For some students, missing school isn’t about wanting to sleep late or simply not wanting to go to class.
Anxiety, depression and other mental-health challenges can make walking through the doors of a school feel nearly impossible.
A Cherry Hill-based program that has spent two decades working with students facing those challenges is continuing its efforts to address school refusal and chronic absenteeism.
First Children Services operates its Transitions Program at 1256 Marlkress Road in Cherry Hill, offering a small-group, center-based instructional setting for students in grades five through 12 who are unable to regularly attend their public schools because of school refusal, anxiety or other mental-health concerns.
The program combines full-day individualized instruction with counseling from licensed clinicians, who also work with families and outside treatment providers. Its goal is to help students develop coping skills and confidence, return to a classroom-like environment and, when appropriate, transition back to their home districts.
“We can’t just send kids home because they’re anxious or depressed and they’re not coming to school,” said Caitlin Summers-Motta, director of business development and mental health services for First Children Services. “We can’t. That’s not helping.”
Transitions was developed about 20 years ago by a group of pediatricians and a special educator as an alternative for students who might otherwise receive traditional homebound instruction.
First Children notes that while home instruction can provide an immediate educational solution, remaining at home can socially isolate a student without addressing the underlying issue preventing regular school attendance. Transitions instead puts students back into a group learning environment with peers.
Students arrive at Transitions through a variety of circumstances. Some enter following hospitalization or participation in an intensive outpatient or partial hospitalization program, using Transitions as an intermediate step before returning to a larger school environment.
Others have developed an ongoing pattern of absences as anxiety or another mental-health concern increasingly interferes with their ability to attend.
Placement is made in partnership with a student’s school district, which must agree that the program is appropriate.
Summers-Motta stressed that school refusal is different from the occasional morning when a child simply doesn’t want to go to school.
School refusal involves an ongoing pattern, she explained, and can be connected to a student’s attempts to escape or avoid something associated with the school environment.
The reasons aren’t always obvious.
Some students may enjoy learning and want to attend school but feel physically unable to enter the building. Others may repeatedly visit the school nurse, feel sick before school or say they don’t feel comfortable in their school environment.
“I like school,” Summers-Motta said some students will tell staff. “But I can’t. I don’t fit in here. I don’t feel comfortable here. I get sick coming to school.”
That distinction is important when separating school refusal from truancy.
A student experiencing school refusal may technically be considered truant because of the number of days missed, Summers-Motta noted, but the underlying reason for the absences can be very different.
“These friends want to come to school,” she said. “They just cannot. It is a trigger. The building is a trigger.”
That is one reason the Transitions center was intentionally designed not to feel like a traditional school.
There are no bells, and Summers-Motta described the atmosphere as quiet, calm and neutral. One former student even told her the building looked more like an insurance broker’s office than a school.
For students who associate a traditional school building with anxiety, that neutral environment can be part of the process of becoming comfortable with attending every day.
Students generally attend from about 8:30 or 8:45 a.m. until 2:30 p.m. and follow a traditional eight-period schedule.
The program’s teachers are certified by the New Jersey Department of Education and its curriculum follows the New Jersey Student Learning Standards. First Children is also a state Department of Education-approved clinic and agency for counseling and home instruction. Students do not need an IEP or 504 plan to attend, and transportation is typically provided by the sending school district.
Transitions offers core academic classes, honors-level courses and a range of electives. Staff obtain students’ transcripts and work to align their schedules with what they were taking in their home districts, Summers-Motta explained. That helps students continue earning the appropriate credits and can make a future return to their home school smoother.
Mental-health support is incorporated throughout the day.
Two social workers provide regular individual and group counseling, with additional sessions and check-ins available when students are having difficult days. First Children says counseling may incorporate cognitive behavioral therapy, mindfulness, social-skills development and family support. Its licensed clinical social workers also coordinate with students’ families and outside treatment providers to maintain continuity of care.
The program serves no more than about 35 students in the building at a time, according to Summers-Motta.
First Children also works directly with school districts to provide mental-health and behavioral-stabilization services inside schools. The organization operates other services in New Jersey and Pennsylvania, including autism clinics, approved private schools for students with disabilities, homebound instruction and school-based mental-health programs.
Summers-Motta said identifying struggling students early is important.
Chronic absenteeism is generally associated with missing about 10% of scheduled school days, she explained, but families and educators shouldn’t necessarily wait until a student reaches that point to start asking questions.
After five, six or seven missed days, she said, it can be worth beginning a conversation about why a student is having difficulty attending.
“We want to get in there early,” Summers-Motta said.
Finding the underlying cause can be complicated.
Summers-Motta compared addressing chronic absenteeism and school refusal to a game of “whack-a-mole.” A student might initially identify a math class as the reason they don’t want to attend. Once that issue is addressed, another concern may emerge – perhaps a particular teacher, social situation or another source of anxiety.
Determining what is actually driving the behavior can require more extensive counseling and clinical intervention than schools are equipped to provide independently, she said.
The program currently begins at fifth grade, but Summers-Motta said anxiety and school-related difficulties aren’t limited to older students.
Younger children may exhibit their struggles differently, including through disruptive or behavioral symptoms, and some may receive support through partial-care programs or additional services within their schools.
Summers-Motta said First Children has discussed the possibility of an elementary-level program, particularly as educators continue to see challenges among children who were very young during the COVID-19 pandemic.
“We think this is the real COVID group coming through right now,” Summers-Motta said of children now in kindergarten through second grade.
First Children is also using its Cherry Hill location to bring educators, families and community members into the conversation about student mental health.
The organization will host a Lunch and Learn from 1:30 to 3 p.m. on Wednesday, Oct. 7, at 1256 Marlkress Road. The presentation, “Anxiety & Autism: Understanding the Connection, Empowering Success,” will be led by Tara Fleck, Transitions Program Manager for First Children Services.
Fleck will explore how anxiety presents in individuals with autism and share strategies to support regulation, confidence and daily success. Food and refreshments will be provided, attendance is complimentary and seating is limited.
The organization also holds an open house every Thursday from 2 to 4 p.m. at its Cherry Hill location, where educators, families and community members can learn more about Transitions.
“When a student stops attending school, waiting isn’t the answer,” First Children CEO Matthew Hess said. “Transitions combines individualized education with clinical support to help students rebuild confidence, reconnect with school, and ultimately return to their home district ready to succeed.”
There isn’t a single timetable for that return.
Some students may spend a semester in Transitions before returning once appropriate supports are in place. Older students, particularly juniors and seniors, may remain through graduation if their district determines that is the environment in which they can be most successful.
Summers-Motta said former students have gone on to pursue a range of paths, including medical school and social work.
For her, success ultimately comes down to helping students reach graduation and whatever comes next.
“I just want my kids to be able to graduate,” Summers-Motta said.
Those interested in learning more about Transitions can contact Summers-Motta at csummers@firstchildrenservices.com or 856-250-8737.
