DrParenting

School-Age Kids: School Refusal, Routines, IEPs and 504 Plans

DrParenting’s guides to the school years in one place: a child who cannot face school, hard mornings and big reactions, attention problems taken for anxiety, sensory tools for the classroom, and how to ask the school for support.

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Written by the DrParenting team · Published October 31, 2026

When school gets hard, a parent can ask the school for an evaluation: under federal law, either a parent or the school may request one, and it must be done within 60 days of the parent’s consent unless the state sets its own timeframe.⁠2 These guides cover school refusal, routines, attention and classroom support.

Key takeaways: the school years

  • School refusal is not truancy. It is a pattern, most often driven by anxiety, that an estimated 1% to 5% of school-age children struggle with at some point, most commonly around ages 5 to 7 and again at 11 to 14.⁠1
  • Small steps back work best. Cognitive behavioral therapy has the strongest research support; it builds a step-by-step plan to return to school, which may start with a shorter day or check-ins with a trusted adult.⁠1
  • You can request an evaluation yourself. A parent or the school may ask for an initial special education evaluation, and it must be done within 60 days of the parent’s consent, or within the state’s own timeframe if it sets one.⁠2
  • An IEP and a 504 plan come from different laws. IDEA provides special education and related services to eligible children ages 3 through 21;⁠3 Section 504 requires a school district to provide a free appropriate public education to each qualified student with a disability.⁠4
  • Parents belong at the IEP meeting. The school must take steps to make sure one or both parents are present at each IEP team meeting or have the chance to take part.⁠5
  • Inattentive girls are easy to miss. Less obvious ADHD symptoms are less likely to lead to a referral, and anxiety or low mood alongside ADHD may be taken for the main condition.⁠6

What does DrParenting’s school page cover?

The years from kindergarten through middle school, and the problems that tend to show up at school first: a child who cannot face the morning, reactions that seem bigger than the moment, attention that slips, and a classroom that is too loud or too bright. The guides below come from across DrParenting, with DrSensory’s guides to asking a school for support.

For the years before school, see DrParenting’s toddler guides; for a teen’s first mental health visit and a parent’s own health, see DrParenting Health.

Which DrParenting school guide answers my question?

Start with the question you have. Each one below leads to the guide that answers it.

What helps a child who struggles to get to or through school?

Finding out what is behind it, then working with the school. The American Academy of Child and Adolescent Psychiatry describes not wanting to go to school as a pattern with several possible causes, most often anxiety, rather than a diagnosis; it tends to show up around big changes like starting school or moving up to middle school, and treatment works best when family, school and therapist work together.⁠1 The guides below cover sensory avoidance and school attendance, mornings and routines, reactions that may need more support, and sensory tools for a classroom.

Sponsored · Health

When Sensory Avoidance Starts Affecting School Attendance and Family Life

How sensory avoidance can grow into missed school, how it differs from truancy, and a gradual, supported way back.
By DrSensory Editorial Team Read the guide
Sponsored · Health

Why Everyday Routines Can Be Hard for Children With Developmental Differences

Why getting dressed, breakfast and bedtime can be hard for children with developmental differences, what helps at home, and when to ask for help.
By DrSensory Editorial Team Read the guide
Sponsored · Health

When a Child’s Big Reactions May Be a Sign They Need More Support

When tears and outbursts fit development, when sensory triggers are part of it, and the signs that a child needs more support.
By DrSensory Editorial Team Read the guide
Buying guide · Sensory

Best Sensory Toys 2026 for Autism and ADHD: A Buying Guide

Sensory toys and tools for kids, matched to sensory profile rather than age, with what the evidence supports, what to look for, and the risks that matter.
Contains affiliate links Read the guide

Why are attention problems in girls often missed at school?

Because the signs are quieter. An expert consensus statement on girls and women with ADHD found that less obvious symptoms are less likely to lead to a referral, so inattentive girls are more often missed, and that anxiety or low mood alongside ADHD may be taken for the main condition.⁠6 In her essay, a psychiatric nurse practitioner who assesses teenage girls for ADHD names the question she would ask a parent first: how long homework actually takes. For the evidence, see DrSensory’s guide to ADHD in teen girls.

Clinician perspective · Development

When the Referral Says Anxiety

Most of the teenage girls she assesses for ADHD were referred for something else. A psychiatric nurse practitioner on what she hears and the question to ask.
By Dr. Stacey Forbes Read the story

How do parents ask a school for an IEP or a 504 plan?

In writing, starting with a request for an evaluation. Either a parent or the school may request an initial evaluation, and it must be conducted within 60 days of the parent’s consent unless the state sets its own timeframe.⁠2 An IEP comes through IDEA, which provides special education and related services to eligible children ages 3 through 21;⁠3 a 504 plan comes through Section 504, which requires a school district to provide a free appropriate public education to each qualified student with a disability.⁠4 Parents have a seat at the table: the school must take steps to make sure one or both parents are present at each IEP team meeting or have the chance to take part.⁠5

DrSensory guide · School

IEPs and 504 Plans: How to Get School Support for Your Child

An IEP changes what a child is taught, a 504 plan the conditions: how to ask for an evaluation in writing.
Read the guide
DrSensory guide · School

Sample Letter: Requesting a School Evaluation

A free sample letter asking for a special education evaluation, who to send it to, and what to do if the school says no.
Read the guide
DrSensory guide · School

Parent-Teacher Conferences for a Neurodivergent Child: What to Ask and What to Say

What to ask, whether to share a diagnosis, your rights, and what to do after the meeting.
Read the guide

What is typical development for children ages 5 to 12?

DrSensory’s school-age guide sets out the milestones for ages 5 to 12, which behaviors are typical and which are a reason to check, and the conditions most often noticed at school, such as ADHD, dyslexia, dyspraxia and anxiety. Its classroom guide covers sensory accommodations for a child with sensory processing differences and ADHD, and its occupational therapy guide explains what therapy does for children 6 to 12.

DrSensory guide · Development

School-Age Children: Development and Concerns

Ages 5 to 12: milestones, the signs of ADHD, dyslexia and anxiety, IEP vs 504, sleep and screens.
Read the guide
DrSensory guide · School

Supporting a Child With SPD and ADHD at School: What Works

Sensory accommodations, 504 plans and IEPs, and what a teacher can do in the classroom.
Read the guide
DrSensory guide · Therapy

Occupational Therapy for School-Age Children

What occupational therapy does for children 6 to 12, what a session involves, and how to request an evaluation.
Read the guide

When should parents ask for help with problems at school?

When a problem lasts for weeks, keeps coming back, or starts to affect sleep, friendships or how your child feels about school. AACAP notes that school refusal that first appears in an older child or teenager is more often tied to problems with friends, bullying, depression or other emerging mental health concerns and usually calls for a closer look, and that the sooner families get help, the better things tend to go.⁠1

Start with your child’s pediatrician and the school. Our sample letter shows how to ask the school for a full evaluation in writing, the short check Does My Child Need an Evaluation? helps you decide which kind, and the DrSensory directory lists occupational, physical and speech therapists near you.

Where can parents read more about learning and school support?

DrSensory’s clinical guides for the school years:

Who writes DrParenting’s school guides?

The DrParenting team publishes them, and a piece from a parent or an outside contributor carries that person’s own byline. Buying guides and product reviews can contain affiliate links, and the cards above mark the ones that do; How DrParenting works explains how products are chosen and how the section is paid for.

None of these guides replaces advice about your own child from your child’s doctor or therapist.

Frequently asked questions

What is school refusal?

A pattern of real difficulty going to or staying at school, most often driven by anxiety, rather than a diagnosis of its own. An estimated 1% to 5% of school-age children struggle with it at some point, most commonly around ages 5 to 7 and again at 11 to 14.⁠1

Is school refusal the same as skipping school?

No. Truancy is skipping school on purpose without a parent knowing, often without feeling upset about it; school refusal comes with real distress, and the two call for different kinds of help.⁠1

How do I ask the school to evaluate my child?

Ask in writing for an initial evaluation. Under federal special education law, either a parent or the school may request one, and it must be conducted within 60 days of your consent, or within your state’s own timeframe if it sets one.⁠2 DrSensory’s sample letter shows what to write.

What is the difference between an IEP and a 504 plan?

They come from different laws. Under IDEA, a public school must have an IEP in effect at the beginning of each school year for each child with a disability it serves;⁠7 under Section 504, a qualified student with a disability receives regular or special education and related aids and services designed to meet their individual needs.⁠4 DrSensory’s guide to IEPs and 504 plans compares the two.

Can parents attend IEP meetings?

Yes. The school must take steps to make sure one or both parents are present at each IEP team meeting or are given the chance to take part.⁠5

Why is ADHD missed in girls?

Less obvious symptoms are less likely to lead to a referral, so inattentive girls are more often missed, and anxiety or low mood alongside ADHD may be taken for the main condition.⁠6

Are DrParenting’s school guides medical or legal advice?

No. They are general information for parents. For your own child, talk with your pediatrician and your child’s school.

Sources

  1. American Academy of Child and Adolescent Psychiatry. School Refusal (Facts for Families No. 7). aacap.org. Checked October 31, 2026.
  2. U.S. Department of Education. 34 CFR § 300.301, Initial evaluations (Individuals with Disabilities Education Act regulations). ecfr.gov. Checked October 31, 2026.
  3. U.S. Department of Education. About IDEA. sites.ed.gov. Checked October 31, 2026.
  4. U.S. Department of Education, Office for Civil Rights. Frequently Asked Questions: Section 504 Free Appropriate Public Education (FAPE). ed.gov. Checked October 31, 2026.
  5. U.S. Department of Education. 34 CFR § 300.322, Parent participation (Individuals with Disabilities Education Act regulations). ecfr.gov. Checked October 31, 2026.
  6. Young S, Adamo N, Ásgeirsdóttir BB, et al. Females with ADHD: an expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC Psychiatry. 2020;20(1):404. doi:10.1186/s12888-020-02707-9.
  7. U.S. Department of Education. 34 CFR § 300.323, When IEPs must be in effect (Individuals with Disabilities Education Act regulations). ecfr.gov. Checked October 31, 2026.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child, and your child’s school about school services.