The term ‘school refusal,’ which first originated from Great Britain, is used to describe problems in children not going to school because of emotional difficulties. School refusal is a symptom and may be accompanied by several psychiatric disorders (such as anxiety disorder, disruptive behavior disorder and mood disorder). School refusal is common in the children of parents with psychological disorders. This supports the idea of genetic and environmental factors being involved in the development of school refusal. A separate therapeutic protocol must be established for each case through the detailed assessment of child-related, family-related and social environment and school-related factors. School refusal is more common in children 5, 6, 10 and 11 years of age. The aim of treatment must be to ensure a return to school as early as possible. Although school refusal is not a clinical disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, it can be associated with several psychiatric disorders. Therefore it is necessary that youths who are school refusing receive an evaluation by a mental health professional. We discuss a case of school refusal in the older of two siblings with an age difference of 1 year who started school in the same class but who were subsequently assigned to different classes. The purpose of this report is to emphasize the importance of siblings of a similar age starting school in difference classes, similarly to twins, and to raise awareness of this.

Keywords: school refusal, anxiety, sibling, child