Parents of kids with school refusal will do just about anything to get them the proper help. Many of us have worked with therapists, psychologists, psychiatrists, educational advocates, and the school child study team.

But for some reason, the role of the behavior analyst (Board Certified Behavior Analysts, BCBA) has been under the radar. They shouldn’t be, though. They can play an integral part in helping kids get back to school.

I had the pleasure of meeting Scott Rossig, a BCBA who specializes in school refusal. Scott is the principal at South Bergen Jointure Commission school district in New Jersey. He consults with schools on school refusal cases and has a private practice, Best Behaved Kids. 

The following information is from an interview that I had with Scott.

According to the Special Education Guide, Behaviorists “help, IEP teams create plans to manage behaviors that affect a student’s learning; they work with the team to provide a comprehensive approach to behavior management that includes evaluation, data collection, interventions, and regular monitoring.”

Scott emphasized that a good behavioral practitioner will provide recommendations, involve themselves in modeling the implementation of interventions, and coach parents/family members on implementing the intervention. They provide consistent feedback, strategizing, collaborating, modeling, which are foundations for success. 

What is a Board Certified Behavior Analyst (BCBA), and how can they help kids with school avoidance? 

Behavior Analysts are experts in understanding and implementing the core principles of behavior analysis. They often visit the families at home to observe behaviors exhibited by the child/youth, assess the environment to determine current approaches used (both positive and negative consequences), and interview the parents. An initial yet ongoing goal is to hypothesize the function of the behaviors associated with school refusal. The behaviorist does this through observation and data collection. The potential functions include the child.

•  Trying to escape or avoid adverse circumstances

• Trying to access attention or tangible items  

They sometimes utilize the School Refusal Assessment Scale (SRAS), an assessment tool that works to understand the function of school avoidance through a questionnaire (link to SRAS).

If possible, they also go to the school to observe the school staff’s environment, actions, and responses. Schools often rely on punitive interventions to address behaviors associated with school refusal. Unfortunately, this will usually only exacerbate the situation. At times, school staff may appear inflexible or unsupportive, often associated with a lack of understanding of the importance of using a more supportive and reinforcing approach to overcome the challenges. 

The behaviorist will work with the school on the use of positive reinforcement to motivate the student. The school should be willing to make accommodations to support the student’s comfort and anxiety level. Accommodations like attending school in small time increments can go a long way. Equally important is not to rush getting back to a full schedule. 

Also, decreasing academic demands at the beginning is essential.  

Most success happens when the school is on board and everyone is on the same page; parents, school, mental health professionals, and behaviorists. 

Parent education and support are an essential part of a behaviorist’s job.

Kids panic in the morning, acting out, and of course, the parent reacts. But it is critical to use extinction principles and train parents to be neutral. Sometimes parents have to physically remove themselves from the situation (as long as their child is safe and not in danger of hurting themselves or anyone).

He emphasizes that this is hard for parents. So working with the support of a behaviorist is a considerable benefit. It takes patience and rehearsal with a parent.

When it comes from a behavioral standpoint and changing behaviors, every person involved needs to adjust behaviors.

Scott shared an example of a teen boy challenged by school refusal, on and off for over ten years!  

The boy first started avoiding school due to challenges he was experiencing with the school work. He would refuse to go to school on days when he had a test, which expanded to multiple days per week due to challenging assignments. His school and district approached this by threatening detention and suspension, which only added to the challenges, ultimately leading to the youth refusing to go to school at all.  

While at home, it was challenging for his mom to establish expectations to return to school and withhold desired items. She had explained that she feels terribly for him because he struggles with significant anxiety, a feeling that is undoubtedly understandable!

Through working closely with Scott, she understood that by accommodating his desire to stay home and access video games and his cell phone all day, the situation became more challenging to overcome. It started with avoidance of things he found challenging in school. Then it was compounded with his understanding that he could now stay home and do something he enjoyed as opposed to working through his challenges. Scott and his mom supported him, explained that goal was to help and motivate him, and laid out clear expectations for him to get back to school, little by little.

They met with the school to inform them of their plan and to encourage them to minimize demands and increase access to reinforcing activities when he returns to school, noting that they would surely increase and re-introduce requests over time. At home, they worked to “cleanse the environment,” taking control of, and removing reinforcing (or rewarding) items, informing the boy that these items would be immediately available to him when he pushes himself to get to school. The mom even took her son’s phone and game console to work with her each day to ensure that he did not have access. The boy was informed that when he stepped onto the bus each day to get to school, his phone would be handed to him, and his game console would be available to him the second he stepped off the bus each upon arriving home.

Additionally, he had an opportunity to choose two days to remain at home each week. Then he would decrease to one day, and ultimately he was expected to attend school five days per week. Getting him back to school was accomplished through the excellent collaboration with the school and with the provision of additional reinforcement!

Scott says he understands the stress and challenges parents face and is never judgmental. Part of the behaviorist’s role is to provide constant encouragement and support. 

Sometimes a child needs a higher level of support and care before working with a behaviorist. For these situations, the kids may need more intensive outpatient or inpatient treatment.

He reiterated that the behaviorist’s job is to look at the environment, look at behaviors, and assess the functions to provide a tailored treatment plan. Every person involved in helping a school-avoidant child needs to adjust their behavior to help get kids back to school.

Does healthcare insurance cover the cost of behaviorist services?

At the moment, health insurance does not reimburse for the services of behavior analysts unless they are working with kids on the autism spectrum.

Do all schools have a Board Certified Behavior Analyst? 

Not all schools have a BCBA, but sometimes the school district has one on staff to share throughout the community. It is a resource that more and more schools realize they need! 

When it comes from a behavioral standpoint and changing behaviors, every person involved needs to adjust behaviors.

Working with a behaviorist could be essential in getting your child with school avoidance back to school. Talk to your school about getting one involved.