Emotional Based School Non Attendance or EBSNA used to be known as ‘School Refusal’ and is really a kind of school phobia or school-specific anxiety. The negative connotations that went along with the term ‘school refuser’ implied in the past that the child was choosing to refuse to go to school, when we know very clearly that this is not the case. Children who are struggling with EBSNA often report that they want to go to school, but that they cannot overcome the anxiety which is hindering them. To better understand, it is important that we listen to the views of the children for whom this is increasingly a barrier to education in this country.
“Through years 8 to year 10 (age 12 to 15) I felt genuinely scared to go to school. The idea of walking through the school gates made me feel scared and made me feel sick. The school was not supportive of me, and I felt that no one beyond the school gates cared about my wellbeing. It felt as if the only thing that they cared about was my attendance and they had no empathy or understanding of my situation. I felt embarrassed to tell the support people at school how I felt because I knew that they wouldn’t do anything different. I used to cry every morning and it would be a physical battle to get me into school. Inside school, I felt trapped and felt like I couldn’t be myself -I wanted to leave and never go back. I didn’t enjoy anything anymore and I was always sad. I was constantly upset, stressed and worried. School made me lose myself. “B, aged 17 (Square Pegs, p 12)
Understanding the emotional impact that EBSNA has on children is paramount, not only so that we can empathise, but critically, so that we can begin to work together to help and support children, parents/ carers and schools who are facing the immense challenge that EBSNA is. Here it is important to remember to recognise and validate your child’s emotions.
ESBNA manifests as a pronounced physical anxiety response towards attending school.
Signs may include:
- Inability to go to school
- Physical illnesses like tummy ache, headache, vomiting
- Excessive worry or crying especially when thinking about school
- Panic attacks in school or on the way to school
- Hiding in the toilets at school
- Inability to sleep
- Low self- esteem
Statistically, the rate of children who are persistently absent (absent more than 10% of the time) or severely absent (absent more than 50% of the time) in schools in England according to the Education Statistics Service of gov.uk has been steadily increasing since before the COVID-19 pandemic. The figures for the 2022/2023 Autumn term showed that the persistent absence rate was now at 22.3% compared to pre-pandemic levels of 10.9% in 2018/2019. Persistent absenteeism has effectively doubled with an overall increase of 117%. With numbers so high, it’s quite likely that you know of someone who is suffering from this type of school avoidance or indeed that your own children are suffering.
So, what are the factors that we see are present in EBSNA and what can we do about it for our children? While there may be many factors that play a part in a child showing signs of not being ok in school, there are some triggers and influences found to be more significant than others in a recent survey:
School Environments: This could be bullying, school ethos, environment or climate, or even just transitioning from one school to another.
Diagnosed Mental Health Difficulties: Anxiety, Depression and trauma can play a part in the welfare of the child.
Special Educational Needs and Disabilities: This can be any SEND from mutism to being gifted and talented, it can be dyslexia or dyscalculia, dyspraxia and may mean that the child has an EHCP plan in place or that they have no plan in place yet.
Autism: Autism and Neurodiversity is often a factor as either suspected or diagnosed in their child who is not attending school.
Physical Illness: This can range from migraine, chronic fatigue syndrome to irritable bowel syndrome, asthma, cystic fibrosis, endometriosis, postural orthostatic tachycardia syndrome (POTS). (NFIS Parent Survey Results 2018-2020)
It’s most likely that one of these is present in many cases of EBSNA, and underlying all of these are the signs we see in the child – usually extreme anxiety or ill health related symptoms.
Once this type of anxiety starts, a child can quickly lose confidence, putting another barrier in the way of attending school.
Once they have missed school significantly, they will most likely find that they are behind in lessons or confused and lost as to how to get back into learning, further adding to their anxiety. The child may find that there is now negativity and added pressure directed towards them either from peers or school staff, to catch up or just get on with it and they find themselves in the grip of a vicious circle.
So, what can families do?
- Firstly, know that you are not alone. With nearly a quarter of young people suffering with EBSNA there is support and there is a community. Please see the links below to one of the biggest support groups NFIS (Not Fine in School).
- Speak to the SEND coordinator in school. It is important from the beginning that parents and schools work together to establish a working relationship for the children who are avoiding school, so speaking to the SENDCo or Inclusion Manager in your child’s school is vital.
- Look after your own mental health. Going through this challenge takes a huge toll on parents and carers, often leading to feelings of inadequacy or failure of some sort. The frustration that parents face when dealing with EBSNA and the effort that parents make to find support affects the whole family. It often has an impact on parent’s ability to continue in employment. It is important to look after your own mental health by getting the support that you need from trusted friends or family, professionals or online support groups. If you are worried about a particular event or situation, it can be really helpful to discuss this with someone you can trust.
- Find out as much as you can about how to manage anxiety. Learning how to lower the stresses in our life, by changing our thinking can be key to improving our chances of recovery from anxiety. This can be helpful for parents and carers to learn how to do for themselves, but can be incredibly helpful at modelling resilience, positive attitudes and more long term mentally healthy behaviour.
- Refrain from appropriating blame onto others, yourself or your child for EBSNA. Instead of blaming anyone, put your efforts into seeking professional guidance, support and community. Engage in a collaborative approach that lets your child know that you are on their side, with a common goal of their wellbeing and educational growth.
It’s important to remember that EBSNA is a complex issue that requires understanding, support and intervention from caregivers, educators and mental health professionals.
They way that Youth Fairies work with young people helps to support the reduction of stress, anxiety and negative thinking which may have become entrenched for the child with EBSNA. Getting early and regular support from mental health professionals can help a young person to navigate the overwhelming feelings and emotions attached to EBSNA. Reach out to a Youth Fairy in your area for support, or for an initial consultation to see just how we can help.
For further support on EBSNA please see the following links to websites, mental health charities and books for further reading.
“Square Pegs Inclusivity, Compassion and Fitting In: A guide for schools” Fran Morgan with Ellie Costello Edited by Ian Gilbert
“Troublemakers: Lessons in Freedom from Young Children at School” Carla Shalaby
“The Orchid and the Dandelion” W. Thomas Boyce, MD