Q:

A school nurse called you to see a 6-year-old boy with school refusal, he is always crying after parental leaving, refuses to stay in the class room

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A school nurse called you to see a 6-year-old boy with school refusal, he is always crying after parental leaving, refuses to stay in the class room, the school nurse informed you that she tried her best during the last 4 weeks; and she met with the parents frequently. Of the following, the BEST action is to


  1. efer the child to a pediatrics psychologist
  2. start selective serotonin reuptake inhibitor treatment
  3. ases the home environment
  4. arrange for parent management training
  5. give the child special attention fron the teacher

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(A). Management of school refusal typically requires parent management training and family therapy, with school personnel is always indicated; anxious children often require special attention from teachers, counselors, or school nurses. Parents who are coached to calmly sending child to school and to reward the child for each completed day of school are usually successful; in this scenario this option had been used. in cases of ongoing school refusal, referral to a child psychiatrist or psychologist is indicated. SSRl treatment may be helpful. Young children with affective symptoms have a good prognosis

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