Paediatric consultations in school refusal cases need to explore the presenting medical symptoms and discuss with families any psychological function of the problems that have led to non-attendance. Understanding possible reinforcements of the child's avoidant behaviour, liaising with school and reassurance of the parents are often enough to manage the situation. However, more chronic and persistent refusal often require support from an extended team around the child, often requiring input from mental health professionals. Behavioural strategies are the recommended approach to improve school attendance and to tackle the underlying anxiety or depression, or both, that may be the root cause of their non-attendance.
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