“But They’re Fine at School!” — Understanding School Refusal in Children with Selective Mutism

By Dr. Elisa Shipon Blum

When anxiety and meltdowns happen at home, the solution may begin at school.

Your child screams, cries, refuses to put on their shoes, won’t get out of the car, or begs to stay home. Yet once they get to school, the teacher says, “They’re fine.” For parents of children with Selective Mutism (SM), this can be incredibly confusing. If the difficult behavior is happening at home, shouldn’t we focus on changing what is happening at home?

Not necessarily.

For many children with SM, school refusal may be the outward sign of a child who does not yet feel comfortable, connected, confident, or adequately supported at school. At the same time, anxious children often function best when their world feels organized and predictable.

Structure, consistency, routine, and predictability are key, both at home and at school. So rather than focusing only on the refusal, “Look, Listen & Learn” from the child.

What are they trying to convey through their behavior—and what might be making school so difficult to enter?

“But They’re Fine Once They Get to School”

A child may scream before school, resist getting dressed, refuse to get into the car, or repeatedly say, “I want to go home.” Then the parent hears:

“They seem perfectly fine once they’re here.”

For a child with SM, appearing calm does not necessarily mean feeling calm. Many children with SM hold themselves together in environments where they feel anxious or uncertain. They may become quiet, compliant, withdrawn, or highly controlled.

At school, they contain their distress. At home, where they feel more comfortable, it may come pouring out. The behavior at home may actually be giving us important information about the child’s experience at school.

Look for the WHYs

Young children often cannot explain exactly why school feels difficult. A child might say:

• “I don’t want to go.”
• “I don’t like recess.”
• “I don’t know where to stand.”
• “What if I do it wrong?”

These concerns may seem small to an adult, but they can feel enormous to an anxious child.

Consider everything a child may need to navigate: a busy classroom, large-group recess, noise, transitions, unfamiliar adults, changing aides, speaking expectations, playground activities, lining up, finding a friend, and figuring out whom to approach when help is needed.

For a child with SM—particularly one with developmental, sensory, motor, physical, or other challenges—these demands can accumulate throughout the day. Instead of asking “How do we make the child go to school?”, ask “WHY does school feel so difficult right now?”

School refusal is communication. Behavior is information.

Make Life More Predictable

Uncertainty can fuel anxiety. That’s why structure, consistency, routine, and predictability should be part of the intervention at both home and school.

At Home

Keep mornings calm, consistent, and predictable. A simple routine might be:

Wake up → Get dressed → Breakfast → Shoes → Backpack → Car → School

Visual schedules, checklists, pictures, or timers can help. Prepare clothing, backpacks, and other necessities the night before. Preview changes in routine ahead of time whenever possible. Consistency doesn’t mean rigidity. It means reducing unnecessary uncertainty.

At School

A child should know: WHO will greet me? WHERE do I go? WHAT do I do first? WHO will be with me?

A familiar adult might greet the child and immediately engage them in a predictable, preferred activity: “You’re here! Come help me with this.” The child no longer has to walk into school wondering what happens next. Predictability creates comfort, and comfort is where progression begins.

Think Comfort → Connection → Confidence → Communication

Within our S-CAT® approach, we emphasize: Comfort → Connection → Confidence → Communication

Before expecting more communication, participation, or independence, consider the earlier steps.

1. Does the child feel comfortable in the environment?
2. Is there a connection with a familiar adult and peers?
3. Does the child feel confident about where to go, what to do, and what comes next?

As comfort, connection, and confidence increase, communication and engagement can progress more naturally. Knowing what to do and feeling confident enough to do it are very different things.

Don’t Wait—Facilitate

It’s common to hear:

• “She’ll get used to it.”
• “Give it time.”
• “Once she makes friends, she’ll be fine.”

Sometimes that happens. But when distress is increasing, simply waiting may not be enough. Don’t wait, facilitate. Help the child become comfortable rather than waiting for comfort to happen on its own.

That might mean temporarily increasing adult support at arrival, establishing a predictable first activity, pairing the child with a familiar peer, or providing more facilitation during challenging parts of the day.

Remember: Recess Can Be Hard

Recess may look like a break to adults, but for many children with SM it is one of the least structured and most socially demanding parts of the day. “Go play!” can be an enormous expectation.

A child who spends the entire recess doing one activity alone may genuinely enjoy it—or it may be the only activity that currently feels manageable. Initially, add structure:

• Who will the child play with?
• What activity will they start with?
• Who can help them join?
• Where will they line up afterward?

Adult facilitation can gradually decrease as the child becomes more comfortable and confident.

Comfort & Connection With Peers Are Crucial

For children with SM, feeling connected to peers can be just as important as feeling connected to adults. Don’t assume friendships and peer interactions will develop on their own. Ask:

• Is there a Buddy Process?
• Is the child intentionally paired with a familiar peer during arrival, classroom activities, lunch, recess, and transitions?
• Are teachers actively facilitating interaction and helping the child enter groups rather than simply telling them to “go play” or waiting for them to initiate?

A familiar peer can become an important bridge. Start with comfort and then gradually expand: One familiar peer → Two peers → Small group → Additional classmates

Purposeful playdates and small-group activities outside school can also help broaden the child’s social connections.

Avoid Turning Mornings Into a Battle

When a child refuses school, parents understandably become focused on getting through the door. But repeated pleading, negotiating, pulling, carrying, or physically forcing a highly distressed child can turn mornings into an escalating struggle.

The answer is not simply allowing avoidance. Rather, maintain a consistent home routine while simultaneously addressing what is contributing to the distress at school. The goal is to change what the child anticipates on the other side of the school doors:

• Someone will be waiting for me.
• I know what I’m doing when I get there.
• I know who will help me.
• I know what happens next.

Home and School Need to Work Together

Morning behavior and the school experience should not be treated as two separate problems. They are connected.

Parents can provide structure, consistency, routine, and predictability at home. School personnel can provide structure, predictability, facilitation, and connection at school. And the adults need to be consistent with one another.

When a child with SM is struggling before school, don’t only ask “Is the child behaving at school?” Ask:

• Is the child comfortable?
• Is the child connected to adults AND peers?
• Is the child engaged?
• Does the child know what comes next?
• Does the child know whom to approach for help?
• Are adults facilitating or waiting for the child to initiate?”

A child who quietly complies throughout the school day may still be working extraordinarily hard to hold themselves together. The meltdown before school may be our clue.

Address the WHYs, Not Just the Behavior

There is no single school-refusal plan that works for every child with Selective Mutism. The key is to understand the WHYs underneath the behavior and develop an individualized plan that builds comfort, connection, confidence, support, and engagement.

And remember:

Structure. Consistency. Routine. Predictability.

At home AND at school. When children know what to expect, they can spend less energy worrying about what comes next and more energy engaging with the people and world around them. And when we improve the child’s experience at school, we may begin to see something important happen at home:

Mornings become easier, too. Don’t wait, facilitate.