School Phobia and School Refusal

The term school phobia reflects the terminological and conceptual confusion that has plagued the problem of excessive school absenteeism since it was first introduced as a phobia by Adelaide M. Johnson and her colleagues (1941). Most investigators currently working in the area, therefore, have come to view school phobia as a subset of school refusal behavior. As a consequence, the more comprehensive term, school refusal behavior (SRB), has come to be preferred over school phobia (Hansen et al. 1998). Even the term SRB has its difficulties, however, as it may be taken to imply a conscious decision on the part of the child to refuse to go to school—a perspective that clearly is not appropriate to all cases (Wicks-Nelson and Israel 1997). Truancy usually is characteristic of children who are absent from school on an intermittent basis, usually without parental knowledge. Children with SRB are absent for extended durations, such as consecutive days, weeks, or months, and usually with parental knowledge. Truancy also is usually associated with other externalizing child behavior problems (e.g., conduct problems) as well as poor academic performance.

Research evidence suggests that the most common age of onset for SRB is generally in early adolescence, though this may simply reflect age at the time of referral. Last and Strauss (1990), for example, reported that onset of school refusal was, on average, about one to two years prior to referral. In terms of gender, SRB occurs fairly evenly across boys and girls (Kearney 1995).