School Refusal 11 y.o.

[kyeager]

Well its been a long journey. My 11y.o. son has been very anxious about school everyday. It actually starts night before.. Following my last post i did put him on Zoloft 25mg daily. It doesn't start working for 2 weeks. The pediatrician gave us a few days off school to adjust. But of course when i tried to get him to school standing outside he decided to give a last fight not to go in. All of his anger came out and decided to hit the social worker. Again took him home for day. The next day he had in suspension school day. At this suspension he did not want to do anything he basically shut down. I was told to come get him again. The school said he needs to get outside help before he can go back. My question is.. has anyone been through something similar? Does it get better with help? Has anyone seen more aggressive feelings with Zoloft? Any recommendations?

[Redpanda5]

Yes I have been in your place. It reared its ugly head starting in middle school with my daughter (formal dx - adhd, social anxiety disorder).

Medication. It can take 4-6 weeks to begin working. As far as the aggression, it’s likely he’s just frustrated. The meds haven’t kicked in yet but note it to let the doctor know and keep an eye on if he’s getting depressed. Ask him if he’s having dark thoughts (can happen after just a few days). If he is, then call the doctor now, yes, before your next appointment so he/she can get your son on different meds. For us it took a year to find the right one. Patience is necessary. I also recommend seeing a child psychiatrist. They are most specialized.

In the meantime. If you are in a public school, ask your counselor about enrolling him in their Home Hospitalization Program so that he doesn’t get behind in school. Public schools have this and call it all different names depending on the district but it’s a temporary way for kids who can’t be in school for whatever reason (surgery, cancer treatments, mental health) to receive instruction either one on one with a teacher who comes to your home or through asynchronous videos.

Psychologist. Find a psychologist who specifically deals with school refusal. You may have to get on a waiting list and that’s okay. Strategies likely won’t help until the antidepressants kick in anyway.

Outlook. Medication and therapy may really help him. You won’t know until you try it. For us it worked for a couple of years but then Covid hit and it all came crashing down and my daughter never went back after 9th grade. It was just too much for her to come back from after being away for so long and then masks gave her panic attacks. Time was wasting and high school diplomas have to be earned in a certain window of time. I had to do something. She is homeschooled now and no longer feels traumatized. She is also an introvert so doesn’t miss all the school activities.

My best advice. Write down your plan of action, start the ball rolling, and fill in the wait time with a lot of patience and grace. Rome wasn’t built in a day.

[MaudQ in reply to Redpanda5]

Great advice - thanks! Looking up home hospitalization program right now 😊 Also, the world is so hard on our kids. Distance learning during the Covid lockdown was a nightmare for my child. And part of what triggered her current school refusal was a shooting near her school. I’m glad that it sounds like you’ve found a plan that’s working for your family.

[MaudQ]

Funny you should ask. My kid has anxiety and ADHD. She had several episodes of school refusal in the past and this week missed three days in a row. Her therapist recommended an intensive in patient program and we’re actually going in for the intake interview today. Both her therapist and psychiatrist told us that school refusal can snowball and the longer it goes on for, the harder it is to come back from. But … before this week, she had been going to school without school refusal for 3 or 4 years. What helped was medication, occupational therapy, regular therapy and a whole lot of therapy and parent coaching for me and my husband. Those things made an enormous difference and I think for a lot of kids it would have been enough. For your child, the aggression is likely a symptom of some other issue: frustration he’s not capable of articulating, anxiety, depression, or something similar. A good therapist and psychiatrist will be able to help you. It might take longer than 2 weeks for Zoloft to take effect. But the person who would really know is your psychiatrist. There’s a lot of tweaking of medication, dose, timing etc that goes in and a good psychiatrist will manage your kid’s medication and be in conversation with you. If you don’t have a provider like that yet, I would start looking for one now. You never know with insurance and waitlists how long it will take to get an appointment. Part of the process is putting your team together. Have you done a neuropsych evaluation yet? Your school district might pay for it. It’s really the best way to find out what your child’s profile actually is. It will help guide your psychiatrist, therapist and school - especially if you’re going to get a 504 or IEP. Also, I already said this I think, but the most important piece so far has been therapy and coaching for me and my husband. You have to take care of yourself and learn how to set boundaries. We’re in the middle of this too, so I get it. Hang in there!