School refusal commonly arises after a period of school absence - due to illness or holidays - or a big change, such as starting a new school or moving from primary to high school.

No one factor or person is to blame for school refusal; it's caused by a complex interaction of multiple risk factors involving the child (such as a fear of failure), their family (such as overprotective parenting or illness), the school (such as bullying), and social challenges (such as pressure to achieve academically).