Newsletter Number 18,
Emotionally-Based School Avoidance
How many children won't return to school this week; not because they're ill, a bit apprehensive or don't want to - but because they can't?
Previously referred to as "school refusal", emotionally-based school avoidance (EBSA) is on the increase. It describes the significantly reduced or total non-attendance at school by a child or young person. The understanding of it requires recognition that it is not "just a behavioural issue", but emotionally-based school avoidance has its root in unmet emotional needs, mental ill-health or poor wellbeing.
The 2022 Attendance Audit from the Children’s Commissioner, Rachel de Souza, identifies that in Autumn of 2021 1 in 4 children were persistently absent. In 2018-2019, the figure was 1 in 9, so persistent absence has more than doubled in this time period. Notable risk factors for such high numbers of non-attendance include anxiety, depression, other mental health concerns, stress and vicarious or "second-hand" trauma, such as a young carer's fear of leaving a vulnerable parent at home.
Some possible signs of emotionally-based school avoidance include:
When the anxiety is linked to school avoidance, the young person may experience anxious and fearful thoughts around attending and coping with school. These feelings may also be accompanied by physiological symptoms such as:
Losing consciousness can also occur in severe cases
These may start the night before or a few days before they are due to return to school. They may also begin during the school holidays, particularly at this time of year following the long summer break.
Many school-age children will be recorded as having regular periods of absence or persistent non-attendance going back for several days, weeks, months or even years. While working for the local authority I sat on the Attendance Panel and heard from families where even the threat of prosecution carrying a fine of up to £2,500 per parent, a Community Order or a custodial sentence of up to 3 months. The court also gives a Parenting Order, but the risk of this outcome was the better option than manhandling their child through the school gates and into the classroom.
Since the onset of Covid in 2020, many children have not attended school and registered as having unauthorised absences. As the lockdown was lifted many didn't return to school and their parents have either continued to keep their children at home, unchallenged by the school or local authority attendance officers or have defied formal requests for their child to attend. Between March 2020 and March 2022, the number of children registered as electively home educated supported by my team in one West Midlands borough grew by 110%.
As a new autumn term begins, the biggest challenge for many schools is getting children through the door. After three years of constant interruptions to education, from lockdowns to Covid outbreaks and teaching strikes, attendance has crumbled. Persistent absence, defined as missing more than 10% of lessons, more than doubled from 8% of primary and 13.7% of secondary school children pre-Covid across England to 17% and 28% respectively in 2022-2023.
Rachel de Souza, calculates that of the 1.6 million children persistently absent during the autumn and spring of 2021-22, 818,000 were off for reasons other than the usual childhood illnesses. Many of these absentees are worryingly vulnerable: children with special educational needs or disabilities (SEND) and children on free school meals are disproportionately more likely to be persistently off. But absence is a complex, many-headed hydra.
Millie was seven years old when she started struggling with going to school. Her teachers weren’t too worried initially, her mother Sarah, said she was managing fine academically. But Millie, who is autistic and has a sensory processing disorder, seemed to find the busy classroom overwhelming. The following year, she began seriously to resist.
The first Covid lockdown in spring 2020 was, for Millie, a welcome relief. “You weren’t allowed to go to school, you weren’t allowed to leave the house, nobody was allowed to come round – it was good for her.” Sarah explained. That September, Millie returned to school armed with an Educational Health and Care Plan (EHCP), a statement of her special needs, which was meant to guarantee specific support in school. But her mother says it wasn’t consistently followed. Millie began having panic attacks, and the following autumn. “She just had an absolute meltdown, breakdown, whatever you want to call it. So she stopped going to school.”
The strain on the family is intense: Sarah has stopped work, her husband had a breakdown himself last year, and she feels judged by other parents. “People say, ‘Just tell them they have to go; shout at them, take their iPad away.’ And I say, ‘It’s not that they don’t want to go to school, it’s that they can’t.’”
But perhaps the most perplexing problem facing headteachers is an apparent wave of chronic anxiety in children. For some children who found school difficult and craved the comfort of home, leaving the cocoon of lockdown was obviously tough. But for others, anxiety seems to have emerged only under the stress and isolation of the pandemic. And sometimes children’s own feelings can be hard to disentangle from those of parents anxious about mixing socially again. Whatever the cause, this autumn offers a critical opportunity for a fresh start.
While Rachel Souza and the education secretary Gillian Keegan are said to be "preparing an autumn offensive", appealing this summer for heads to "fetch children in from home themselves if necessary", parent groups say crackdowns on non-attendance risk stigmatising those whose children genuinely can’t cope. They want better pastoral care and SEND provision in schools instead, and for children’s happiness to be prioritised. “All we’ve been measuring is results, tests, exams,” says the director of Square Peg, Ellie Costello. “I think our children have been holding a mirror up to us – the life we are asking them to live, the expectations on them, the pressures on them.” This isn’t just an argument about attendance – in part, it’s about the nature of childhood itself."
She thinks schools can help by teaching strategies for managing anxiety. Visiting a secondary school in Bolton where a staggering 30 local parents had died of Covid, she expected to find the pupils traumatised; but instead they talked about how teachers had helped them support each other through tough times. “These children were in the worst situations and they were finding a way to grow through it and not let it hold them back.” The key, she argues, is fostering emotional resilience, or the ability to bounce back from difficult experiences.
Relationships are key at this trauma-informed school based on understanding how childhood trauma affects development, serving a proud but deeply deprived neighbourhood. Pupils speak 30 languages between them, a third have SEND and almost half are eligible for pupil premium; some have had difficult early lives. The headteacher is fiercely ambitious for them and so, she says, are their parents. The school has above average attendance for the area. “I can’t think of any of our families who don’t want the absolute best for their children, who don’t have the same aspirations they’d have if they lived in the [more affluent] south end of the city. It’s that some face different barriers we have to support them to overcome.
The deputy head has led a programme within school teaching children to regulate their emotions, helping them calm themselves when they’re anxious or angry and settle down to learning. Called the "Zones of Regulation", feelings are colour-coded: the red zone is for anger or fear, yellow for anxiety or over-excitement, blue for sadness and to help children identify emotions and understand that they can change zones by using simple strategies. The children are encouraged to be in the green zone and this can be effectively used by parents.
“Instead of coming in saying, ‘He’s really angry this morning’ they can say, ‘He’s in the red zone, I’ve tried to get him in, I don’t know what to do,’” She says. "Previously, parents might end up shouting at children to go to school in desperation, but now they have other tools. Parents who have done the work on emotions, they understand the children are not being awkward.”
This is a very different approach from schools where the rules are very clear and rather punitive. Failure to call in and explain absence from school or its attached nursery prompts a call or home visit, and parents are fined for taking term-time holidays. Instead, if children are off sick, the school’s family liaison officer will use her judgment on whether to call parents and gently try to find out if complaints of tummy ache might be masking something else. “If you know the child, you know the family, you can speak to Mum and say, ‘Do you think this is anxiety?’ and we will get to the root of it,” she explains. Sometimes she’ll offer to fetch a child herself in the morning, and some pupils sit with her for 10 minutes before the day starts, to calm themselves. The idea is to do whatever it takes to get anxious children in, so absence doesn’t become a habit; parents are reminded that lessons build on each other, so if a child misses one day, the next will be harder. But the key is winning families’ trust, she says. “They know me and I know them, they can ring me on my mobile if they’re having a bad morning.”
She explains that the whole approach is to walk a mile in parents’ shoes rather than blaming them if they can’t get their children in. “It’s easy to sit in judgment and say, ‘You’ve got to do this, you’re the parent, it’s your responsibility.’ If you say that without underpinning it with support for the child or the parent, you’re just adding pressure to an already pressured situation.”
While such a policy may be easier in a small primary school where teachers can get to know all the families, it might not suit a big, anonymous secondary. But primaries can help secondaries by ingraining good habits early on. Research shows children who attend nursery aged two go on to have better school attendance records when they’re older. It’s by starting with the youngest children that attendance seems most likely to be cracked in the end. Millie’s mother Sarah believes: “ It’s getting the people who have the power to make things change.”
The Anna Freud Centre’s resource on EBSA (annafreud.org)
Parents can also find helpful information on how to help their child get through tough times with school anxiety and refusal on the BBC Parents’ Toolkit Addressing emotionally-based school avoidance: School anxiety and refusal: How parents can help their child get through tough times - BBC Parents' Toolkit - BBC Bitesize.
Mentally Healthy Schools also has a resource on addressing emotionally-based school avoidance: Mentally Healthy Schools.
There are resources co-produced with parents to provide advice and tips to support children and young people with EBSA. Emotionally Based School Avoidance (EBSA) resources for children and families - Suffolk County Council.
Children, schools and parents are not alone in the necessity to address the paralysing effects of emotionally based school avoidance, but the right approaches are needed to prevent the perpetuation of this traumatically stressful situation for many years to come. Details taken from: ‘Children are holding a mirror up to us’: why are Britain’s kids refusing to go to school? | Schools | The Guardian.
It's likely that there will be pupils who have additional anxiety, following the concerns regarding Reinforced Autoclaved Aerated Concrete (RAAC) that has been used in British schools. Fears that the building may collapse on top of them or additional time off while the problem is resolved may compound existing emotional issues. There may also be pupils who have not previously had worries about attending school for whom this event will trigger a new anxiety. Their concerns should not be dismissed as simply being caused by a "media frenzy" that will soon subside; appropriate support and reassurance for these pupils should be provided.
To access my support for professionals, parents or for a child, please email:
In my own experience during a combined period of 16 years, I worked with children who were home educated and children with behavioural issues. In both roles I saw a range of approaches to overcoming emotionally-based school avoidance. Most of them were at best negative and at worst violent. Unfortunately, inappropriate manual handling, verging on physical assault - observed by parents and/or staff was common.
“It would start the night before,” says Sarah, a children’s nurse. “She couldn’t sleep, couldn’t eat her dinner, then in the morning she’d be absolutely flat out – it was taking an hour to get her out of bed. I would have to dress her, she’d be like a rag doll. And all the time they kept saying, ‘Just get her in, she’s fine once she’s in.’ It got to the point where I was physically unable to carry her, she’d be lying on the floor kicking and screaming.”