14 year old refusing to go to school

[Juniper52]

Our 14 year old son is in eighth grade, diagnosed with ADHD since last spring, and has been fairly successfully helped by Vyvanse, Guanfacine, and citalopram. However, he has struggled all year with school attendance. So far he is up to 15 days of unexcused absences, most of which are because he simply refuses to go to school. He can’t seem to come up with a reason for why he desperately doesn’t want to go to school, we know that he has had some negative interactions with teachers and students, but that doesn’t seem to be the real reason. Today, after assuring us last night that he would go, he refused, claiming that he was sick, and that we shouldn’t send him to school with a sore throat, even though he has had a regular spring cold for the past week and a half and he seems perfectly fine. He now seems to be able to make himself throw up (probably because we used to say that the only reason we would let him stay home from school was if he was throwing up or had a fever), but we know he doesn’t have a stomach bug. We told him that if is chooses to stay home he will lose screens for the night, possibly even the entire week. It doesn’t stop him (but he will absolutely fight with us to get them back tonight)… Does anyone have experience with this and any good advice for us?

[Onthemove1971]

I am sorry that you guys are struggling with this.. it sounds as painful for him as it is you guys. Do you think a therapist could assist you guys? Any idea what he is doing on the tablet? I also wonder if the electronics were turned off and taken away if that would change things?

Could the school help at all?

Just some thoughts.

Big hug for all your struggles!!

[Redpanda5]

I feel your pain because I have been in your shoes. It sounds like classic anxiety disorder. It might be a good time to get him tested.

My daughter was diagnosed with generalized anxiety disorder and adhd just before sixth grade. The anxiety piece was then determined to be social anxiety disorder. School crippled her. I couldn’t get her to attend. She had an IEP that included a fast pass to the nurse if she felt uncomfortable but then it became hard to even get her go at all.

Her psychologist then had us take baby steps (exposure therapy). Meaning, the first day just tell her that we’d drive by the school but not get out (then we had to absolutely NOT do anything more than what we’d asked - EVER). The process progressed slowly from there. The second day do that again or just drive through the parking lot and nothing more. Day 3 get out of the car and go just into the lobby. Day 4 just go into the school office. Day 4 go to the nurses office. Day 5 attend first period. You get the idea. Obviously get the school on board with this ahead of time.

This did work for a while for my daughter but there were still days that she wouldn’t go once she was back to a full day or she would elope.

We ended up enrolling her in private online school this year (her senior year) because she could no longer ever attend.

She has also since been diagnosed with high functioning autism which may be why the exposure therapy failed for her. The online school is helping her get through school but I wish she had extracurricular activities but she’s also an introvert.

It’s hard. I would recommend looking to get him screened for anxiety and autism and then finding a psychologist well versed in the diagnosis’ you receive.

There are more parents dealing with this than is evident. Hang in there. Be strong for him.

P.S. The psychologist also had us take away electronics during school hours but give them back after school hours. The reasoning was that online friends may be the only friends these kids have and to not cut off their support. He’s not trying to be defiant with you. He needs help not punishment.

[NYCmom2 in reply to Redpanda5]

Agreed, anxiety was the underlying issue with our son as well. Medication, a strict bedtime schedule (medication helped with that as well), and predictable momentum in the morning got him back to school regularly.

Working with the school to have a staff member to meet him on tough mornings and check in on him helped. Also, having a respite during the day whether it be eating lunch in the library to relax and reset, or being allowed to go outdoors and take a walk, or having permission to drop into the guidance counselors office when he’s struggling. The “sick” or “I threw up, but don’t check the bathroom” episodes stopped.

wishing you patience and luck with this!

[BlueFalcon]

I can offer sympathy, but not solutions, because we are in the midst of a similar crisis with our 16 year old son (11th grade), who was diagnosed with inattentive-type ADHD in the middle of last acacademic year. Vyvanse seemed to help, so we were optimistic this year would be better, but it started unraveling in December (following a pattern similar to previous years). Trouble with two specific teachers and classes ballooned into refusal to go even on days when he has only classes and teachers he likes. He wanted to get back to normal, then couldn’t do it, which led to feeling like a failure and a downward spiral. About a week ago we decided he would not attend in person for the rest of the year, which was definitely the right decision because the severe “events” (panic attacks? Situational depression?) that exploded every time he had to consider going haven’t occurred and he seems happier. But, we have no idea yet what this means for finishing the school year, nor what’s really going on. I echo Redpanda5’s advice: try to set up psychological testing. We suspect some kind of anxiety or autism-spectrum and have testing scheduled for next week. We really hope this provides some answers and direction, but we’ll have to see.

[Hidden]

Do you think he really ‘makes himself’ throw up?

All those meds he is on can cause gastrointestinal symptoms including nausea…

To give you an example, my son has been always a poor eater, getting full and even as a baby ‘than one more spoon meant so many times that he’d vomit everything and I had to be starting again…’ It continues now he’s 10, we have checked him with various specialist tests, with gastroenterologists etc and one said that kids who are neurodiverse often suffer from gastric symptoms (but it’s ‘functional’ so basically it doesn’t mean any illness such as Coliac or allergy or anything).

So now on top of pre-existing stuff then giving a kid like this ADHD meds that do have frequently side effects of nausea, stomach ache, flu like symptoms etc. I can get that physically those kids then feel even worse… For example my son has always been getting ALL tummy bugs and he recovers very slowly- before Easter he had one and he had to be off school for 9 days and we kind of could t believe and once he said he feels sick yet again after a few days and I pushed him to school that day and he …vomited on his desk. Then all over the bathroom… Teacher must get him as we don’t have a cleaner at school during the day (they come after kids are out) so it’s the teaching assistant cleaning all this…

All I’d say look at your son from the baby and has he always been a good eater, physical health good, not getting stomach bugs and now he suddenly does feel sick and like vomiting… It could be side effects of his meds. Or maybe he’s constipated which also is a frequent side effect of those meds…

Saying that, I totally understand your frustration. I mean, today my son yet again said that ‘tummy aches and I feel sick like for vomiting’ and I thought I’d flip! I kept him home a bit to give him like 1 hour after breakfast (if he vomits it’s normally by 10am) and I sent him to school. To be honest on that 1 hour he went to the loo 3 times and did nr2 and was constipated (rants droppings). I couldn’t tell the school that he said he felt ‘sick’ so I said he had an episode of palpitations (which he also did have, his pulse at breakfast was 129…).

I’d say check your son’s vitals, how’s his blood pressure, how’s his pulse…

It could be psychosomatic. It could be that there is psychological reason and he ‘makes up the feeling sick’ but it could be that he really doesn’t feel well.

[SurvivorFan]

I'm so sorry you all are going through that. Obviously not a doctor but what you describe very much sounds like he is dealing with anxiety. For my son, before we started medication for anxiety- his symptoms came out in the form of body aches and pains, defiance, irritability. I'm sure you know this already but the more times he is able to keep himself home the harder it will be to get him back.

Definitely talk with his doctor about options weather that be medication if your comfortable with it and or someone to talk the anxiety over with. In our experience, therapy alone wasn't enough and I wasn't about to make my kiddo suffer day in and day out with anxiety he cannot control.

Also, include his IEP team if he has one or his teacher/school support about what is happening so you can have the support around you and your son.

[Juniper52]

Thanks everyone, I truly appreciate all of your thoughts, ideas, suggestions, and stories. Our son has been diagnosed with anxiety disorder (hence the Citalopram), and I’m not sure what we could be doing more to help with that specifically (he currently gets in-home therapy since he landed in the ER in December after a self- and other- harm threat got out of hand).

He would never ever be comfortable doing anything other than what all the other kids are doing at school (more anxiety stuff - he is highly self-conscious), so unfortunately anything that would involve going off script for a normal school activity wouldn’t fly for him.

I’ve thought about the eventual possibility of online school, but am hoping to avoid it because he really thrives on interactions with friends (which is why we are so stymied by this school refusal as he has some good friends there!).

The good news is that on Tuesday, after we both talked to him about the idea that something must be going on that’s keeping him from wanting to go to school, even though he couldn’t verbalize anything, he did ask us to help him get up earlier in the mornings so he could have extra time to even go back to sleep for a bit if he felt he needed it. It worked yesterday and he went to school with no problem… we shall see how things go the rest of the week and school year!

Again, thanks for taking time to read and reply - I so appreciate this community!