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Perfect storm: emotionally based school avoidance in the post-COVID-19 pandemic context

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School absences have risen following the COVID-19 pandemic and persistent absenteeism remains high in primary and secondary schools in England compared with pre-pandemic levels. This coincides with an upward trend in emotionally based school avoidance (EBSA). EBSA adversely affects children’s educational attainment, health, social functioning and life prospects and warrants early intervention before a pattern of absenteeism becomes entrenched. In this article, we consider how the COVID-19 pandemic and its sequelae have created a ‘perfect storm’ of conditions, amplifying known school, family and child-based risk factors for EBSA while simultaneously reducing access to support services. We then outline priorities for developing new EBSA interventions and argue for a multi-component approach, which works across education, health and social care, and voluntary sectors to address the complex interplay between risk factors. Given the difficulties that families often face in obtaining timely support for EBSA, it is also essential that new interventions are accessible, resource-efficient and scalable. To this end, we specifically discuss the potential for contextually-sensitive, parent-focused interventions that can be delivered online with minimal synchronous support from a trained coach or facilitator.

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✉Elizabeth Pellicano, Department of Clinical, Educational and Health Psychology, UCL, London, UK. Email: l.pellicanoucl.ac.uk

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“He’s shouting so loud but nobody’s hearing him”: A multi-informant study of autistic pupils’ experiences of school non-attendance and exclusion

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Children and young people on the autism spectrum frequently report a range of negative educational experiences and face disproportionally high rates of school non-attendance, including school avoidance and permanent exclusion, which can have a…

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High prevalence in ASC, advice to use 'School Distress' as term for non attendance

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Options to have a voucher if not able to access school dinners but eligible for them

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3 mins read

Human rights lawyers have written a free school meals guide and four template letters to help families whose disabled child is eligible for free school meals, but can't access them in the standard way.

Who are the resources for?

Many eligible disabled children are unfairly missing out on a free lunch because they can't attend school or are unable to eat the meal provided due to dietary or sensory needs.

You can use these letters to ask your child's school to provide an alternative, such as a supermarket voucher.

The four letters cover:

Children who are in an independent/non-maintained school.

Children with have Education Otherwise Than At School (EOTAS).

Children on roll at a state-maintained school, academy or free school and eligible because they are in Reception, Year 1 or Year 2.

Children who are financially eligible for free school meals and on roll at a state-maintained school, academy or free school.

You can highlight your particular situation in our online flow chart. You'll be directed to the correct template letter to use. The letters include important information including who to send the letter to at the school or local authority.

Please note: these letters were written for those living in England. We will be writing letters for children living in other parts of the UK, and they will be available soon.

Written by human rights lawyers

Public law human rights lawyers Alex Rook, Rosie Campbell and Katie Sinclair from Rook Irwin Sweeney and Steve Broach from 39 Essex Chambers wrote the free school meals guide and template letters.

Parent and founder of the free school meals campaign Natalie Hay independently raised funds through a crowdfunding website to enable the legal team to do this.

Imogen Steele, Contact's Policy Lead on free school meals, said: "A third of eligible disabled children are missing out on free school meals, worth £570 a year. This number will grow as free school meal schemes expand to more pupils across the country this year.

"We are calling for swift action from the government to update its guidance to ensure this discrimination is stopped. In the meantime, we must ensure as many disabled children as possible get the school lunch they are entitled to. The letters and guide are a great tool for making that happen."

Free school meals webinar recording

As part of the campaign Contact hosted a webinar featuring lawyers Alex Rook, Steve Broach and campaign founder Natalie Hay. The webinar is available to watch back here.

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Free school meals: New parent carer guide and template letters to use if your disabled child is missing out

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Human rights lawyers have written a free school meals guide and four template letters to help families with this issue.

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Dr Mollie Higgins, Educational Psychologist, shares the key themes and outcomes of her doctoral research around Autistic Young People experiencing Emotional Based School Avoidance (EBSA). Mollie has been working alongside Dr Jerricah Holder to create a new chapter for the EBSA Horizons EP Course - Supporting Autistic CYP experiencing EBSA. To be released early next year. Sign up here to access the course. The Ideal School: EBSA and Autism
In addition to the risk factors for EBSA, autistic young people experience a number of differences which further increase their feelings of anxiety within the school environment. These include:

Differences in identifying and describing their own and others' emotions

Emotional regulation difficulties

Differences in sensory processing and finding the sensory environment overwhelming e.g. loud corridors, different smells, busy classrooms

Difficulties understanding and predicting social situations and managing interactions with others

Worries around change or transitions e.g. moving between classrooms, changes to timetables, supply teachers

Executive functioning and organisation difficulties - remembering books, homework, equipment

Masking - try to 'fit in' or attempting to appear more neurotypical by changing their behaviour and internalising any anxiety

Experiencing performance anxiety related to the schoolwork or exams

These challenges mean that some autistic students try and manage their anxiety by avoiding school altogether. This is reflected in statistics which show higher levels of EBSA amongst autistic students (Department for Education, 2021). I felt it was important to speak with students directly to hear their views and opinions about what might help them attend school.

I asked ten autistic secondary-age students to describe the best school ever and the worst school ever. This technique is known as The Ideal School and is based on Personal Construct Psychology. By asking students to describe their ideal and non-ideal schools, I was able to understand the type of adjustments that would help these students feel more able to attend school.

Five key themes were identified from the data and the key points are summarised below.

So What Can Schools Do?

This technique was adapted by Williams and Hanke (2005) using Moran's (2001) Drawing the Ideal Self.
If EBSA is an area which you're supporting CYP with, we've been fortunate to work with Dr Jerricah Holder on her EBSA Horizons courses for Educational Psychologists and School Staff. - New ** EBSA Horizons | School Training
Stay connected with news and updates!

Sign up to receive updates, resources, inspiring blogs and early access to our courses.
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Sharing EP Practice: EBSA and Autism - What Can Schools Do?

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Dr Mollie Higgins, Educational Psychologist, shares the key themes and outcomes of her doctoral research around Autistic Young People experiencing Emotional Based School Avoidance (EBSA). Mollie has been working alongside Dr Jerricah Holder to create a new chapter for the EBSA Horizons EP Course - Supporting Autistic CYP experiencing EBSA.

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Free Resources and Advice

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5 steps to mental health and wellbeing framework for schools

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5 steps to mental health and wellbeing framework for schools

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What's it like to be a family with children who struggle to attend school? 

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What's it like to be a family with children who struggle to attend school? 

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What’s it like to be a family with children who struggle to attend school?

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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

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Emotionally based school refusal: How can we respond? vulnerable children mental health anxiety Covid wellbeing attendance

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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

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Helping you support autistic children and young people since 2007

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Our Being Misunderstood report highlights that 70% of children with a PDA profile of autism are not in school or regularly struggle to attend. This figure is much higher than for the ASD population as a whole, and shows how challenging school can be with PDA.

This page is for families and includes information on: specialist SEN organisations; requesting support in school; Education, Health & Care Plans & assessments; school placements & other options; and school refusal.

Information for teaching professionals, including helpful educational approaches for PDA, can be found here and in our information sheet for teaching professionals.

Specialist SEN organisations

The information below provides just a brief overview and we strongly encourage you to contact these specialist SEN organisations which can provide up to date information about securing support in school and navigating the legal process:

Legal duties of schools & LAs

​The information below relates to the current legislation and guidance applicable to England - the process may be different if you live in other parts of the UK. The relevant codes of practice are England: SEND code of practice 0-25 years; Northern Ireland: SEN Code of Practice and Supplement to Code; Scotland: Supporting Children's Learning Code of Practice; Wales: SEN Code of Practice for Wales

Schools and local authorities have a legal duty to ensure that they identify and support the special educational needs (SEN) of children for whom they are responsible.

Part 3 of the Children and Families Act 2014 places legal duties on Local Authorities (LAs) to identify and assess the special educational needs (SEN) of children and young people for whom they are responsible. LAs become responsible for a child/young person in their area when they become aware that the child/young person has or may have SEN. They must then ensure that those children and young people receive a level of support which will help them "achieve the best possible educational and other outcomes" - Section 19 (d).

​A child does not require a medical diagnosis of a specific disability before a school or local authority should identify, assess and support a child's special educational needs.

Needs are usually grouped on four broad areas of need and support: Communication and interaction; Cognition and learning; Social, emotional and mental health; and Sensory and/or physical needs.

Requesting support in school

If you feel that your child has special educational needs and requires additional support in school, the first step is to arrange an appointment with your school SENCO (Special Educational Needs Coordinator) to discuss your concerns. Request that your child is named on the school's SEN Register and ask for an Individual Education Plan (IEP), sometimes known as a Personal Provision Map, to be drawn up for your child.

There are lots of education-specific PDA resources you can share with your child's school about PDA, including our information sheet for teaching professionals and the PDA PANDA Approaches resources for teaching professionals which we co-produced with Twinkl.

It is very common for autistic children to mask or camouflage their differences/difficulties with different people or in different settings. There can often be a mismatch between behaviours at school and at home, which can lead to misunderstandings, so it may be helpful to share information about masking with your child's school if you feel this is a factor.

The school may arrange for your child to be seen by other professionals and agencies in relation to your child's needs: this could be the local inclusion support team, local autism outreach service, a speech & language therapist, an occupational therapist, a paediatrician, an educational psychologist, CAMHS (Child & Adolescent Mental Health Services) or social services (children's disability team). Parents can also request support directly from these professionals.

Education, Health & Care Plans

Local Authorities have a duty to assess a child or young person's education, health and care (EHC) needs where they may have SEN and may need special educational provision beyond what may be considered 'reasonable adjustments'.

An EHC assessment can be requested by the school or college, by a professional or by parents/guardians (young people aged 16-25 can also make the request themselves).

Once a request is made, the LA must respond within 6 weeks to say whether they will or won't carry out an assessment. If the LA refuses, reasons must be provided and the decision can be challenged via mediation or a Special Education Needs & Disability Tribunal. If the request is granted, an EHC needs assessment is undertaken and the LA will decide whether or not to issue an EHC Plan (EHCP). If a plan is refused, again reasons must be provided and the decision can be appealed. If a plan is issued, a draft must be provided for the parents or young person to consider. Only at this stage will the parents or young person be asked to name the type of provision (e.g. mainstream or specialist setting) or specific individual placement they wish to have included in the plan.

Please see our guide for Education, Health and Care Plans to support a PDA profile of autism for more information and examples of good practice.

School placements & other options

There are many different educational settings which may be able to successfully accommodate PDA:

Mainstream schools (many PDA children may need some extra support via a Teaching Assistant and/or small group work)

Mainstream with an attached unit (usually an ASD unit)

Alternative provision

Local Authority special school (an ASD school or a school for children with 'social, emotional or behavioural difficulties' for instance)

Independent school (smaller class sizes can work well for PDA children)

Independent specialist school

Specialist residential school (38 week or 52-week placements)

There isn't one single 'ideal setting' for a child with a PDA profile of autism but all successful placements tend to share a similar ethos: a genuine commitment to inclusion; strong support from the leadership team; a willingness to learn and adapt; a positive, creative and flexible outlook; and a commitment to working closely with the family.

There are some excellent examples of good educational practice for PDA children and there have been particularly positive outcomes in alternative placements which don't 'look like' school or with flexi-schooling (a combination of some time in school with some time at home and/or in an alternative setting).

Don't be afraid to ask lots of questions, share information about PDA and recommended education approaches, and have several visits before deciding whether or not you feel a school can meet your child's specific needs.

Other options

For some children, other options may be more appropriate.

If the Local Authority is satisfied that it would be "inappropriate" for a child to be educated at school, they can arrange for "education otherwise than school" to be provided - this might be home tutoring or online education - in this case the LA would be responsible for securing and funding provision.

Alternatively, parents may choose to home educate their child - this is called "elective home education" and parents are responsible for all the arrangements and funding. Our home education "hub" has suggestions for helpful approaches and resources to support parents who are electively home educating PDA children and young people.

School avoidance

School avoidance (also know as school refusal) - when a child is unable to attend school due to anxiety, phobia or trauma - is common with PDA, and should be treated as a health and/or SEN need.

If your child isn't currently attending school because the school cannot meet your child's special educational needs, the school and/or your local authority should be looking to provide the correct provision as soon as possible.

In both these cases, the situation should not be viewed as truancy and parents shouldn't be prosecuted for their child's non-attendance at school.

It's the duty of the local authority to provide a suitable alternative education - in the case of school refusal due to health reasons, this should begin 15 days following the period when school refusal began.

The National Autistic Society provides useful information to help everyone understand difficulties with school and 'school refusal' - though p lease note that the strategies suggested would require considerable adaptation for a PDA child.

When mental health prevents school attendance: Guidance summary by Special Needs Jungle provides a summary of The DfE's 2023 guidance on this topic.

Not Fine in School, School Refusal Support Services and Define Fine are parent-run organisations which focus on school avoidance and attendance difficulties.

Fran Morgan from Square Peg talks about the barriers to school attendance in this presentation.

In this podcast about PDA & school avoidance, James (a PDA young person) discusses why school is difficult for young people with a PDA profile.

These are some pointers if your child is avoiding school:

Keep school regularly updated via email/phone, keeping a log of all communications

Contact your GP to discuss your child's mental health, request a doctor's note for your child's absence from school and ask for your child to be referred to Child and Adolescent Mental Health Services (CAMHS)

Provide school with information about PDA and helpful approaches

Request that school provides a couple of hours of support within the home either weekly or daily depending on your child's ability to cope - this support should ideally be centred around relationship-building and focus on your child's interests rather than direct teaching of the national curriculum

As a next stage, it may be possible to encourage your child to spend small amounts of time in school during very quiet periods, such as the end of the day. This suggestion will need to remain flexible and within your child's control. It may then be possible to build up to more regular attendance in small steps.

Alongside the above, apply for an Education, Health and Care assessment to have your child's needs more accurately assessed.

Transitions

The following resources and links provide useful information to help with school transitions:
Transitions to adulthood
It's good practice for schools to start thinking about transition for SEND children from year 9 (age 14). For children with an EHCP, this will start at the Y9 annual review. Please see our Transition to adulthood resource for further information about post 16 options.

Further information

Recordings of our past Q&A sessions, where guest speakers with lived experience answer questions about PDA and education, are available to purchase for 30 days via our training hub.

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PDA & School Our Being Misunderstood report highlights that 70% of children with a PDA profile of autism are not in school or regularly struggle to attend. This figure is much higher than for the ASD population as a whole, and shows how challenging

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What can I do if my child wont go to school

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This section looks at reason why your child might struggle with going to school and how you and your childs school can help.

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It's normal for children and young people to feel worried about something that's happening at school - for example, when starting a new school or during exams. Sometimes, however, school can become challenging, stressful or distressing over a much longer period of time.

If your child is feeling anxious about school, or not able to go, it can be exhausting for both of you. Mornings in particular can become really stressful for the whole family, as you try to juggle your child's feelings alongside the need to get them to school and get on with your other responsibilities such as work. Even if you manage to get your child to the school gate, you might know how difficult they're going to find the day - or know that you'll be facing the same problem tomorrow morning.

If you're in this situation, we've got advice to help you explore what's going on with your child, make changes at school that can help, and find the support you need if your child can't go to school.

Young people can feel anxious about school for lots of different reasons. They might be worried about making friends or fitting in, find schoolwork or lessons confusing, feel pressured to learn in a certain way or find their relationships with teachers difficult.

Sometimes, going through difficult experiences outside of school - such as bereavement, an illness in the family or being a young carer - can also make it harder for a child to feel settled at school.

For some young people, the school environment isn't right for them, and trying to fit into it can create a huge amount of stress. This might be the case if they are struggling with their mental health, or have a neurodiverse condition or Special Educational Need (SEN) such as autism, ADHD, dyslexia or dyspraxia. This can make the school environment anxiety-provoking and exhausting, especially if their condition or need is undiagnosed or not being well supported.

Young people might show they're feeling anxious about school by:

not wanting to get up and get ready

saying they can't go

worrying a lot about small issues, such as having the right equipment for a lesson

feeling sick, or having stomach aches or headaches

not sleeping well

not doing schoolwork, or their grades dropping

being angry or upset, or acting out - at school or at home

withdrawing - seeming low, quiet or depressed

It's often difficult for your child to articulate the problem. They may be in a heightened state of stress and not know why or feel able to explain. Your child probably wants to feel able to be in school, just as much as you want them to be there. In many cases it just doesn't feel possible.

Sometimes it can be difficult to work out what's making your child feel anxious, and the first step is often helping them to identify exactly what's worrying them. Once you understand the problem, you'll be in a much better position to make changes that can help.

Young people can find it hard to explain what's causing their feelings, and might not be able to answer direct questions like 'what's going on?' Using an anxiety iceberg can help to open up the conversation - giving you a more relaxed way of exploring together what's causing their anxiety.

Watch our video to find out how to make an anxiety iceberg with your child.

If you're making an anxiety iceberg with younger children, you might want to draw images on the iceberg, or encourage them to write simple words. With older children and teenagers, you can ask them to write key words and phrases on the iceberg, or do this as a mind map, with 'school' in the middle and all the things they're finding difficult around the outside.

Through this exercise, you might identify worries such as arriving at school, finding the environment noisy or overwhelming, finding lessons confusing, feeling lonely through the day, or feeling uncomfortable during specific subjects.

Once you understand what's going on for your child, you can use their anxiety iceberg or mind map to communicate with the school and ask for specific changes.

Follow these steps to start a conversation with the school:

Here are some examples of things you can ask the school for:

Remember that even though this situation can be really tough for you and your child, it's a good idea to maintain a positive relationship with the school. Recognise the support they're offering and any changes they're making. This will help you work together to make things better for your child.

Building a relationship with the attendance team at my son's school was hugely helpful, we were talking with them each day.

If your child isn't going to school at the moment, it might feel incredibly stressful and tiring. You might be worried about when they will be able to get back to school or the impact on their education. Or you might feel overwhelmed because you're juggling this alongside work and other family commitments. Things are probably feeling tough for your child too.

During this time, it's important to keep working with teachers and other staff to try strategies that can help your child get back to school. Keep encouraging them to take achievable steps towards attending too. When the right support is in place, it's often easier for a young person to get back into their usual routine if they can return to school as quickly as possible.

If your child's anxiety about school has built up to the point where they can't go, it's a good idea to get them some professional mental health or SEN support. Find out how to do this further down the page.

Alongside requesting professional help, try to:

The school's SEN and attendance policies should be on their website. Knowing what these are can support you during meetings with the school.

This can help if your child is unable to go to school for a longer period of time and you need to ask for more support, including provision of alternative full-time education.

Encourage your child to get up, do some studying and stop for lunch at the same times they would if they were in school. This will make adapting back to school easier. Explain to your child that if they cannot go to school, they will need to study at home - at least until alternative arrangements are put in place. Ask the school to help you facilitate tasks and activities your child can do and use online resources such as BBC Bitesize.

Not going to school could leave your child feeling really isolated. Make sure they stay connected to the outside world by seeing friends and family, doing activities they enjoy and getting outside for walks and exercise.

Speaking to friends online can be really important if your child is feeling isolated at home. Sometimes, however, you might notice that your child is spending lots of time gaming or on their phone, and that this is getting in the way of important daily activities like spending quality time with family, learning, or sleeping and eating well. If this is becoming a problem, have a look at our guide to gaming or guide to social media for more information and advice.

Local authorities must provide alternative education if a child of compulsory school age is unable to attend school over a longer period of time. If your child cannot attend school because of a mental or physical health issue, the local authority should provide an alternative as soon as it is clear that they will be away from school for more than 15 days (either consecutively or over time). Find out how to request alternative education.

Getting back to school after weeks or months may feel extremely difficult for your child, but you and the school can help make it more manageable. Here are some things you can do to help:

Set small, achievable targets, such as visiting the building outside school hours or attending one lesson.

Request a home visit from a school staff member so your child can check in while feeling safe, see that the school cares and discuss any strategies that might help them.

Ask for a reduced timetable, with regular reviews to discuss building back up at a manageable rate.

Discuss changing classes or sets if your child thinks this would help.

Focus on qualifications needed for what your child wants to do next, perhaps dropping a less relevant GCSE to reduce stress.

My son wasn't questioned about his absence when he did feel able to pop in for favourite lessons, helping to ease him back into full days of education.

If your child is struggling with anxiety and it's affecting their day-to-day life, learning or relationships, it's a good idea to find some professional support. Speaking to the GP and finding them a counsellor or therapist are two good places to start. You can find more information about GPs, counsellors and other mental health services in our guide to getting support from mental health services.

If there is no other obvious reason for your child's inability to attend school, they may have an undiagnosed Special Educational Need (SEN) such as dyslexia, autism or ADHD.

If you think this is the case:

Speak to the school's SENCO or your GP to ask for a referral for an assessment.

While you are waiting for an assessment, you can also ask the SENCO to refer your child for support from other professionals, such as an Educational Psychologist or Speech and Language Therapist. These professionals can identify specific needs and make recommendations for additional support the school can put in place - even if your child hasn't had a formal diagnosis yet.

SEN support at school
If your child is diagnosed with SEN, extra support and adjustments should be put in place at school to help them attend and learn. This is called SEN support, and should be available within the school's existing resources. Speak to the school's SENCO in the first instance about how the school will support your child.
Education, Health and Care (EHC) plans
If you do not think your child's needs can be met by the school's existing resources, you can ask the local authority to carry out an Education, Health and Care needs assessment (EHC needs assessment). If the local authority decides your child needs additional support, they will then make an Education, Health and Care plan (EHC plan). This outlines how the extra support they need will be provided. Find out more about EHC plans.
Your Local Offer
Your Local Offer is the information, support and services available for young people with SEN, and for their parents and families. You can find out what support is available in your area by going to your local authority's website and searching for their Local Offer.

While we take care to ensure that the organisations we signpost to provide high quality information and advice, we cannot take responsibility for any specific pieces of advice they may offer. We encourage parents and carers to always explore the website of a linked service or organisation to understand who they are and what support they offer before engaging with them.

We have more tips and advice on supporting your child with school, and information about how you can get in touch with our Parents Helpline.
This page was reviewed in December 2022. It was created with parents and carers with lived experience of supporting their child or young person with school anxiety. We will next review the page in 2025. YoungMinds is a proud member of PIF TICK - the UK's quality mark for trusted health information.
Whether you love the page or think something is missing, we appreciate your feedback. It all helps us to support more young people with their mental health.

Please be aware that this form isn't a mental health support service. If your child is in crisis right now and you want to talk to someone urgently, find out who to contact on our urgent help page.

At YoungMinds we take your privacy seriously. If you'd like to read more about how we keep the information we collect safe, take a look at our privacy policy.

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School Anxiety and Refusal | Parent Guide to Support

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If your child is anxious about school, or refusing to go to school at all, read our tips and advice on how you can support their mental health.

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SCHOOL ATTENDANCE PROBLEMS are commonly referred to as 'school refusal'. This describes the reaction of children who experience severe anxiety and distress in relation to attending school, often resulting in prolonged absences. Children experience a range of psychological and physical symptoms, and in severe cases suffer with depression, self-harm and sometimes attempt suicide. School refusal is acknowledged as a multi-dimensional, dynamic and diverse emotional reaction, meaning each case is individual and complex to resolve.

Differing terminology has been used over time, since 'absence from school due to excessive anxiety' was first noted by Broadwin in 1932. Then in 1941 the term 'school phobia' was used by Johnson, et al. to refer to: 'a type of emotional disturbance in children associated with great anxiety, that leads to serious absence from school'. Since then a variety of labels have reflected developments in thinking about underlying influences, including 'home-bound school absence' (Waller and Eisenberg, 1980); 'school refusal' (Berg, et al., 1969), 'extended non-attendance' (Pellegrini, 2007) and 'emotionally based school avoidance' (West Sussex Educational Psychology Service, 2018).

'School refusal behaviour' was defined by Kearney and Silverman (1999) as child motivated refusal to attend school and / or difficulties remaining in school for the whole day. This definition related to children who want to attend school, but stay at home due to fear or anxiety and in addition, their parents know they have remained at home. There are also children who do not attend because of defiant behaviour or disinterest in school, and their parents are usually unaware of this absence, this is referred to as 'truancy' (Berg, 1997). However, Kearney (2018) acknowledged that the concept of truancy is problematic, as many 'truants' avoid school for reasons other than delinquency or disinterest.

The high level of confusion concerning the terms 'school phobia', 'school refusal' and 'truancy' highlights tensions that exist in defining the problem and apportioning cause or blame. For instance, Fortune-Wood discussed professionals' reluctance to use the term 'school phobia' because;

It would admit that the problem is in the school rather than in the family. Instead 'experts' will tend to opt for the label 'school refusal', which denies that school is the problem, denies a medical label and instead puts the onus on faulty behaviour.

Pellegrini (2007) suggests this variation happens because the problem has been 'conceptualised by different agencies' and so has tended to reflect the related clinical, medical or educational focus. In response, he suggests the term 'extended school non-attendance' would be preferable as a more neutral and less judgmental option to describe the problem.

The lack of an agreed standard term or definition can be said to restrict the identification of children requiring support, and cause misunderstandings about the reasons for school absence that effect approaches used to resolve the situation. The range of terminology creates obstacles for families in getting the correct support because the focus on 'within-child' explanations deflects attention from alternative factors. This is significant as Kearney and Silverman (1990) highlighted, the crucial issue in resolving school refusal is to identify the function and need behind the behaviour.

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SCHOOL ATTENDANCE PROBLEMS are commonly referred to as 'school refusal'. This describes the reaction of children who experience severe anxiety and distress in relation to attending school, often resulting in prolonged absences. Children experience a range of psychological and physical symptoms, and in severe cases suffer with depression, self-harm and sometimes attempt suicide.

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School Refusal Support Services are a peer organisation offering support to those wishing to understand the condition SCHOOL REFUSAL.

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Exclusions_School stress and anxiety_I-S (1)

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Exclusions_Steps to avoid the exclusion of autistic pupils_I-S (1)

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Part- time school timetables Guidance April 2022

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Luton and Bedfordshire's Neurodevelopmental Disorder Pathway (NDD) Information

Luton and Bedfordshire's Community Health Services and Child and Adolescent Mental Health Services (CAMHS) have...

Find out more

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Luton Special Educational Needs and Disabilities, Information and Advice Service - a free, confidential and impartial service

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School refusal is more common than we think, and we need to be aware of that. This film wants to give you a perspective of a young student who is  struggling with school refusal.

The short film is available in English, Dutch, French, Turkish and Arabic voices. All have the possibility to add English subtitles to follow along.

More information on school refusal on www.hogent.be/schoolrefusal