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Autism and School Avoidance

Autism and School Non-attendance

Various terms have been used to describe the frequent absences from school due to anxiety or feeling overwhelmed: e.g., school refusal, problematic absenteeism, or school avoidance. Students who miss 10% or more of school are described as having "persistent non-attendance/absence" or "problematic non-attendance." The rate of school non-attendance is notably higher for students on the autism spectrum compared with neurotypical students.

What is the rate of school absence/avoidance for autistic students?

•     Autistic students in mainstream education (no intellectual disability) had a higher rate of school refusal behavior than the general student body in Norway (43% of autistic students versus 7%) [Munkhaugen 2017]. Interestingly, parents of these autistic students noted higher levels of "school refusal behavior" (53%) than that reflected in the actual absence rate.

•     The most common reason for school absence for the autistic student is school refusal. [Adams, 2022; Totsika, 2020]

•     Kurita reported school refusal in 24% of their sample (of note: the study was in 1991 and used the former diagnostic criteria for autism and pervasive developmental disorder rather than the current criteria for ASD; therefore, their sample was more limited in scope than more recent studies).

How much school is missed by autistic students?

•     International estimates of school absence across all students (ASD and neurotypical) suggest that students miss 5-7% of school.

•     Children on the autism spectrum were found to miss 6 full days in 20 days of classes on average (4 weeks/one month, most absences were secondary to school refusal). This rate of non-attendance translates to missing 30% of school and is noticeably higher than the 1 - 1.4 days missed by the general student population [Adams 2022, Australia]

•     Regardless of the cause of non-attendance... children on the autism spectrum are missing (on average, at least) four times more school than their peers. [Adams, 2022]

•     In a UK study, 2020 [Totsika], ASD students missed an average of 5 days across 23 days (missing 22% of school).

How common is persistent non-attendance (missing 10% or more of school) in autistic students?

•     Persistent non-attendance in the Totsika study occurred among 43% of the 486 students; Other studies report rates of persistent absence for autistic students near 20% [Department for Education in England, 2019]. The department of education study included only those students with ASD listed in their educational plan as their primary need. Totsika included UK autistic students at a broader community level.

How common is truancy for the autistic student?

•     Truancy (i.e., absence without school permission and usually involving effort on the part of the student to conceal the absence from the parents) is almost non-existent in the autistic students, whereas 4-11% of the general study body miss at least one full day of school per month due to truancy [Adams, 2022 and citations; Totsika 2020]

Which autistic students show the most nonattendance?

•     Problematic non-attendance was higher in ASD students WITHOUT intellectual disability than those with ID [Totsika, 2020; Kurita, 1991]

•     School non-attendance for the autistic student has been found to increase with age [Adams, 2022; Totsika, 2020]

•     Factors identified by families and professionals as contributing to school non-attendance included late diagnosis of ASD "resulting in needs not identified and therefore not addressed," lack of understanding in schools, poor transition from primary to secondary settings, sensory issues such as noise, and more. [Preece, 2018]

Students who are anxious about and avoid school should be screened for autism characteristics. The more we know about the student's neurologic characteristics, the better able we are to support them in a school environment. Autistic individuals who find effective strategies for regulation at school may be better equipped to find comfortable ways to succeed in a workplace.

Adams D. Child and Parental Mental Health as Correlates of School Non-Attendance and School Refusal in Children on the Autism Spectrum. J Autism Dev Disord. 2022 Aug;52(8):3353-3365. doi: 10.1007/s10803-021-05211-5. Epub 2021 Jul 30. PMID: 34331173; PMCID: PMC8323746. Australia

David Preece & Marie Howley (2018) An approach to supporting young people with autism spectrum disorder and high anxiety to re-engage with formal education – the impact on young people and their families, International Journal of Adolescence and Youth, 23:4, 468-481, DOI: 10.1080/02673843.2018.1433695 United Kingdom

Kurita H. School refusal in pervasive developmental disorders. J Autism Dev Disord. 1991 Mar;21(1):1-15. doi: 10.1007/BF02206993. PMID: 2037546. Japan

Munkhaugen EK, Torske T, Gjevik E, Nærland T, Pripp AH, Diseth TH. Individual characteristics of students with autism spectrum disorders and school refusal behavior. Autism. 2019 Feb;23(2):413-423. doi: 10.1177/1362361317748619. Epub 2017 Dec 14. PMID: 29241346. Norway

Totsika V, Hastings RP, Dutton Y, Worsley A, Melvin G, Gray K, Tonge B, Heyne D. Types and correlates of school non-attendance in students with autism spectrum disorders. Autism. 2020 Oct;24(7):1639-1649. doi: 10.1177/1362361320916967. Epub 2020 May 18. PMID: 32419486; PMCID: PMC7545649. United Kingdom

1,497 views8 comments


Oh, this is so validating and insightful, thank you!. My middle child in HS would tell me that school was horrible and that no one cared about learning. He would call, asking me to pick him up early from school. He would tell me he didn't want to go to school. I could not figure out what was happening - his older sibling attended the same school and did fine. His reasons? He was stressed from the day before and was up all night from insomnia. Or there was too much socializing and he could learn better just by doing the classwork & homework from home. Rather than take more AP classes, he decided to graduate HS a semester early…

Replying to

It's such important information isn't it! I'm glad you found it helpful. Thanks for sharing, Dr. Regan


Jude Valencia
Jude Valencia
Dec 02, 2023

This is rather striking to me. As I chose to not go to school starting as early as the 2nd grade. By 5th I was having "intervention" and then in 8th they even threatened my mother with jail time. I eventually dropped out with just a few units left. I hated school because of the forced socialization was absolutely exhausting, not to mention I was bullied relentlessly.

If this was part of the school system's awareness back then I would have been diagnosed at 10, instead of self diagnosing at 45.

Replying to

Yes, I feel like so many students need advocacy rather than consequences! Dr. Regan


Amy Bain
Amy Bain
Dec 10, 2022

This is so validating for my own experience with HS as well as both of my kids - and at the same time I’m struggling with a deep sense of grief over the misunderstandings this experience has created in our lives. I was a ‘truant’ in HS, and it was just so weird - felt like the nerdiest least rebellious ‘rebel‘ ever. I loved learning and doing well - HS prioritizes things that I (and my kids) majorly struggled with. My mind thought the main goal was learning but the experience didn’t support that. It was just awful!

My kids are reflected in this data and their behavior is misunderstood by the school, themselves, and by me. Until just now!!…

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Nov 28, 2022

Very insightful. I haven't been diagnosed yet, but I have high susceptibility that I am autistic. One year in high school, I believe I missed a total of 120+ days... I convinced my mother to let me school abroad and I ended up photoshopping my report card so that the school would let me in. I often left school just to go on long walks because I got so overwhelmed. I didn't realize I had many sensory issues back then, but things are starting to make sense now on why I did what I did.


I had issues with “school avoidance” starting in early elementary school, and it almost led to being held back a year. I wasn’t diagnosed until last year at age 35, and this same avoidance tendency led to missing a lot of work. This article really shed light on the causes of my anxiety towards the school environment. Going back after absence was always a cause for dread in school and work (and still is to a lesser degree). Thank you for all the podcasts and articles you publish! I’m learning so much!

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