persistent reluctance to go to school, which usually occurs during the primary school years and is often a symptom of an educational, social, or emotional problem. School refusal may be a feature of separation anxiety disorder. It may be triggered by a stressor (e.g., loss of a pet or loved one, a change of school, loss of a friend due to a move), or it may occur after a summer vacation when the child has spent more time with the primary caregiver. School refusal is often associated with complaints and physical symptoms (e.g., upset stomach, nausea, dizziness, headache) and anxiety at the start of the day. Also called school avoidance; school phobia.