School Refusal Behavior in Japan: The Impact of COVID-19 on Children
Abstract
1. Introduction
2. The Current Status of School Refusal Behavior in Japan and Worldwide
3. Factors Contributing to School Refusal
4. The Impact of COVID-19 on Children
4.1. Physical and Mental Health
4.2. Family Dynamics
4.3. Societal Impacts
4.4. Direct Impact on School Refusal
5. Interventions, Support, and Future Directions
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Authors (Ref. No.) | Year | Summary |
---|---|---|
Ministry of Health, Labor, and Welfare, Japan (Ref. [1]) | 2023 | Japan’s official annual demographic statistics highlighting a record low total fertility rate of 1.20 in 2023, which showed the demographic backdrop against which school refusal is increasing. |
Ministry of Education, Culture, Sports, Science, and Technology, Japan (Ref. [2]) | 2023 | Japan’s official annual report on school absenteeism, including details on prevalence, reasons for absenteeism, and the sharp increase during COVID-19, with breakdowns by school level and absence duration. |
Kearney CA (Ref. [3]) | 2008 | A review article defining school absenteeism and refusal behaviors in youth, which discussed prevalence, etiological factors, and frameworks for intervention, forming the conceptual basis for the review. |
Dee TS (Ref. [4]) | 2024 | A report from the Proceedings of the National Academy of Sciences of the United States of America, describing chronic absenteeism trends in U.S. schools, showing a near doubling during the pandemic to 28.3%. |
Lester KJ, Michelson D (Ref. [5]) | 2024 | A review paper, exploring the phenomenon of emotionally based school avoidance in the post-COVID-19 era, which highlighted the ‘perfect storm’ of risk factors exacerbated by pandemic disruptions. |
Rahman MA et al. (Ref. [6]) | 2023 | A large multi-country study on chronic absenteeism in 71 nations, examining prevalence and associated factors. |
de Figueiredo CS et al. (Ref. [7]) | 2021 | A review paper exploring the multifactorial impact of COVID-19 on children’s and adolescents’ mental health, which integrated biological, environmental, and social influences relevant to school refusal. |
Ministry of Education, Culture, Sports, Science, and Technology, Japan (Ref. [8]) | 2021 | Japan’s official annual report tracking physical fitness trends among Japanese children, which noted declines during COVID-19 due to reduced physical activity and disrupted routines. |
Saito M et al. (Ref. [9]) | 2022 | An original article assessing mental health in Japanese schoolchildren during school closures, which found disrupted sleep, eating habits, and physical activity patterns. |
National Center for Child Health and Development, Japan (Ref. [10]) | 2023 | Japan’s national center report summarizing the overall health impact of COVID-19 on Japanese children, which included mental, physical, and lifestyle changes observed during the pandemic. |
Ministry of Health, Labor and Welfare, Japan (Ref. [11]) | 2024 | Japan’s official annual report on child suicide in Japan, which highlighted a sharp increase in suicides among children during the pandemic. |
Racine N et al. (Ref. [12]) | 2021 | A meta-analysis of global studies on depression and anxiety in children and adolescents during COVID-19, which found doubled prevalence compared to pre-pandemic estimates. |
Roumeliotis N et al. (Ref. [13]) | 2024 | A Canadian population-based study reporting increased youth hospitalizations for mental health issues during the pandemic, which highlighted conditions such as anxiety, personality disorders, and suicidality. |
Madigan S et al. (Ref. [14]) | 2023 | A systematic review and meta-analysis of pediatric ED visits for suicide attempts, self-harm, and ideation, which found significant increases during the pandemic. |
Okajima, I et al. (Ref. [15]) | 2022 | An original article from Japan linking COVID-19-related sleep problems and anxiety to loneliness, which identified an indirect link to school refusal feelings among adolescents. |
Hiraoka D, Tomoda A (Ref. [16]) | 2020 | An original article from Japan on parenting stress during school closures, which found heightened stress linked to disrupted routines and caregiving demands. |
Bourion-Bédès S et al. (Ref. [17]) | 2023 | An original article from France examining stress levels in parents during the first lockdown, which identified socioeconomic and family structure factors as risk modifiers. |
El-Osta A et al. (Ref. [18]) | 2021 | A UK cross-sectional survey on the mental health of parents during lockdown, which reported elevated depression and anxiety symptoms linked to childcare and homeschooling burdens. |
Achterberg M et al. (Ref. [19]) | 2021 | A Dutch longitudinal study on the mediation effect of perceived stress on parental and child wellbeing, which showed pre-existing negative emotions increased vulnerability to pandemic stress. |
Johnson MS et al. (Ref. [20]) | 2021 | A Norwegian longitudinal study following parents during and after the first lockdown, which found declines in clinically significant depression and anxiety over time, suggesting resilience in some families. |
Whaley GL, Pfefferbaum B (Ref. [21]) | 2023 | A review article summarizing parental challenges during the pandemic, which discussed risk and protective factors relevant to child outcomes. |
Gender Equality Bureau Cabinet Office, Japan (Ref. [22]) | 2021 | Japan’s official white paper on gender equality, including statistics showing a significant increase in domestic violence reports during COVID-19. |
Children and Families Agency, Japan (Ref. [23]) | 2023 | Japan’s official annual report on child abuse cases, noting a 5% increase in 2023 compared to 2022, with implications for child mental health. |
Cohodes EM et al. (Ref. [24]) | 2021 | An original article from the U.S. on parental buffering of stress during COVID-19, which found that supportive parenting can mitigate youth psychological symptoms despite pandemic stressors. |
Agostinelli F et al. (Ref. [25]) | 2022 | An economic analysis on the role of schools, peers, and parents in child development during closures, highlighting the unequal effects of shutdowns across families. |
Patrinos HA (Ref. [26]) | 2023 | A World Bank analysis quantifying learning loss per week of school closures, which estimated that long closures can result in learning deficits equivalent to nearly one school year. |
Goudeau S et al. (Ref. [27]) | 2021 | A review article on how COVID-19 lockdown and remote learning increased the social class achievement gap, which explained mechanisms by which inequalities in resources and support widened. |
Nippon Foundation and Mitsubishi UFJ Research and Consulting, Japan (Ref. [28]) | 2021 | A survey assessing the impact of COVID-19 on educational disparities in Japan, which found significant gaps in access to technology and learning resources. |
Johnson SB et al. (Ref. [29]) | 2024 | An original article from the U.S. showing developmental score declines in children aged 0–5 years during COVID-19, which affected communication, problem-solving, and personal-social skills. |
McDonald B et al. (Ref. [30]) | 2023 | A UK qualitative study on school attendance problems post-pandemic, which captured perspectives of parents and professionals on re-engagement challenges. |
Dessain A et al. (Ref. [31]) | 2024 | A systematic review of longitudinal cohort studies on children with ADHD during the pandemic, which found worsening mental health symptoms and functional difficulties. |
Tso WWY et al. (Ref. [32]) | 2022 | A Hong Kong survey of families during COVID-19, which identified greater psychosocial risk in children with special educational needs or from vulnerable families. |
Yamamoto T et al. (Ref. [33]) | 2022 | A Japanese caregiver survey on children with neurodevelopmental disorders during school closures, which found links between infection prevention difficulties and relationship changes post-reopening. |
Matano M et al. (Ref. [34]) | 2022 | A pilot study from Japan on internet-delivered parent–child interaction therapy for children with ASD, which suggested feasibility of remote intervention during pandemic restrictions. |
Ministry of Education, Culture, Sports, Science, and Technology, Japan (Ref. [35]) | 2023 | A Japanese government’s ‘COCOLO Plan’ addressing school refusal, which outlined goals for diverse learning opportunities, early detection, and inclusive school environments. |
Department of Defense Education Activity (Ref. [36]) | 2025 | Information from the U.S. DoDEA recognizing homeschooling as a valid alternative to formal school attendance, which provided an international comparison for Japan’s evolving policies. |
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Matsubara, D.; Kotani, K.; Osaka, H. School Refusal Behavior in Japan: The Impact of COVID-19 on Children. Children 2025, 12, 1105. https://doi.org/10.3390/children12091105
Matsubara D, Kotani K, Osaka H. School Refusal Behavior in Japan: The Impact of COVID-19 on Children. Children. 2025; 12(9):1105. https://doi.org/10.3390/children12091105
Chicago/Turabian StyleMatsubara, Daisuke, Kazuhiko Kotani, and Hitoshi Osaka. 2025. "School Refusal Behavior in Japan: The Impact of COVID-19 on Children" Children 12, no. 9: 1105. https://doi.org/10.3390/children12091105
APA StyleMatsubara, D., Kotani, K., & Osaka, H. (2025). School Refusal Behavior in Japan: The Impact of COVID-19 on Children. Children, 12(9), 1105. https://doi.org/10.3390/children12091105