Early Identification Checklist for School Refusal

A Checklist for Teachers and Parents

Research shows that early identification of warning signs is key to successful school refusal interventions.

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* 1. Which of the following School Refusal symptoms have you observed in the past week?

 
Complaints about attending school
Reluctance to talk with parents about school
Sleeping difficulties (under or over sleeping, frequently tired at home and school)
Social withdrawal, isolating behaviour at home
Excessive internet use (gaming, youtube and social media)
Feeling sick before school (waking up with a headache, stomach ache or sore throat)
Frequent crying spells or temper tantrums / aggressive behaviour
Separation anxiety (difficulty leaving the house, getting out of the car or in the school gate)
Unexplained absences (or often running late to school)
Frequent crying with requests to go home
Absences on significant days (tests, oral presentations, physical education classes)
Conflict with teacher/s and parents
Peer relational problems (being bullied)
Academic difficulties
Excessive worry about a parent when at school
Panic symptoms
Threats of self-harm

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* 2. On a scale from 0 to 10 thumbs, how manageable is the current situation for you?

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* 3. I would like to a counsellor to call me back to discuss my checklist responses:

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* 4. If you selected 'Yes please' (above), please enter your contact information below: 

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* 5. Are there any other concerns or questions you have?

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