Emotionally based school avoidance occurs when a student feels genuinely unable to attend school because of stress or other wellbeing barriers. How should we respond? Darren Martindale advises

It should go without saying that regular attendance at school is a prerequisite for pupils’ learning and achievement.

With the exception of pupils who have access to a good quality and effective home education, if they are not in school, they are not going to be learning.

This will obviously have serious implications, not only for their academic progress, but also their social development, mental and emotional wellbeing and physical health, as well their future chances of progressing into further education, employment or training.

It is no wonder, then, that pupils who become persistently absent are a major worry for schools, as well as parents and other adults with responsibility for supporting them.

There can be a variety of reasons for none-attendance, and some of these may be relatively straightforward to address. Other attendance problems, however, may not be so simple to solve, and can be extremely worrying, especially when a child is already vulnerable.

Within children’s services, when we look at the case histories of pupils who are vulnerable – children involved with social care and/or the youth justice system, for example – who have become disengaged from school, we often find that one of the first agencies to become involved was education welfare. Absence from school, especially in the earlier stages, can be a very good indicator of greater problems to come.

Emotionally based school refusal

But what to do about pupils who refuse to (or feel genuinely unable to) attend school because of stress or other barriers related to mental and emotional wellbeing, resilience, confidence or self-esteem? What if these issues are related to difficulties within a child’s home life or other issues outside school?

Emotionally based school avoidance (EBSA) – which has previously been known as emotionally based school refusal – is the term generally given to cases when a child avoids school for emotional factors. One of the first local authorities to regularly coin the term and offer concrete guidance was West Sussex, and their contribution to this area deserves reference (2018). Another local authority that has developed useful guidance is Derbyshire (Hull & Clarke).

On the subject of anxiety, Derbyshire’s guidance points out: “While EBSA is not, of itself, a mental health disorder, it is characterised by feelings of anxiety related to school attendance. Anxiety can be thought of as the body’s warning signal and is a normal response to a perceived or real threat.

“It can be helpful in terms of preparing the body for action by releasing the hormone adrenaline ... this is crucial when we need to escape from an immediate physical threat. Likewise in some situations, such as in an interview or exam, a moderate amount of anxiety can help an individual focus and concentrate.

“However, high levels of anxiety can, over time, become harmful, particularly when it starts to interfere with an individual’s ability to cope with the stresses and strains of everyday life.”

Fear. Anxiety. Negative thoughts. This grows into a powerful, embodied response akin to a physical illness.

Early intervention

The Department for Education offers general guidance for schools and local authorities on promoting school attendance (DfE, 2021). Most of the key principles of that guidance reinforces what I have to say here, such as the advice that school leaders should “make sure staff, pupils and families understand that absence from school is a potential safeguarding risk and understand their role in keeping children safe”.

However, some other approaches, such as “use physical presence to reinforce routines and expectations on arrival and departure”, while perfectly appropriate for the general school population, are likely to be counter-productive for pupils exhibiting EBSA. A more bespoke approach which is evidence-based and carefully tailored to a pupil’s individual needs and circumstances is more likely to prove successful.

This has been supported by research. Kearney (2008) highlights the importance of understanding the underlying reasons behind a child’s non-attendance. Kearney identified four potential key reasons: avoiding school-related stressors, avoiding aversive situations (such as social situations), attention needing or separation anxiety, or reinforcing activities (such as activities bringing enjoyment or gratification).

In most cases, there is no single or easily identifiable cause, but a complex interplay of different factors relating to school, the family/home, and other factors often outside school which would be contributing toward persistent school avoidance.

Clearly, early intervention is key and this will be supported by having a whole-school ethos which not only, as the DfE puts it, communicates “a clear vision for attendance, underpinned by high expectations and core values”, but also recognises the fact that there is no one-size-fits-all approach. As always, a properly managed assess-plan-do-review action plan is critical. In accordance with the principles of early intervention, schools should take a graduated approach, utilising the range of resources they have at their disposal and seeking advice and help at the appropriate stage and level, when it is needed.

As a pupil’s needs become more complex or specific, the need for support from external agencies is likely to increase and strategies will become more detailed and carefully targeted. If it becomes necessary to create a modified timetable or to seek alternative provision, that carefully staged approach will aid a school’s understanding of their pupil’s experiences, strengths, barriers and motivators, and help to ensure that the right package of support is put in place.

Assessment and planning

At the assessing and planning stage, it is useful to recognise that there are a number of factors which are often prevalent in relation to EBSA. These can be related to the school, the child, and their family or home environment.

School factors can include bullying (one of the most common), difficulties with school work and academic demands (with the obvious implication of a possible need for an educational psychologist’s assessment), anxieties over exams or other assessments, and difficulties with relationships with peers or adults.

Family-related factors can include traumatic changes such as bereavement, separation or divorce, high levels of stress within the family, and the health problems of parents or other family members.

Other factors related to the child can include confidence/self-esteem, hopes or aspirations, struggles with transition, anxieties such as separation anxiety, learning difficulties or the impact of past (and/or present) trauma. Then there are the wider factors around that child’s life or environment – religious or cultural, socio-economic factors, even their journey into and from school, can all be relevant or even pivotal.

Other factors can include difficulties with diet or sleep, communication difficulties and risk-taking behaviour. At the most worrying end, it could be a symptom of criminal exploitation.

Covid-19 has introduced a whole range of additional (or potentially increased) factors, such as death/bereavement, social isolation, increased risk of domestic violence and/or mental health issues, and anxieties around returning to school after partial school closures during lockdown.

Push and pull

Think about the resilience or risk factors – or “push” and “pull” factors. What might push a child toward attending school more regularly? What might pull them away and further into a pattern of none-attendance? If these questions can be discussed with the pupil, their answers are likely to be the best place to start the planning process.

Do you, as a school, have the right tools for this? There are frameworks which will help to write a detailed “risk profile” for a vulnerable pupil, and to properly identify their barriers and push/pull factors, then balance or prioritise these in terms of risk level, urgency or complexity.

Ask your educational psychology, education welfare or inclusion service for advice and support, if you need it. School leaders should also talk to each other! Discuss experiences, learning – successes and challenges – and share good practice.

Good day/bad day

A “good day/bad day” discussion can be a useful way to unpick a child’s difficulties with them. The following is adapted from advice developed by the Educational Psychology Service at Wolverhampton City Council:

  • Ask the child to think back to the last bad day they had.
  • Ask them to describe what happened and why it was bad.
  • Discuss with them what could have helped them on this bad day.
  • Now ask the child to describe what would make a good day.
  • Who helped to make this day good and what did they do?
  • They may struggle to describe a good day or a bad day, but can tell you about the last week in detail, so then you can gently ask which bits of the day were good and which not so good.
  • If the child has not had good days for some time, they may be able to tell you about a good day from their past.
  • When the child cannot tell you directly themselves, then family or support staff should be able to help.

A useful follow-up exercise to this can be to describe through words and/or pictures – simple drawings can be a powerful medium – the main elements of a good school, or a school that they like to go to, and then a bad school, or a school they would not want to go to.

Think about the pupil, their class mates, the other adults, the building itself, what would be happening and what that would look and feel like. By exploring the ideal school and classroom (and its opposite), we can start to dig down to their core values, or what is really important to them, and this information should be invaluable in informing your assess-plan-do-review plan to follow.

A good support plan

A good support plan for EBSA is likely to contain certain key elements. One is a restorative focus on relationships – peer-to-peer, child-to-family, pupil-to-teacher, home-to-school. It may be, for instance, that the child’s parents did not attend school regularly when they were young or had negative experiences of education.

Another is a sense of agency – pupils in this position often struggle with feelings of powerlessness or loss of control. Facilitate their input, look for ways to give choices around, for example, a staged return to school or the structure of the school day, at least in the early stages.

Transition is another area where pupils who struggle with anxiety are likely to need extra support. The transition from primary to secondary school, for instance – arriving, as it does, at a crucial stage in a young person’s development – can be hugely unsettling for a pupil who lacks confidence or resilience, or struggles with anxiety in any way.

Such a change involves loss and separation, and again, children may be particularly sensitive to this given the additional uncertainties of the pandemic.

These pupils are likely to need additional support before, during and after such changes. Going a step further in making sure that they are confident in finding their way around the school, for example, or knowing how and where to spend their unstructured time such as lunch breaks, as well as using peer mentors and buddy systems, can be critical in preventing any anxieties from blowing up into bigger problems including EBSA.

So, the back-to-school plan needs to be very carefully thought out, flexible, is likely to be gradual (while a part-time timetable should normally be a short-term measure, it may be necessary to re-introduce the pupil to situations that provoke anxiety in a gradual way), and may include the support of other agencies outside school, such as education welfare, other children’s services and therapeutic or counselling support if appropriate.

A good, individualised learning plan, developed along assess-plan-do-review principles, is not vague or “wishy-washy” in any way. It should contain SMART, personalised targets (which the pupil has helped to design) to improve attendance and engagement. These targets will tell the pupil exactly what they are looking to achieve, in bite-sized chunks, and what success will look like when they get there.

The process can include writing, drawing, talking, scaling, reflecting, and being as creative as you can be to move forward, one step at a time, and to understand that it may be three steps forward and one step back, at times. And at those times – when things do not work out as planned – don’t just throw the plan out: review, change, add, remove, adapt, and try again.

  • Darren Martindale is service manager for vulnerable learners, encompassing the role of the virtual school head, at City of Wolverhampton Council. Read his previous articles for Headteacher Update via http://bit.ly/htu-martindale

Further information & resources

  • DfE: Guidance: Improving school attendance: Support for schools and local authorities, last updated March 2021: https://bit.ly/3aoNyEZ
  • Hull & Clarke: Emotionally Based School Refusal: A guide for primary and secondary schools, Derbyshire County Council (undated): https://bit.ly/2QhQE71
  • Kearney: School absenteeism and school refusal behaviour in youth: A contemporary review, Clinical Psychology Review (28, 3), March 2008: https://bit.ly/2OZuC8k
  • Martindale: Supporting looked after children, Best Practice Focus pdf download, Headteacher Update, June 2020: https://bit.ly/3b6dQw4
  • Martindale: Darren Martindale has given advice on two episodes of The SecEd Podcast focused on supporting vulnerable children (June 2020, February 2021): www.sec-ed.co.uk/podcasts/
  • West Sussex County Council: Emotionally Based School Avoidance: Good practice and guidance for schools and support agencies, Educational Psychology Service, 2018: https://bit.ly/3gqtgie