequently Asked Questions About School Anxiety & School Attendance Difficulties

What is school anxiety?
School anxiety describes significant anxiety or worry associated with school or aspects of the school experience. A child might worry about separation, schoolwork, mistakes, friendships, bullying, social situations, sensory experiences or other parts of the school day.

What is school avoidance?
School avoidance describes a pattern in which a child or teenager increasingly avoids attending school or particular aspects of school. The term describes what is happening but doesn't explain why it is happening.

Is school avoidance always caused by anxiety?
No. Anxiety can contribute, but school attendance difficulties may also involve learning difficulties, sensory overload, bullying, communication differences, neurodivergent needs, physical health, family circumstances, academic pressure or environmental factors.

Is school refusal the same as school avoidance?
The terms are sometimes used to describe similar attendance difficulties. Language varies between families, schools and professionals. Belong Health generally prefers language that encourages understanding the barriers to attendance rather than implying that the child is simply refusing to cooperate.

What are signs that my child is struggling with school attendance?
Signs may include frequent requests to stay home, difficulty getting ready, late arrivals, distress at drop-off, physical complaints, avoiding particular classes, frequent requests to leave school, Sunday-night anxiety or gradually declining attendance.

Why does my child complain of stomach aches before school?
Stress and anxiety can contribute to physical symptoms, but physical complaints shouldn't automatically be assumed to have a psychological cause. Persistent, significant or unexplained symptoms should be discussed with your child's GP.

Can Autism contribute to difficulty attending school?
Autistic children may experience barriers involving sensory environments, communication demands, unpredictability, social demands, transitions, masking, bullying or exhaustion. Support should consider both the child's needs and the environment.

Can ADHD affect school attendance?
ADHD may contribute to difficulties with attention, executive functioning, organisation, task initiation, working memory, emotional regulation and other school demands. Repeated negative experiences can make school increasingly difficult for some children.

Can sensory overload make a child avoid school?
Yes. Noise, crowds, lighting, smells, uniforms, busy classrooms and other sensory demands may be difficult for some children and can affect participation.

Can learning difficulties cause school avoidance?
Learning difficulties can contribute. A child who repeatedly struggles with reading, writing, spelling, mathematics or other academic tasks may become anxious, embarrassed, frustrated or reluctant to attend.

Can bullying cause school attendance difficulties?
Yes. Bullying, exclusion, friendship breakdown and other difficult social experiences can make school feel unsafe or distressing. Counselling may support emotional wellbeing, but the bullying or unsafe environment itself also needs to be addressed.

Why does my child fall apart after school?
Some children use substantial effort to manage school demands throughout the day and release that distress once they reach a safer or more familiar environment. It can be useful to consider the demands they have been managing rather than looking only at the behaviour occurring after school.

Is my child just being defiant?
Not necessarily. Refusing to attend school can look oppositional, but behaviour alone doesn't explain why attendance is difficult. Understanding the barriers is important before assuming the problem is defiance or motivation.

Should I force my child to attend school?
There isn't one approach suitable for every child. School attendance is important, but significant distress should be understood rather than addressed through pressure alone. Persistent attendance difficulties may require collaboration between the family, school and relevant health professionals.

What should I ask my child if they don't want to go to school?
Rather than only asking “Why won't you go?”, you might ask which part of the school day feels hardest, whether anything has changed, when they feel most uncomfortable and what might make school feel more manageable.

Should I talk to my child's school?
Yes. The school may have information about learning, friendships, classroom participation, attendance patterns or other factors that aren't visible at home. Sharing information can help develop a more complete understanding of the situation.

Can counselling help with school anxiety?
Counselling may help when emotional factors such as anxiety, stress, bullying experiences, adjustment, confidence or emotional regulation are contributing to school difficulties.

Does counselling fix school refusal?
Counselling can't guarantee school attendance and shouldn't be viewed as a way to simply make a child comply with attending school. Effective support depends on understanding and addressing the factors contributing to the difficulty.

When might Occupational Therapy help?
Occupational Therapy may be relevant where sensory processing, emotional regulation, executive functioning, motor skills, daily routines or other functional factors are affecting school participation.

When might Speech Pathology help?
Speech Pathology may be relevant where language, communication, social communication or difficulty understanding and expressing information is affecting school participation.

When might a Psychology Assessment help?
Psychology assessment may be worth considering when school difficulties occur alongside questions about Autism, ADHD, learning difficulties, intellectual functioning or cognitive functioning.

When should I speak with my child's GP?
Consider speaking with your child's GP if distress is significant, attendance is substantially affected, physical symptoms are frequent, sleep or appetite changes, low mood persists or you have concerns about your child's physical or mental health.

Does my child need a diagnosis to access counselling?
Not necessarily. A formal diagnosis isn't generally required for a child or teenager to access counselling for anxiety, stress, adjustment, confidence or other emotional wellbeing concerns.

​Can Not Eating Enough at School Affect a Child’s Capacity?
Yes. Eating adequately during the school day can be one factor influencing a young person’s energy and capacity to manage learning, social, sensory and emotional demands.
Some children and teenagers may eat very little at school because of:

• Anxiety or feeling overwhelmed
• Sensory preferences or sensitivities around food
• Busy or noisy eating environments
• Social concerns about eating around other people
• Limited time to eat
• Difficulty opening packaging or managing lunch independently
• Medication-related appetite changes
• Becoming distracted during break times

Rather than assuming a child has eaten because food was packed for them, it can be helpful to understand whether they are actually eating during the school day and whether something about the environment is making eating difficult.
Persistent concerns about eating, appetite, nutrition or growth should be discussed with an appropriate health professional.

Why Might My Child Not Drink Enough at School?
There can be many reasons a child or teenager drinks very little during the school day.
They may:

• Forget to drink
• Become absorbed in activities
• Dislike the available water
• Have difficulty accessing their drink bottle
• Avoid drinking because they don't want to use the school toilets
• Have difficulty recognising or responding to thirst

It can be useful to consider whether the young person has easy and acceptable access to fluids throughout the school day and whether there are practical, sensory or environmental barriers making drinking more difficult.

Can Poor Sleep Make School More Difficult?
Yes. Insufficient or disrupted sleep can leave a child or teenager with less capacity available to manage the demands of school.
Sleep can influence:

• Learning and concentration
• Attention
• Emotional regulation
• Social interaction
• Managing frustration
• Sensory demands
• Transitions
• Problem-solving
• Energy throughout the day

It can be helpful to consider not only what time a child goes to bed, but how well they are sleeping, whether they appear rested and whether they have enough opportunity to recover before the next school day.
Persistent sleep difficulties, significant daytime sleepiness, snoring or other concerns about sleep should be discussed with a GP or appropriate health professional.

Does My Child Need Downtime After School?
Some children and teenagers benefit from lower-demand time after school, particularly when they use substantial energy managing academic, social, sensory, communication or emotional demands throughout the day.
Downtime will look different for different young people. It might involve:

• Outdoor or imaginative play
• Drawing, craft or building
• Physical activity
• Spending time with pets
• Listening to music
• Reading
• Quiet time
• A favourite hobby or interest
• Connecting with family
• Simply having time without another scheduled activity

The aim isn't to prescribe a particular activity. It is to consider whether the young person has enough opportunity to decompress and recover between school days.

Should After-School Downtime Be Device-Free?
Not necessarily. Devices, gaming and online activities can be enjoyable and relaxing for some children and teenagers and may also provide opportunities for connection and shared interests.
However, it can be helpful to ensure that young people also have opportunities for device-free, lower-demand and unstructured time, such as play, movement, hobbies, quiet time or connecting with family.
Rather than focusing only on the amount of screen time, consider the overall balance:
“Does our child have enough time and space in their day to play, unwind and recover in ways that work for them?”
The goal isn't necessarily to remove devices. It is to make sure the child's week also contains opportunities for rest, play, connection and genuine recovery from the demands of school.


What age does Belong Health provide counselling from?
Belong Health currently provides counselling for children aged 7+ and teenagers, as well as adults and older adults, depending on individual needs and clinician suitability.

Where is counselling available?
In-clinic counselling is currently available from Belong Health's Falcon clinic near Mandurah. Telehealth may also be available across Perth and Western Australia where clinically appropriate.

Can we meet the Counsellor before starting?
Where available, Belong Health offers a free 20-minute Meet & Greet so families can briefly discuss their needs, ask questions and determine whether the Counsellor may be an appropriate fit.

How do we get started?
Contact Belong Health or complete our online enquiry form. Our admin team can discuss current availability and the next steps.
Enquire With Belong Health

---

​Last reviewed: August 2026
This page is reviewed periodically to reflect current evidence, clinical practice and relevant NDIS guidance.