Sensory Processing Sensitivity and Psychosocial Characteristics in Elementary School Children with School Refusal

Abstract Background School refusal (SR) in late childhood is often accompanied by emotional distress, yet temperamental factors conferring vulnerability remain insufficiently understood. Sensory processing sensitivity (SPS), within the environmental sensitivity framework, may amplify stress reactivity and maladjustment; however, evidence in elementary school–aged children is limited. This study examined SPS and related psychosocial characteristics in children with and without SR experiences. Methods Japanese children in Grades 3–6 with current or past SR (SR group; n = 27) and peers with regular attendance (RA group; n = 35) completed self-report measures of SPS (Japanese version of the Highly Sensitive Child Scale for Childhood; J-HSCS-C), stress responses (Children’s Stress Response scale; CSR), and interpersonal sensitivity (Short Forms of the Children’s Interpersonal Sensitivity Measure; CISM). Parents completed the J-HSCS-C. Group comparisons and within-group correlations were conducted. Results The SR group reported higher overall SPS than the RA group (J-HSCS-C mean 5.12 vs. 4.53; t(60) = 2.19, p = .033, d = 0.56). Differences were concentrated in the combined Low Sensory Threshold/Ease of Excitation (LST/EOE) facet (SR > RA; z = − 2.54, p = .011), whereas Aesthetic Sensitivity did not differ. The SR group showed markedly elevated stress responses (CSR total: z = − 4.39, p < .001), while no significant group differences were observed for CISM scores. In the SR group, SPS was positively associated with stress responses (SPS mean with CSR total: r = 0.44, p < .05) and negative interpersonal sensitivity (SPS mean with CISM-NIS: r = 0.42, p < .05). In the RA group, SPS was associated primarily with negative interpersonal sensitivity (SPS mean with CISM-NIS: r = 0.54, p < .01) and showed no significant association with CSR total (r = 0.30). Exploratory parent–child analyses suggested clearer correspondence in the SR group (total SPS: r = 0.45, p < .05) than in the RA group (total SPS: r = 0.22). Conclusions Children with SR experiences may be characterized by elevated SPS—particularly LST/EOE—alongside heightened stress reactivity. Considering SPS may be useful for assessment and support planning for elementary school children experiencing SR.