When School Anxiety Becomes Disabling

  • January 12, 2017

A Case Study of School Refusal of a Student in Special Education

By Cathy Brooks


“No!” yells Eric* as he rips his paper up and pushes everything off the desk. The room goes silent, and with all eyes on him, he storms over and begins to rip posters off the wall. Once again, a teacher’s assistant leads him to the “behavior lab”, a room close to the counselor’s office comprised of two empty rooms and no windows. Eric knows this room well. This has become a routine trip. Things have escalated to the point to where Eric rarely lasts longer than an hour in his classroom before making the trek to the place that has been designated by school officials as a refocusing tool. Unfortunately, the behavior lab has evolved into a place of daily isolation and discipline. Eric is only in the second grade.

On first inspection, many observers would determine this child is being purely disobedient. Surely he just needs some good old fashioned discipline. As the cafeteria worker at his school announced, “He’s just a brat!”

Inappropriate discipline and a lack of behavioral interventions can cause situations to spiral out of control resulting in removal from school and a denial of Free Appropriate Public Education (FAPE)

For Eric, diagnosed with attention deficit hyperactivity disorder (ADHD), second grade had become a place of failure and anxiety. Though highly intelligent, he struggled to complete written work.  His analytical skills were advanced beyond those of most students his age, but his ability to write lagged behind his peers. Embarrassed, frustrated and with a complete aversion to failure, Eric’s situation was spiraling out of control.  He was acting out in the classroom and the teacher had begun to rely on the behavior lab and removal from class instead of working with him. Eric’s parents met multiple times with school personnel to ask them to develop a better plan that would ensure that Eric received the supports he deserved. Every option that the parents suggested was refused by the principal, and the school system representatives supported the principal stating, “It’s her decision, because it’s her school.”

His parents were told, “You can pull him out anytime and homeschool him.” How often does this happen across our country? Unfortunately, parents report this sentiment from schools far too often. 

Luckily for Eric’s parents, someone in the school system explained homebound services to them and told them their child might qualify. Homebound services are educational services provided by the school in the student’s home. These services are provided to students who medically qualify and require documentation from a doctor. This is different than homeschooling where the parent provides ALL the education. Through homebound, a special education student with an Individual Education Plan (IEP), may still receive some IEP services from the school system. Although this was not a good permanent solution for Eric, his parents had been put into a situation where they felt they had no choice. His doctor felt his anxiety was significant enough at this point for him to qualify. The school staff had created an environment for this student that had increased his anxiety, resulting in behaviors of school refusal. 

What the school system forgot when they supported the principal over the student’s rights is that Federal law overrides local control.

The school system had allowed a principal to control the situation due to the system’s concern for allowing “local control.” This stance was made at the expense of following federal laws. Administrators at the system level should keep in mind that as the Local Education Agency (LEA), the system is always ultimately responsible. This is where Disability Rights Tennessee (DRT), the federally mandated Protection & Advocacy Agency for the state, stepped into the picture. Eric’s mother called DRT and her case was assigned to an education advocate.  

“We had gotten as far as we could get on our own and had still not gained any ground for our son,” said Eric’s mom. “To say we were angry and frustrated would truly be an understatement. We had already gotten to the point our son was pulled out of school. We thought we had no other options.”

Months of extensive negotiations with the school system through letter writing, phone conferences and IEP meetings resulted in the development of a step-by-step plan to reintegrate Eric back into school.  

Steps of Reintegration Plan in Eric’s Case:

  • The school system contracted with an outside Board Certified Behavioral Analyst (BCBA) to collect data for a Functional Behavioral Assessment (FBA) in order to determine the purpose of Eric’s behaviors and then to develop an appropriate Behavior Intervention Plan (BIP).
  • The BCBA helped to revise a BIP for the homebound services to improve instruction until Eric could be reintegrated into a school setting.
  • The school system provided improved reading instruction and curriculum as well as more advanced material for the homebound instruction.
  • The school system agreed to allow Eric to gain a fresh start at a new school. The BCBA recommended that the teacher be hand-picked.
  • Parents began taking Eric to a private psychologist.
  • The BCBA, and Eric and his parents made several visits during the spring to the new classroom to prepare Eric for this environment during the Fall.
  • The advocate and his parents devised a plan for the family to visit the new school campus for recreational purposes during the summer to allow him to play on the playground.
  • After observations during the spring classroom visits, the IEP (Individualized Education Program) team developed a plan to reintegrate Eric through a full-time special education classroom and to slowly introduce him to the larger setting of general education. The special education classroom will continue to act as a “homebase (his safety zone)” during the school year. A comprehensive Behavior Intervention Plan was developed.
  • A formal schedule for reintegration into the general education classroom was developed to ensure Eric works his way back into general education fulltime.
  • The school provided Assistive Technology to help Eric with his writing difficulties.

Changing schools is an extreme course of action and should not be the first choice, but when the relationship between school and home is totally broken and a child PERCEIVES that he has been traumatized, it should be considered.

Dr. Christopher A. Kearney, an expert in school refusal at the University of Nevada, offered advice to parents whose child is beginning to show signs of school refusal

“There are several things to keep in mind. Keeping the child in school as much as possible, even if for a short time, is preferable to missing entire days. Maintaining the morning routine before school, even if the child is not in school, is helpful for later treatment purposes as well. Working closely with school officials and getting a consultation from a psychologist are recommended also.”

DRT’s advocate, when researching this topic, noticed that the term school phobia was not being used as frequently as in the past. She posed the question to Dr. Kearney, “Is school phobia an outdated term or is it a term that focuses on the intensity level of the problem?”  

Dr. Kearney explained, “School phobia is a bit outdated but generally refers to fear-based absenteeism, or absenteeism due to a specific, irrational fear of something in or related to school. This is quite rare, however. School refusal means anxiety-based absenteeism, which is a broader term that encompasses apprehensiveness about many different social or performance or general school situations. School refusal behavior is an even broader term that refers to any child-motivated refusal to attend school, whether anxiety-based or not.” When working a reintegration plan due to school refusal, the team must understand there will be an ebb and flow of successes and setbacks. 

This is to be expected.  It’s unrealistic to believe you’ll walk a straight line to success. An interdisciplinary approach with multiple people who see things from different angles is helpful in developing the right plan. The advocate’s role is often to keep things on track and moving in the right direction. That’s just what DRT had to do when setbacks occurred. 

For example, the first school visit did not go well. Eric was not able to stay the whole time due to his anxiety, and he wanted to escape during the entire visit. The school had not followed the schedule they had provided to the parent who had prepped her child based on this information. This is where the importance of collaboration comes into play. The Advocate and BCBA brainstormed to develop a less stressful school visit for the next time. Even with these steps, the first day of school proved to be rough. Eric didn’t want to go into the building. He told his mom, “There are monsters there.” She was able to explain to Eric that there are not monsters at the new school and provided him with the safety net he needed to enter the doors.  

Even with a good plan in place and a change to a more welcoming school, there were still three incidents during that first week. Eric tested the waters with his old behaviors when he was directed to complete writing assignments. The principal actually suspended him and it looked as if the problems might escalate into the same patterns the team had tried so hard to break. Once again the advocate worked with the school system, educating them on the fact that removing the student from school would only further reinforce his school refusal behaviors. After this meeting, the plan was revised and new suggestions were implemented. Within days Eric was finally experiencing success.

Reintegration is a Process 

In Eric’s case, the plan experienced hiccups, but with continued communication and perseverance, the plan and Eric were able to move forward. “Our son may have the occasional hiccup, but now enjoys going to his new school where he has teachers that are open to his needs to succeed,” said Eric’s mom. “Now we feel like we have our son back, we see him shining thru again.”

Eric is thriving in his new environment and has been given the role of computer assistant in his new classroom. He was even able to attend a field trip with his classmates. 

With the right plan, success is possible!

*Student’s name has been changed to protect his identity.

Disability Rights Tennessee (DRT) is a nonprofit legal services organization that provides free legal advocacy services to protect the rights of Tennesseans with disabilities.

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