# data[].attributes.body
If you have the capacity to use a tablet this can be a fun way of pupils have control over the task and demonstrating their worries about school.

# data[].attributes.body
This website features a whole host of information supporting understanding of positive and negative thoughts. Look at the resources section for lesson plans as well as online "thinking cards" which you may want to explore in a session with a young person.

# data[].attributes.attachment_link.readable_text
A learning tool to support young people in identifying their helpful and unhelpful thought patterns 🧠

Uses techniques from Cognitive Behaviour Therapy and mindfulness 🧘🏽

Thinking Card packs and teaching resources available for Key Stage 2 and 3+4 🃏

Beautiful pre-printed Thinking Cards available to order.

# data[].attributes.attachment_link.title
Fun Mental Wellbeing Education | thinkingcards.org

# data[].attributes.attachment_link.description
Thinking Cards is a learning tool for young people that helps them identify and think about their helpful and unhelpful thought patterns. Videos, visuals and teaching resources available for KS2 and KS3/4. Beautiful pre-printed cards available to order.

# data[].attributes.headline
Advice for Teachers (Babcock and Devon EPS)

# data[].attributes.subject
Advice for Teachers (Babcock and Devon EPS)

# data[].attributes.body
This One Pager is a quick read providing tips on how working with CYP experiencing EBSNA.

# data[].attributes.body
This tool developed by Babcock and Devon EPS may be useful to think about the different levels through which you can support students; at a whole school level, staff training, social interactional level, well being...etc...

# data[].attributes.body
This guidance from Babcock EPS provides some tips and ideas for you when working with CYP experiencing EBSNA.

# data[].attributes.body
This checklist can be used by any staff member who has a concern about a young person to assess where the risk is which may help guide school policy or how staff interact with this individual student.

# data[].attributes.body
This webpage shares a few resoures to support autistic young people with managing their anxiety, not just about school, but in other areas too. Some of the resources may be useful for you to explore.

# data[].attributes.attachment_link.title
Anxiety Management - Best Practice Resource

# data[].attributes.attachment_link.description
Background Information Anxiety is often closely associated with autism. It is essential that anxiety is addressed as it has a significant impact on future outcomes for the child or young person. It will affect confidence and is likely to lead to increased social isolation, academic underachievement, lack of skill development across all areas, and places ...

# data[].attributes.headline
Information for Young People (Surrey Local Offer)

# data[].attributes.subject
Information for Young People (Surrey Local Offer)

# data[].attributes.body
Redirect young people who want to take an active role in understanding their EBSNA to the Surrey Local Offer information for young people site. It contains information and links to different services and groups they may wish to explore for support.

# data[].attributes.attachment_link.readable_text
What is EBSNA?

Emotionally Based School Non-Attendance (EBSNA) is a term used to describe the difficulty children and young people experience in attending school due to emotional reasons, such as stress, anxiety and/ or feeling overwhelmed. This can result in prolonged periods of absence from school.

Other terms EBSNA is known by include:

Emotionally Based School Refusal (EBSR)

Anxiety Related Non-Attendance (ARNA)

Emotional Based School Avoidance (EBSA)

School refusal

In Surrey we use the term Emotionally Based School Non-Attendance (EBSNA) to include children who are unable to attend school, rather than choosing not to attend, because of increased feelings of fear and anxiety that may make school feel unsafe.

If you are looking for support for your child or for someone you care for or support, please know that you are not on your own. We hope this webpage will provide you with the information you need.

What are the signs of EBSNA?

Spotting the signs of EBSNA and taking action quickly can enable a child or young person to remain in education and achieve their aspirations.

Children and young people can display a range of behaviours, which on their own may not be a sign of EBSNA. However, Parents/ Carers of children and young people with EBSNA have reported the following behaviours:

Frequently feeling unwell

Separation anxiety

Frequent minor absences

Tearfulness and general irritability

Sleep difficulties

Emotional volatility

Lack of appetite

Friendship issues

Changes in personality

Poor academic attainment

Autistic young people are also described as experiencing 'Autistic Burnout'.

What is the impact of EBSNA on children?

The impact of EBSNA on children is far reaching and can include:

poor academic attainment

reduced social opportunities

limited employment opportunities

an association with poor mental health in adulthood

EBSNA absence can often lead to long periods of time away from school. EBSNA is different from absence for physical illness and truancy. Most young people experiencing EBSNA can be highly anxious and show significant distress about attending school. In many instances, they remain engaged with education and want to return to school even though they feel unable to do so. Often, the young person's anxiety will reduce during weekends or school holidays.

EBSNA is complex and the issues are specific to each individual so there is not one way to resolve the situation for all children and young people. It is likely to be a gradual process to support a child to return to school particularly when it may feel that the EBSNA is well established, but there are many avenues of support available. This webpage offers information, advice, and a range of strategies gained from Surrey families' lived experiences.

How can EBSNA impact families?

Supporting your child with EBSNA can impact on families in different ways, we've listed some of these below, along with potential sources of support.

Parent Carer mental health and wellbeing

Caring for a child with EBSNA might impact on your mental health and wellbeing. You may feel lonely or isolated, but please know that you are not to blame, and you are not on your own. Family Voice Surrey have created a School Anxiety group for parents and carers.

It is important to look after yourself. If you find that your mental health and emotional wellbeing is poor, there are services that can offer advice or emotional support:

The Child Mind Institute offer information on why Self-Care is essential to parenting on their website

Mindworks Surrey information for Parents/Carers - Every child or young person is different and may require different services. Mindworks Surrey will guide you through each step you need to take as a parent or carer, from your initial concerns to being introduced to the Mindworks service

Healthy Surrey Wheel of Well-being - The Wheel of Well-being is a handy way to think about things you can do to help improve your mood, reduce the risk of depression, strengthen your relationships, and even add up to seven years to your life

Relate - services include relationship counselling, family counselling, mediation and children's and young people's counselling

Parent and Carers Group - The Hope Service - The Hope Service is a multi-agency service for young people aged 11-18 who are experiencing complex mental health, emotional, social and behavioural needs.

Barnardo's Parent Wellbeing Service - The Parent Wellbeing Service offers support to parents or carers whose children are experiencing poor mental health and wellbeing such as anxiety, depression, stress, self-harm and eating disorders. The service will enable parents and carers to be a protective factor for their child/young person in their wellbeing recovery. Increasing their confidence to support their child/young person

This shortlist of Helplines and online support services for parents has the details of further services who may be helpful to refer to.

Parenting support and advice:

For more general parenting support and advice, the following may be helpful.

Family Lives - provides targeted early intervention and crisis support to families who are struggling. The issues they support families with include family breakdown, challenging relationships and behaviour, debt, and emotional and mental wellbeing

Surrey Family Information Service's parenting courses and advice web page

Surrey Family Learning offer a wide range of free courses which are offered online, from parenting and wellbeing to Maths and English for parents who speak English as an additional language

The Free online parenting guides which are available to all Surrey residents that include top tips from childcare, education and NHS health experts.

Finances:

Supporting a child experiencing EBSNA can also have a financial impact on families if for instance, parents have given up work or reduced their working hours to support their child or have paid privately for education provision, counselling, therapy and assessments. There is a range of financial assistance that may be available to you.

Siblings:

EBSNA may also have an impact on siblings, if for instance they are often late for school or mirror their sibling's behaviour. The Local Offer Support for sibling and young carers web page, provides details of activities that siblings can do together, help for young carers and financial assistance.

Ways you can support your child

Unfortunately, there are many children and young people across the UK struggling with school-based anxiety and other difficulties that can impact on school attendance.

Such difficulties should not be viewed as a behavioural or parenting problem. There are many different things that can trigger anxiety and attendance difficulties including bullying, academic pressure and sensory issues in the school environment.

It is common for children to pretend or hold in their distress until they get home from school - this is called "masking". This can lead to misunderstandings and differences in opinion between home and school. It is important that professionals work in partnership with parents and listen to the voices of children and young people.

What you can do if your child is struggling to go to their education setting?

Believe your child's distress is real, listen to what they say and trust your instincts as a parent

One of the most important ways you can support your child is to calmly listen to them and acknowledge that their fears are real to them. Remind them how important it is to access education and reassure them that you and the education setting will try and make it a happier place for them.

Listen to and talk with your child

Consider when and where you will talk. Think about what communication method might be easiest for your child e.g. text messaging, letters, brainstorming key words and feelings. You may find ' mapping the landscape visuals', to be a useful method of communication for your young person. Your young person can 'drag and drop' their thoughts.

Agree an appropriate time and place with your child, e.g., this could be in the time after school and before dinner if your child is attending school. For children who are not attending, agree with them the best time to talk for instance, in the middle part of the day or after they have had breakfast. Try to avoid first thing in the morning before they are fully awake or just before bed as they may be tired or it might disrupt sleep.

When you speak to your child, try to remove any distractions (such as family members, TV or electronic devices) and also set a limit on how long you speak to them for.

You may like to refer to the NHS Talking to your child about feelings web page for support in approaching this conversation.

Focus on listening

If your child has opened up to you, it is because they trust you and feel a need to share their difficulties. Let them talk and try to ask open questions that encourage a fuller response than 'yes' or 'no'.

Examples of open conversation starters:

What is going well for you at the moment?

What would you be doing differently if it wasn't for these difficulties?

What is going well in school?

If things get better, how would that look?

How are things with friends?

If you woke up tomorrow and knew it was better, what would have changed?

What do you want to change?

When things where better than they are now, what was happening then to make it better?

When did this start?

What ideas do you have about what you need to feel better at the moment?

How does it affect you?

What kind of support would help you?

What is this stopping you doing......?

Are there things or people that help?

Let them know if you do not understand or need clarity

Answers can get muddled as children try to explain feelings they may not understand, asking clarifying questions shows you are listening and trying to understand.

Examples of ways of clarifying might include:

"Did I understand you when you said?"

"Did I hear you correctly when you said?"

"Let me check [...] you feel angry/ frustrated/ sad because [...]"

At the end of your conversation validate their feelings, acknowledge their strength and clarify priorities.

Examples of how to do so:

"I can see that things are difficult at the moment. However, you managed to share/ talk about a lot of things today. So, let us recap/ see where we've got to..."

Empathise and acknowledge how hard it is

It is important to let your child know that overcoming anxiety is hard, and that you are proud of their efforts. Let them know you are trying to understand their experience, are listening to what they have to say and want to help. Try not to validate their fears. The message you want to send is, "I know you're scared, and that's okay, and I'm here, and I'm going to help you get through this."

Make yourself available to talk again if needed

It can be a relief to talk, but ongoing anxiety is not solved with just one conversation. Let them know they can speak to you again. Explain that you will look at how you can help them. Never leave this kind of conversation without agreeing next steps, this will help the child to realise that you are working with them to move things forward.

A support plan can be used to support your child/young person think through how support can be individualised to support their own needs. This can be completed independently, with a parent/carer, trusted adult or with friends. This plan can be shared with school/college to help create a package of ongoing support.

It is crucial that all adults, at home and in school, work together to understand the reasons for EBSNA and find solutions together. As soon as signs are spotted parent/carers should tell the school there is a problem and request a meeting.

If you have a younger child who is experiencing anxiety with accessing a pre-school environment you may find the NHS Learning to talk resources following resource helpful to support the development of language.

Activities outside of an education setting

You may like to look at encouraging participation in activities outside of an education setting to support social interaction and reduce isolation. Some suggestions of how to do so include:

The Local Offer Directory contains details of both one off and ongoing leisure and social activities.

Club 4 holiday activities run during the longer school holidays and offer healthy food and fun activities for eligible children aged 5 to 16. The Club 4 website also includes a number of holiday ideas for children.

The video below aims to support parents and carers to develop plans to manage the anxiety of getting into school.

Who can you contact for support?

There are a number of services who can offer support if and when you feel you need it.

Support from School or education setting

It is important to communicate any concerns regarding EBSNA with your child's school/setting. They can help to find out what's worrying your child and what you and they can do to help. A support plan can be created that could include:

Home-school meeting to understand the reasons for the non-attendance.

An allocated named key adult who can maintain daily communication, to include a wellbeing check and ensure work is set, if not in class

Meeting with the pupil to gain their views around the non-attendance or participation

Jointly creating a support plan with you, your child and the school/setting.

Making reasonable adjustments according to your child's needs and the reasons for their non-attendance/participation.

Schools in Surrey can take a Surrey Healthy Schools approach to wellbeing and health and can access a range of resources and services to support your child. Support can include mental health support, counselling, and access to a School Nurse, they can also ask Specialist Teachers for Inclusive Practice (STIPs) to assess your child's difficulties.

Children and Young People with Additional Needs

An underlying Additional Need or Disability can contribute to anxiety levels; this can include Autistic Spectrum Conditions, ADHD, Sensory Processing Disorder or Dyslexia. These can make school feel like a difficult place to be for a child, even if they do want to attend school. It is worth noting that additional needs includes Social, Emotional or Mental Health Difficulties. These can affect a child's ability to make friendships and cope with strong emotion.

You may therefore also wish to discuss with the school if they feel an assessment of your child for any relevant additional needs is required.

If you need a bit more help

There are times when the challenges of family life become more difficult, and families may need some personalised support for a period of time. Targeted help focuses on the specific needs of the family to help them make positive changes. Requests for support (we used to call these referrals) can be made by all health, education and social care practitioners. Parent/carers can also request support via the Children's Single Point of Access (CSPA).

Helpful resources and services

You may also find the information and support offered by these services is helpful to you. The details of further services can be found on our Local Offer Directory.

Define Fine
A small UK parent led organisation that support families affected by EBSNA.

Not Fine In School
A UK based organisation set up to support parents, young people and professionals impacted by EBSNA: They also have a family support group on Facebook.

Young Minds
Have a parent's guide to School Anxiety and Refusal.

Every Mind Matters- Children's Mental Health
This is important for children of all ages, but in particular if the child is transitioning from one school to another, or to another class, which may make them more anxious about school.

SEND Advice Surrey
Offer impartial, confidential, free advice and support to parents/carers of children and young people with special educational needs and/or disabilities.

Family Voice Surrey
Champions the needs and rights of SEND families in Surrey: families with children or young adults up to the age of 25 who have special educational needs, chronic illnesses, including mental health conditions, or disabilities.

The National Autistic Society Surrey Branch
Is a volunteer-run support group founded by parents to support other parents. Volunteers offer a variety of local support group meetings, talks, parent programmes and activities for families that include autistic children or adults.

Are safe spaces for young people to drop into to talk about worries and mental health confidentially. There is also a phone service and virtual workshops operating alongside the face-to-face sessions. The opening times and phone number are listed on their website. They also offer two daytime projects for young people who aren't in school called 'Slow Grow' and 'Forests Skills'.

Children and Family Health Surrey

Have a number of sensory video workshops, on their website.

Your Child's GP can offer support which might include a referral to a Paediatrician or Mindworks who provide advice, help and support to children, young people and their families through a wide range of emotional wellbeing and mental health service,

You can also speak to your child's school nurse. The video below describes what a school nurse does and how they can help.

EBSNA information for young people

Everyone feels anxious or worried about school or college sometimes. This is normal, Anxieties are part of life and learning to deal with them is part of growing up However, sometimes anxiety or constant worrying can become a problem especially when it stops us doing what we want or need to do. If you have high levels of anxiety and worry about attending school, you may be experiencing Emotionally Based School Non-Attendance (EBSNA).

You most definitely are not alone and there is lots of useful information which can help you to find the best ways to help support yourself with this.

Some signs of EBSNA

Getting head or stomach aches

Feeling unsure

Feeling bad tempered

Worrying about relationships

Struggling to sleep

Feeling scared

Feeling depressed

'Autistic Burnout'

Remember you are not alone many children and young people feel this way.

We understand that it can be hard to start a conversation about how you are feeling sometimes as you may be worried about the reaction you will get. You may be surprised to know that your parent/carer or teacher may already have an idea that you are finding things difficult and it may be an easy conversation to have. It's important to tell your family and school how you feel so they can support you. There is no wrong way to do so and you might like to write a letter or send a text to say how you are feeling.

You may wish to complete a support plan which can be used to support you think through how support can be individualised to support your needs. This can be completed independently, with a parent/carer, trusted adult or with friends. This plan can be shared with school/college to help create a package of ongoing support.

You can also let them know about this webpage so they can come and look at the resources for parent/carers and schools.

Some of these services might also be able to help you:
Please remember, in the case of an emergency, call 999 or 112 from a mobile.
How can you support a child with EBSNA you are working with?

EBSNA is a complex issue, staying curious, feeling confident to try a different approach, remembering that no one is to blame for the situation, along with a culture that promotes staff and student well-being, can all support a successful reintegration.

It is important to remember most school-anxiety/ school refusing children do WANT to attend school however their difficulties and anxiety are overwhelming. They care about their education and want to succeed; however, they need understanding and support at home and at school to do so. They may need adjustments to their daily routines, timetables, or their school environment. Pressures to focus on attendance rather than the child's needs can make things even harder to 'fix'. As soon as concerns are raised, a designated member of school staff should reach out and connect with the parents/ carers. Preferably staff with a trusting relationship.

Many of the factors associated with positive outcomes will already be present within your education settings existing good practice and include:

Developing a Surrey Healthy Schools approach to wellbeing, health, inclusion and achievement

Early Intervention

Working with parents and staff as well as the child or young person

Working flexibly with a focus on understanding the function of the child or young person's avoidance behaviour

A focus on a rapid return to an education setting alongside intervention, support and adaptations within the school and home environment (be mindful that a focus on rapid return will not be appropriate for all children and young people).

Implementation of the 'Assess, Plan, Do, Review' Four part cycle:

Assess

As part of the 'Assess' phase you can identify EBSNA signs and risk factors, education setting push and pull factors to gather information to build a rich picture of the situation. You can use Surrey's Early Help Assessment form and Early Help Assessment practitioner guidance.

Plan

As part of the 'Plan' you can bring together all the information gathered and use it to inform a co-authored action and support plan.

Do

The 'Do' strand should describe strategies and interventions that have been effective in supporting the reintegration of a child or young person who is experiencing difficulties coming to an education setting. Carry out additional High Quality Teaching strategies and note differences made. Refine delivery of strategies to maximise the effect they have. Ensure that additional provision is delivered as it is meant to be. Think about what you need to adjust considering initial observations and feedback.

Review

Using assessment measures to monitor the progress of an intervention and adjust the plan for next steps will be part of your 'Review.'

Where can I receive advice or support with EBSNA?

Training and Webinars

Surrey Educational Psychologist Service and Mindworks School Based Needs Services are continually delivering training. The training is underpinned by research and provides extensive resources. Training for schools/settings can be booked on the training section of the Surrey Education Services. Third sector and wider partner EBSNA webinars have been uploaded to the Surrey Youth Focus webpage.

There is a progressive programme of training and support for schools to assist in the development and maintenance of a supportive and inclusive school culture. For more information visit Surrey Healthy Schools

Effective Family Resilience incorporating Early Help Assessment training is bookable through the Surrey Children's Services Academy: Training covers how to use the Family Resilience Windscreen and identify the range of services available to support families.

Resources

Individual support for children and young people

A Profile of Risk of EBSNA has been developed that looks at 5 key risk areas for EBSNA. The checklist is for use alongside the usual attendance monitoring systems in education settings, e.g., SIMS and consideration of patterns of attendance, to screen for possible EBSNA in relation to non-attendance. If the resultant profile suggests to you that the pupil is at risk of emotionally based school non-attendance, the next step is to obtain the views of the pupil, parent/carers and other staff within a setting. A support plan should be co-produced with the pupil, parent/carers and education setting using the EBSNA support guide for settings and the EBSNA Support Plan template provided by Surrey County Council and partners.

If the family need resources to be made accessible e.g., no access to technology or are not confident using it, are visually impaired or have English as an additional language you must ensure the resources available to families can be made accessible and families are supported to use them.

As part of any plan to support the child to attend well, education settings should facilitate relevant pastoral support. This should be done with the clear aim of improving attendance as much as possible while supporting the underlying EBSNA issue. The Department for Education have published examples of effective reasonable adjustments.

You may also like to refer to the Department for Education's summary of responsibilities where a mental health issue is affecting attendance.

Additional Support Services

The Inclusion Service provides support to schools, parents and young people in providing services on behalf of the Local Education Authority and deals with non-attendance, child Protection and making enquiries about children missing education.

Surrey's Education Psychology Service offer a weekly helpline for education settings that operates in every quadrant every Wednesday from 1-4pm (including school holidays).

Surrey County Council are developing a new support pathway for EBSNA via our Learners Single Point of Access (L-SPA), this will allow referrals for support to be made direct to our multi-professional team. More information COMING SOON

Whole School best practice

By asking "can we create an environment where EBSNA doesn't exists?" schools are already employing many strategies that support CYP who may experience school related anxiety. We suggest that schools develop a Surrey Healthy Schools approach to wellbeing, health, inclusion and achievement and use the Self-Evaluation Tool and training to assist the leadership and management of these areas. This can help to foster a compassionate, respectful and anxiety friendly environment.

Surrey Healthy Schools presents an opportunity for schools to actively promote physical, emotional and mental health and wellbeing. It is a commitment to encouraging personal, social and health development and supports the links between health, behaviour and achievement. It is not aimed merely at pupils' health or school curriculum development but centres around the whole school environment and all aspects of school life.

By looking at the systems already in place and creating opportunity for open discussion, you will develop a solid foundation that works for your school.

Where can you find support and advice?

This EBSNA Padlet website has an EBSNA resource bank designed for professionals.

Surrey Educational Psychology Service EBSNA Whole School Initial Audit Tool for Schools is a useful tool to gain a whole school understanding of EBSNA awareness and will help to identify areas of development.

Graduated Response Early Years information and documents to help special educational needs coordinators (SENCOs), early years practitioners, home-based childcarers and playworkers support children with Special Educational Needs and Disabilities (SEND) and their families.

Surrey Inclusion & Additional Needs service schools a document designed to schools and settings understand Surrey County Council service offers available to support schools to meet pupils needs as they emerge.

Ordinarily available provision (schools) this guidance aims to support settings, practitioners, families, and carers to work together to ensure that children's additional needs are met at the earliest opportunity.

Surrey Wellbeing Partnership (SWP) is a formal joint venture of local and national charities of various sizes with a common goal: to work with children and young people in the community to improve wellbeing and mental health so that they can live full, fun and confident lives.

Mindworks School Based Needs Team: offers advice and signposting for children, young people, parents and school staff, 1-1 support and group work for children, young people and parents (both within school and out of school settings).

Mindworks - Complex Mental Health Needs Teams (Community Teams)- work across Surrey and are made up of health and social care professionals. These multi-disciplinary teams promote good mental health and provide assessment and treatment to children and young people up to the age of 18 with a mental health condition. The teams assess and treat children and young people who are struggling with difficulties associated with neurodevelopment conditions where these are having a significant impact on the child's development and quality of life and causing them and/or their carers distress.

Mindworks - Mental Health Support Team for Specialist Schools in Surrey - a school-based service, which supports the mental health of children and young people in specialist schools across Surrey. The team offer support and advice to key people (teacher and or parent/ carer) around the child or young person to enable them to identify any concerns, understand what has happened for that child or young person and support any developing mental health needs.

The Mindworks 24/7 mental health crisis line, is available for children and young people who are worried about themself, a friend, or for parents worried about their child or young person. It can be contacted on 0800 915 4644, is open all day and all night, seven days a week.

Transitioning from primary to secondary school or changing schools in-year is a particularly significant change for children. Learning about change and how to cope with it will help them with transition and prepare them for many other changes and challenges they will face in life. Young Minds have a section of resources related to supporting school transitions.

Youth Engagement Scheme (YES) - is an early intervention for young people, between the ages of 13 and 16, who are struggling with one or more of: school attendance, low self-esteem, lack of self-confidence and/or are at risk of becoming involved in anti-social behaviour and the criminal justice system.YES is an early intervention for young people, between the ages of 13 and 16, who are struggling with one or more of: school attendance, low self-esteem, lack of self-confidence and/or are at risk of becoming involved in anti-social behaviour and the criminal justice system. You can email yes@surreycc.gov.uk for more information.

You may also find the details of further services who offer information and support on our Local Offer Directory.

# data[].attributes.attachment_link.title
Emotionally Based School Non-Attendance (EBSNA)

# data[].attributes.attachment_link.description
Emotionally Based School Non-Attendance (EBSNA) refers to children who are unable to attend school, rather than choosing not to attend because of increased feelings of fear and anxiety that may make school feel unsafe. Support for EBSNA is available.

# data[].attributes.headline
Supporting your child with Emotionally Based School Avoidance - a guide for parents

# data[].attributes.subject
Supporting your child with Emotionally Based School Avoidance - a guide for parents

# data[].attributes.body
This guide provides information about EBSNA, why children may avoid school, including the cycle of avoidance and anxiety, and guidance on talking to your child about school in useful videos.

# data[].attributes.attachment_link.readable_text
HWB.GOV.WALES uses cookies which are essential for the site to work. Non-essential cookies are also used to tailor and improve services. By continuing to use this site, you agree to our use of cookies.

# data[].attributes.headline
Emotionally Based School Non-Attendance (EBSNA)

# data[].attributes.subject
Emotionally Based School Non-Attendance (EBSNA)

# data[].attributes.body
On the Surrey Local Offer, there is guidance for parents on what EBSNA is, the impact of EBSNA and support for families.

# data[].attributes.attachment_link.readable_text
What is EBSNA?

Emotionally Based School Non-Attendance (EBSNA) is a term used to describe the difficulty children and young people experience in attending school due to emotional reasons, such as stress, anxiety and/ or feeling overwhelmed. This can result in prolonged periods of absence from school.

Other terms EBSNA is known by include:

Emotionally Based School Refusal (EBSR)

Anxiety Related Non-Attendance (ARNA)

Emotional Based School Avoidance (EBSA)

School refusal

In Surrey we use the term Emotionally Based School Non-Attendance (EBSNA) to include children who are unable to attend school, rather than choosing not to attend, because of increased feelings of fear and anxiety that may make school feel unsafe.

If you are looking for support for your child or for someone you care for or support, please know that you are not on your own. We hope this webpage will provide you with the information you need.

What are the signs of EBSNA?

Spotting the signs of EBSNA and taking action quickly can enable a child or young person to remain in education and achieve their aspirations.

Children and young people can display a range of behaviours, which on their own may not be a sign of EBSNA. However, Parents/ Carers of children and young people with EBSNA have reported the following behaviours:

Frequently feeling unwell

Separation anxiety

Frequent minor absences

Tearfulness and general irritability

Sleep difficulties

Emotional volatility

Lack of appetite

Friendship issues

Changes in personality

Poor academic attainment

Autistic young people are also described as experiencing 'Autistic Burnout'.

What is the impact of EBSNA on children?

The impact of EBSNA on children is far reaching and can include:

poor academic attainment

reduced social opportunities

limited employment opportunities

an association with poor mental health in adulthood

EBSNA absence can often lead to long periods of time away from school. EBSNA is different from absence for physical illness and truancy. Most young people experiencing EBSNA can be highly anxious and show significant distress about attending school. In many instances, they remain engaged with education and want to return to school even though they feel unable to do so. Often, the young person's anxiety will reduce during weekends or school holidays.

EBSNA is complex and the issues are specific to each individual so there is not one way to resolve the situation for all children and young people. It is likely to be a gradual process to support a child to return to school particularly when it may feel that the EBSNA is well established, but there are many avenues of support available. This webpage offers information, advice, and a range of strategies gained from Surrey families' lived experiences.

How can EBSNA impact families?

Supporting your child with EBSNA can impact on families in different ways, we've listed some of these below, along with potential sources of support.

Parent Carer mental health and wellbeing

Caring for a child with EBSNA might impact on your mental health and wellbeing. You may feel lonely or isolated, but please know that you are not to blame, and you are not on your own. Family Voice Surrey have created a School Anxiety group for parents and carers.

It is important to look after yourself. If you find that your mental health and emotional wellbeing is poor, there are services that can offer advice or emotional support:

The Child Mind Institute offer information on why Self-Care is essential to parenting on their website

Mindworks Surrey information for Parents/Carers - Every child or young person is different and may require different services. Mindworks Surrey will guide you through each step you need to take as a parent or carer, from your initial concerns to being introduced to the Mindworks service

Healthy Surrey Wheel of Well-being - The Wheel of Well-being is a handy way to think about things you can do to help improve your mood, reduce the risk of depression, strengthen your relationships, and even add up to seven years to your life

Relate - services include relationship counselling, family counselling, mediation and children's and young people's counselling

Parent and Carers Group - The Hope Service - The Hope Service is a multi-agency service for young people aged 11-18 who are experiencing complex mental health, emotional, social and behavioural needs.

Barnardo's Parent Wellbeing Service - The Parent Wellbeing Service offers support to parents or carers whose children are experiencing poor mental health and wellbeing such as anxiety, depression, stress, self-harm and eating disorders. The service will enable parents and carers to be a protective factor for their child/young person in their wellbeing recovery. Increasing their confidence to support their child/young person

This shortlist of Helplines and online support services for parents has the details of further services who may be helpful to refer to.

Parenting support and advice:

For more general parenting support and advice, the following may be helpful.

Family Lives - provides targeted early intervention and crisis support to families who are struggling. The issues they support families with include family breakdown, challenging relationships and behaviour, debt, and emotional and mental wellbeing

Surrey Family Information Service's parenting courses and advice web page

Surrey Family Learning offer a wide range of free courses which are offered online, from parenting and wellbeing to Maths and English for parents who speak English as an additional language

The Free online parenting guides which are available to all Surrey residents that include top tips from childcare, education and NHS health experts.

Finances:

Supporting a child experiencing EBSNA can also have a financial impact on families if for instance, parents have given up work or reduced their working hours to support their child or have paid privately for education provision, counselling, therapy and assessments. There is a range of financial assistance that may be available to you.

Siblings:

EBSNA may also have an impact on siblings, if for instance they are often late for school or mirror their sibling's behaviour. The Local Offer Support for sibling and young carers web page, provides details of activities that siblings can do together, help for young carers and financial assistance.

Ways you can support your child

Unfortunately, there are many children and young people across the UK struggling with school-based anxiety and other difficulties that can impact on school attendance.

Such difficulties should not be viewed as a behavioural or parenting problem. There are many different things that can trigger anxiety and attendance difficulties including bullying, academic pressure and sensory issues in the school environment.

It is common for children to pretend or hold in their distress until they get home from school - this is called "masking". This can lead to misunderstandings and differences in opinion between home and school. It is important that professionals work in partnership with parents and listen to the voices of children and young people.

What you can do if your child is struggling to go to their education setting?

Believe your child's distress is real, listen to what they say and trust your instincts as a parent

One of the most important ways you can support your child is to calmly listen to them and acknowledge that their fears are real to them. Remind them how important it is to access education and reassure them that you and the education setting will try and make it a happier place for them.

Listen to and talk with your child

Consider when and where you will talk. Think about what communication method might be easiest for your child e.g. text messaging, letters, brainstorming key words and feelings. You may find ' mapping the landscape visuals', to be a useful method of communication for your young person. Your young person can 'drag and drop' their thoughts.

Agree an appropriate time and place with your child, e.g., this could be in the time after school and before dinner if your child is attending school. For children who are not attending, agree with them the best time to talk for instance, in the middle part of the day or after they have had breakfast. Try to avoid first thing in the morning before they are fully awake or just before bed as they may be tired or it might disrupt sleep.

When you speak to your child, try to remove any distractions (such as family members, TV or electronic devices) and also set a limit on how long you speak to them for.

You may like to refer to the NHS Talking to your child about feelings web page for support in approaching this conversation.

Focus on listening

If your child has opened up to you, it is because they trust you and feel a need to share their difficulties. Let them talk and try to ask open questions that encourage a fuller response than 'yes' or 'no'.

Examples of open conversation starters:

What is going well for you at the moment?

What would you be doing differently if it wasn't for these difficulties?

What is going well in school?

If things get better, how would that look?

How are things with friends?

If you woke up tomorrow and knew it was better, what would have changed?

What do you want to change?

When things where better than they are now, what was happening then to make it better?

When did this start?

What ideas do you have about what you need to feel better at the moment?

How does it affect you?

What kind of support would help you?

What is this stopping you doing......?

Are there things or people that help?

Let them know if you do not understand or need clarity

Answers can get muddled as children try to explain feelings they may not understand, asking clarifying questions shows you are listening and trying to understand.

Examples of ways of clarifying might include:

"Did I understand you when you said?"

"Did I hear you correctly when you said?"

"Let me check [...] you feel angry/ frustrated/ sad because [...]"

At the end of your conversation validate their feelings, acknowledge their strength and clarify priorities.

Examples of how to do so:

"I can see that things are difficult at the moment. However, you managed to share/ talk about a lot of things today. So, let us recap/ see where we've got to..."

Empathise and acknowledge how hard it is

It is important to let your child know that overcoming anxiety is hard, and that you are proud of their efforts. Let them know you are trying to understand their experience, are listening to what they have to say and want to help. Try not to validate their fears. The message you want to send is, "I know you're scared, and that's okay, and I'm here, and I'm going to help you get through this."

Make yourself available to talk again if needed

It can be a relief to talk, but ongoing anxiety is not solved with just one conversation. Let them know they can speak to you again. Explain that you will look at how you can help them. Never leave this kind of conversation without agreeing next steps, this will help the child to realise that you are working with them to move things forward.

A support plan can be used to support your child/young person think through how support can be individualised to support their own needs. This can be completed independently, with a parent/carer, trusted adult or with friends. This plan can be shared with school/college to help create a package of ongoing support.

It is crucial that all adults, at home and in school, work together to understand the reasons for EBSNA and find solutions together. As soon as signs are spotted parent/carers should tell the school there is a problem and request a meeting.

If you have a younger child who is experiencing anxiety with accessing a pre-school environment you may find the NHS Learning to talk resources following resource helpful to support the development of language.

Activities outside of an education setting

You may like to look at encouraging participation in activities outside of an education setting to support social interaction and reduce isolation. Some suggestions of how to do so include:

The Local Offer Directory contains details of both one off and ongoing leisure and social activities.

Club 4 holiday activities run during the longer school holidays and offer healthy food and fun activities for eligible children aged 5 to 16. The Club 4 website also includes a number of holiday ideas for children.

The video below aims to support parents and carers to develop plans to manage the anxiety of getting into school.

Who can you contact for support?

There are a number of services who can offer support if and when you feel you need it.

Support from School or education setting

It is important to communicate any concerns regarding EBSNA with your child's school/setting. They can help to find out what's worrying your child and what you and they can do to help. A support plan can be created that could include:

Home-school meeting to understand the reasons for the non-attendance.

An allocated named key adult who can maintain daily communication, to include a wellbeing check and ensure work is set, if not in class

Meeting with the pupil to gain their views around the non-attendance or participation

Jointly creating a support plan with you, your child and the school/setting.

Making reasonable adjustments according to your child's needs and the reasons for their non-attendance/participation.

Schools in Surrey can take a Surrey Healthy Schools approach to wellbeing and health and can access a range of resources and services to support your child. Support can include mental health support, counselling, and access to a School Nurse, they can also ask Specialist Teachers for Inclusive Practice (STIPs) to assess your child's difficulties.

Children and Young People with Additional Needs

An underlying Additional Need or Disability can contribute to anxiety levels; this can include Autistic Spectrum Conditions, ADHD, Sensory Processing Disorder or Dyslexia. These can make school feel like a difficult place to be for a child, even if they do want to attend school. It is worth noting that additional needs includes Social, Emotional or Mental Health Difficulties. These can affect a child's ability to make friendships and cope with strong emotion.

You may therefore also wish to discuss with the school if they feel an assessment of your child for any relevant additional needs is required.

If you need a bit more help

There are times when the challenges of family life become more difficult, and families may need some personalised support for a period of time. Targeted help focuses on the specific needs of the family to help them make positive changes. Requests for support (we used to call these referrals) can be made by all health, education and social care practitioners. Parent/carers can also request support via the Children's Single Point of Access (CSPA).

Helpful resources and services

You may also find the information and support offered by these services is helpful to you. The details of further services can be found on our Local Offer Directory.

Define Fine
A small UK parent led organisation that support families affected by EBSNA.

Not Fine In School
A UK based organisation set up to support parents, young people and professionals impacted by EBSNA: They also have a family support group on Facebook.

Young Minds
Have a parent's guide to School Anxiety and Refusal.

Every Mind Matters- Children's Mental Health
This is important for children of all ages, but in particular if the child is transitioning from one school to another, or to another class, which may make them more anxious about school.

SEND Advice Surrey
Offer impartial, confidential, free advice and support to parents/carers of children and young people with special educational needs and/or disabilities.

Family Voice Surrey
Champions the needs and rights of SEND families in Surrey: families with children or young adults up to the age of 25 who have special educational needs, chronic illnesses, including mental health conditions, or disabilities.

The National Autistic Society Surrey Branch
Is a volunteer-run support group founded by parents to support other parents. Volunteers offer a variety of local support group meetings, talks, parent programmes and activities for families that include autistic children or adults.

Are safe spaces for young people to drop into to talk about worries and mental health confidentially. There is also a phone service and virtual workshops operating alongside the face-to-face sessions. The opening times and phone number are listed on their website. They also offer two daytime projects for young people who aren't in school called 'Slow Grow' and 'Forests Skills'.

Children and Family Health Surrey

Have a number of sensory video workshops, on their website.

Your Child's GP can offer support which might include a referral to a Paediatrician or Mindworks who provide advice, help and support to children, young people and their families through a wide range of emotional wellbeing and mental health service,

You can also speak to your child's school nurse. The video below describes what a school nurse does and how they can help.

EBSNA information for young people

Everyone feels anxious or worried about school or college sometimes. This is normal, Anxieties are part of life and learning to deal with them is part of growing up However, sometimes anxiety or constant worrying can become a problem especially when it stops us doing what we want or need to do. If you have high levels of anxiety and worry about attending school, you may be experiencing Emotionally Based School Non-Attendance (EBSNA).

You most definitely are not alone and there is lots of useful information which can help you to find the best ways to help support yourself with this.

Some signs of EBSNA

Getting head or stomach aches

Feeling unsure

Feeling bad tempered

Worrying about relationships

Struggling to sleep

Feeling scared

Feeling depressed

'Autistic Burnout'

Remember you are not alone many children and young people feel this way.

We understand that it can be hard to start a conversation about how you are feeling sometimes as you may be worried about the reaction you will get. You may be surprised to know that your parent/carer or teacher may already have an idea that you are finding things difficult and it may be an easy conversation to have. It's important to tell your family and school how you feel so they can support you. There is no wrong way to do so and you might like to write a letter or send a text to say how you are feeling.

You may wish to complete a support plan which can be used to support you think through how support can be individualised to support your needs. This can be completed independently, with a parent/carer, trusted adult or with friends. This plan can be shared with school/college to help create a package of ongoing support.

You can also let them know about this webpage so they can come and look at the resources for parent/carers and schools.

Some of these services might also be able to help you:
Please remember, in the case of an emergency, call 999 or 112 from a mobile.
How can you support a child with EBSNA you are working with?

EBSNA is a complex issue, staying curious, feeling confident to try a different approach, remembering that no one is to blame for the situation, along with a culture that promotes staff and student well-being, can all support a successful reintegration.

It is important to remember most school-anxiety/ school refusing children do WANT to attend school however their difficulties and anxiety are overwhelming. They care about their education and want to succeed; however, they need understanding and support at home and at school to do so. They may need adjustments to their daily routines, timetables, or their school environment. Pressures to focus on attendance rather than the child's needs can make things even harder to 'fix'. As soon as concerns are raised, a designated member of school staff should reach out and connect with the parents/ carers. Preferably staff with a trusting relationship.

Many of the factors associated with positive outcomes will already be present within your education settings existing good practice and include:

Developing a Surrey Healthy Schools approach to wellbeing, health, inclusion and achievement

Early Intervention

Working with parents and staff as well as the child or young person

Working flexibly with a focus on understanding the function of the child or young person's avoidance behaviour

A focus on a rapid return to an education setting alongside intervention, support and adaptations within the school and home environment (be mindful that a focus on rapid return will not be appropriate for all children and young people).

Implementation of the 'Assess, Plan, Do, Review' Four part cycle:

Assess

As part of the 'Assess' phase you can identify EBSNA signs and risk factors, education setting push and pull factors to gather information to build a rich picture of the situation. You can use Surrey's Early Help Assessment form and Early Help Assessment practitioner guidance.

Plan

As part of the 'Plan' you can bring together all the information gathered and use it to inform a co-authored action and support plan.

Do

The 'Do' strand should describe strategies and interventions that have been effective in supporting the reintegration of a child or young person who is experiencing difficulties coming to an education setting. Carry out additional High Quality Teaching strategies and note differences made. Refine delivery of strategies to maximise the effect they have. Ensure that additional provision is delivered as it is meant to be. Think about what you need to adjust considering initial observations and feedback.

Review

Using assessment measures to monitor the progress of an intervention and adjust the plan for next steps will be part of your 'Review.'

Where can I receive advice or support with EBSNA?

Training and Webinars

Surrey Educational Psychologist Service and Mindworks School Based Needs Services are continually delivering training. The training is underpinned by research and provides extensive resources. Training for schools/settings can be booked on the training section of the Surrey Education Services. Third sector and wider partner EBSNA webinars have been uploaded to the Surrey Youth Focus webpage.

There is a progressive programme of training and support for schools to assist in the development and maintenance of a supportive and inclusive school culture. For more information visit Surrey Healthy Schools

Effective Family Resilience incorporating Early Help Assessment training is bookable through the Surrey Children's Services Academy: Training covers how to use the Family Resilience Windscreen and identify the range of services available to support families.

Resources

Individual support for children and young people

A Profile of Risk of EBSNA has been developed that looks at 5 key risk areas for EBSNA. The checklist is for use alongside the usual attendance monitoring systems in education settings, e.g., SIMS and consideration of patterns of attendance, to screen for possible EBSNA in relation to non-attendance. If the resultant profile suggests to you that the pupil is at risk of emotionally based school non-attendance, the next step is to obtain the views of the pupil, parent/carers and other staff within a setting. A support plan should be co-produced with the pupil, parent/carers and education setting using the EBSNA support guide for settings and the EBSNA Support Plan template provided by Surrey County Council and partners.

If the family need resources to be made accessible e.g., no access to technology or are not confident using it, are visually impaired or have English as an additional language you must ensure the resources available to families can be made accessible and families are supported to use them.

As part of any plan to support the child to attend well, education settings should facilitate relevant pastoral support. This should be done with the clear aim of improving attendance as much as possible while supporting the underlying EBSNA issue. The Department for Education have published examples of effective reasonable adjustments.

You may also like to refer to the Department for Education's summary of responsibilities where a mental health issue is affecting attendance.

Additional Support Services

The Inclusion Service provides support to schools, parents and young people in providing services on behalf of the Local Education Authority and deals with non-attendance, child Protection and making enquiries about children missing education.

Surrey's Education Psychology Service offer a weekly helpline for education settings that operates in every quadrant every Wednesday from 1-4pm (including school holidays).

Surrey County Council are developing a new support pathway for EBSNA via our Learners Single Point of Access (L-SPA), this will allow referrals for support to be made direct to our multi-professional team. More information COMING SOON

Whole School best practice

By asking "can we create an environment where EBSNA doesn't exists?" schools are already employing many strategies that support CYP who may experience school related anxiety. We suggest that schools develop a Surrey Healthy Schools approach to wellbeing, health, inclusion and achievement and use the Self-Evaluation Tool and training to assist the leadership and management of these areas. This can help to foster a compassionate, respectful and anxiety friendly environment.

Surrey Healthy Schools presents an opportunity for schools to actively promote physical, emotional and mental health and wellbeing. It is a commitment to encouraging personal, social and health development and supports the links between health, behaviour and achievement. It is not aimed merely at pupils' health or school curriculum development but centres around the whole school environment and all aspects of school life.

By looking at the systems already in place and creating opportunity for open discussion, you will develop a solid foundation that works for your school.

Where can you find support and advice?

This EBSNA Padlet website has an EBSNA resource bank designed for professionals.

Surrey Educational Psychology Service EBSNA Whole School Initial Audit Tool for Schools is a useful tool to gain a whole school understanding of EBSNA awareness and will help to identify areas of development.

Graduated Response Early Years information and documents to help special educational needs coordinators (SENCOs), early years practitioners, home-based childcarers and playworkers support children with Special Educational Needs and Disabilities (SEND) and their families.

Surrey Inclusion & Additional Needs service schools a document designed to schools and settings understand Surrey County Council service offers available to support schools to meet pupils needs as they emerge.

Ordinarily available provision (schools) this guidance aims to support settings, practitioners, families, and carers to work together to ensure that children's additional needs are met at the earliest opportunity.

Surrey Wellbeing Partnership (SWP) is a formal joint venture of local and national charities of various sizes with a common goal: to work with children and young people in the community to improve wellbeing and mental health so that they can live full, fun and confident lives.

Mindworks School Based Needs Team: offers advice and signposting for children, young people, parents and school staff, 1-1 support and group work for children, young people and parents (both within school and out of school settings).

Mindworks - Complex Mental Health Needs Teams (Community Teams)- work across Surrey and are made up of health and social care professionals. These multi-disciplinary teams promote good mental health and provide assessment and treatment to children and young people up to the age of 18 with a mental health condition. The teams assess and treat children and young people who are struggling with difficulties associated with neurodevelopment conditions where these are having a significant impact on the child's development and quality of life and causing them and/or their carers distress.

Mindworks - Mental Health Support Team for Specialist Schools in Surrey - a school-based service, which supports the mental health of children and young people in specialist schools across Surrey. The team offer support and advice to key people (teacher and or parent/ carer) around the child or young person to enable them to identify any concerns, understand what has happened for that child or young person and support any developing mental health needs.

The Mindworks 24/7 mental health crisis line, is available for children and young people who are worried about themself, a friend, or for parents worried about their child or young person. It can be contacted on 0800 915 4644, is open all day and all night, seven days a week.

Transitioning from primary to secondary school or changing schools in-year is a particularly significant change for children. Learning about change and how to cope with it will help them with transition and prepare them for many other changes and challenges they will face in life. Young Minds have a section of resources related to supporting school transitions.

Youth Engagement Scheme (YES) - is an early intervention for young people, between the ages of 13 and 16, who are struggling with one or more of: school attendance, low self-esteem, lack of self-confidence and/or are at risk of becoming involved in anti-social behaviour and the criminal justice system.YES is an early intervention for young people, between the ages of 13 and 16, who are struggling with one or more of: school attendance, low self-esteem, lack of self-confidence and/or are at risk of becoming involved in anti-social behaviour and the criminal justice system. You can email yes@surreycc.gov.uk for more information.

You may also find the details of further services who offer information and support on our Local Offer Directory.

# data[].attributes.attachment_link.title
Emotionally Based School Non-Attendance (EBSNA)

# data[].attributes.attachment_link.description
Emotionally Based School Non-Attendance (EBSNA) refers to children who are unable to attend school, rather than choosing not to attend because of increased feelings of fear and anxiety that may make school feel unsafe. Support for EBSNA is available.

# data[].attributes.body
This tool gives you a process for recording your learnings whilst supporting someone. This can be most useful when you try out new activities or work with a new young person. By capturing this information, the whole team can see in-depth knowledge and understanding of a person is shared with the wider team so that they too can support them well. They should be reviewed regularly by team leaders and shared with the people involved in the support.

# data[].attributes.headline
Developing Sense of Belonging to School Community

# data[].attributes.subject
Developing Sense of Belonging to School Community

# data[].attributes.body
This worksheet can provide a structure to think about what a young person does within the school environment, so that we can see opportunities for them to make new connections and contribute to the school community in new ways. This can help you develop an understanding of their sense of belonging at school and possible ways to help improve this.

# data[].attributes.body
As a really simple way of analysing what is happening in someone’s life from more than one perspective, it can help to look at what is working and not working from different perspectives, this makes it clear where there is agreement and where there is difference. From here, you could start a discussion around areas of difference and make small steps to change these.

# data[].attributes.body
Similarly to the Ideal School, this may be easier for some children to think about, as it asks them to imagine their perfect week. This can be written or drawn and then used to prompt discussions about how this could be adapted to include school and enjoyment of school.

# data[].attributes.headline
Emotionally Based School Non-Attendance (Surrey Local Offer)

# data[].attributes.subject
Emotionally Based School Non-Attendance (Surrey Local Offer)

# data[].attributes.body
On the Surrey Local Offer, you can find a refresher of terms we use when describing EBSNA; there is information about recognising the signs, the impact of EBSNA and also support for parents.

# data[].attributes.attachment_link.readable_text
What is EBSNA?

Emotionally Based School Non-Attendance (EBSNA) is a term used to describe the difficulty children and young people experience in attending school due to emotional reasons, such as stress, anxiety and/ or feeling overwhelmed. This can result in prolonged periods of absence from school.

Other terms EBSNA is known by include:

Emotionally Based School Refusal (EBSR)

Anxiety Related Non-Attendance (ARNA)

Emotional Based School Avoidance (EBSA)

School refusal

In Surrey we use the term Emotionally Based School Non-Attendance (EBSNA) to include children who are unable to attend school, rather than choosing not to attend, because of increased feelings of fear and anxiety that may make school feel unsafe.

If you are looking for support for your child or for someone you care for or support, please know that you are not on your own. We hope this webpage will provide you with the information you need.

What are the signs of EBSNA?

Spotting the signs of EBSNA and taking action quickly can enable a child or young person to remain in education and achieve their aspirations.

Children and young people can display a range of behaviours, which on their own may not be a sign of EBSNA. However, Parents/ Carers of children and young people with EBSNA have reported the following behaviours:

Frequently feeling unwell

Separation anxiety

Frequent minor absences

Tearfulness and general irritability

Sleep difficulties

Emotional volatility

Lack of appetite

Friendship issues

Changes in personality

Poor academic attainment

Autistic young people are also described as experiencing 'Autistic Burnout'.

What is the impact of EBSNA on children?

The impact of EBSNA on children is far reaching and can include:

poor academic attainment

reduced social opportunities

limited employment opportunities

an association with poor mental health in adulthood

EBSNA absence can often lead to long periods of time away from school. EBSNA is different from absence for physical illness and truancy. Most young people experiencing EBSNA can be highly anxious and show significant distress about attending school. In many instances, they remain engaged with education and want to return to school even though they feel unable to do so. Often, the young person's anxiety will reduce during weekends or school holidays.

EBSNA is complex and the issues are specific to each individual so there is not one way to resolve the situation for all children and young people. It is likely to be a gradual process to support a child to return to school particularly when it may feel that the EBSNA is well established, but there are many avenues of support available. This webpage offers information, advice, and a range of strategies gained from Surrey families' lived experiences.

How can EBSNA impact families?

Supporting your child with EBSNA can impact on families in different ways, we've listed some of these below, along with potential sources of support.

Parent Carer mental health and wellbeing

Caring for a child with EBSNA might impact on your mental health and wellbeing. You may feel lonely or isolated, but please know that you are not to blame, and you are not on your own. Family Voice Surrey have created a School Anxiety group for parents and carers.

It is important to look after yourself. If you find that your mental health and emotional wellbeing is poor, there are services that can offer advice or emotional support:

The Child Mind Institute offer information on why Self-Care is essential to parenting on their website

Mindworks Surrey information for Parents/Carers - Every child or young person is different and may require different services. Mindworks Surrey will guide you through each step you need to take as a parent or carer, from your initial concerns to being introduced to the Mindworks service

Healthy Surrey Wheel of Well-being - The Wheel of Well-being is a handy way to think about things you can do to help improve your mood, reduce the risk of depression, strengthen your relationships, and even add up to seven years to your life

Relate - services include relationship counselling, family counselling, mediation and children's and young people's counselling

Parent and Carers Group - The Hope Service - The Hope Service is a multi-agency service for young people aged 11-18 who are experiencing complex mental health, emotional, social and behavioural needs.

Barnardo's Parent Wellbeing Service - The Parent Wellbeing Service offers support to parents or carers whose children are experiencing poor mental health and wellbeing such as anxiety, depression, stress, self-harm and eating disorders. The service will enable parents and carers to be a protective factor for their child/young person in their wellbeing recovery. Increasing their confidence to support their child/young person

This shortlist of Helplines and online support services for parents has the details of further services who may be helpful to refer to.

Parenting support and advice:

For more general parenting support and advice, the following may be helpful.

Family Lives - provides targeted early intervention and crisis support to families who are struggling. The issues they support families with include family breakdown, challenging relationships and behaviour, debt, and emotional and mental wellbeing

Surrey Family Information Service's parenting courses and advice web page

Surrey Family Learning offer a wide range of free courses which are offered online, from parenting and wellbeing to Maths and English for parents who speak English as an additional language

The Free online parenting guides which are available to all Surrey residents that include top tips from childcare, education and NHS health experts.

Finances:

Supporting a child experiencing EBSNA can also have a financial impact on families if for instance, parents have given up work or reduced their working hours to support their child or have paid privately for education provision, counselling, therapy and assessments. There is a range of financial assistance that may be available to you.

Siblings:

EBSNA may also have an impact on siblings, if for instance they are often late for school or mirror their sibling's behaviour. The Local Offer Support for sibling and young carers web page, provides details of activities that siblings can do together, help for young carers and financial assistance.

Ways you can support your child

Unfortunately, there are many children and young people across the UK struggling with school-based anxiety and other difficulties that can impact on school attendance.

Such difficulties should not be viewed as a behavioural or parenting problem. There are many different things that can trigger anxiety and attendance difficulties including bullying, academic pressure and sensory issues in the school environment.

It is common for children to pretend or hold in their distress until they get home from school - this is called "masking". This can lead to misunderstandings and differences in opinion between home and school. It is important that professionals work in partnership with parents and listen to the voices of children and young people.

What you can do if your child is struggling to go to their education setting?

Believe your child's distress is real, listen to what they say and trust your instincts as a parent

One of the most important ways you can support your child is to calmly listen to them and acknowledge that their fears are real to them. Remind them how important it is to access education and reassure them that you and the education setting will try and make it a happier place for them.

Listen to and talk with your child

Consider when and where you will talk. Think about what communication method might be easiest for your child e.g. text messaging, letters, brainstorming key words and feelings. You may find ' mapping the landscape visuals', to be a useful method of communication for your young person. Your young person can 'drag and drop' their thoughts.

Agree an appropriate time and place with your child, e.g., this could be in the time after school and before dinner if your child is attending school. For children who are not attending, agree with them the best time to talk for instance, in the middle part of the day or after they have had breakfast. Try to avoid first thing in the morning before they are fully awake or just before bed as they may be tired or it might disrupt sleep.

When you speak to your child, try to remove any distractions (such as family members, TV or electronic devices) and also set a limit on how long you speak to them for.

You may like to refer to the NHS Talking to your child about feelings web page for support in approaching this conversation.

Focus on listening

If your child has opened up to you, it is because they trust you and feel a need to share their difficulties. Let them talk and try to ask open questions that encourage a fuller response than 'yes' or 'no'.

Examples of open conversation starters:

What is going well for you at the moment?

What would you be doing differently if it wasn't for these difficulties?

What is going well in school?

If things get better, how would that look?

How are things with friends?

If you woke up tomorrow and knew it was better, what would have changed?

What do you want to change?

When things where better than they are now, what was happening then to make it better?

When did this start?

What ideas do you have about what you need to feel better at the moment?

How does it affect you?

What kind of support would help you?

What is this stopping you doing......?

Are there things or people that help?

Let them know if you do not understand or need clarity

Answers can get muddled as children try to explain feelings they may not understand, asking clarifying questions shows you are listening and trying to understand.

Examples of ways of clarifying might include:

"Did I understand you when you said?"

"Did I hear you correctly when you said?"

"Let me check [...] you feel angry/ frustrated/ sad because [...]"

At the end of your conversation validate their feelings, acknowledge their strength and clarify priorities.

Examples of how to do so:

"I can see that things are difficult at the moment. However, you managed to share/ talk about a lot of things today. So, let us recap/ see where we've got to..."

Empathise and acknowledge how hard it is

It is important to let your child know that overcoming anxiety is hard, and that you are proud of their efforts. Let them know you are trying to understand their experience, are listening to what they have to say and want to help. Try not to validate their fears. The message you want to send is, "I know you're scared, and that's okay, and I'm here, and I'm going to help you get through this."

Make yourself available to talk again if needed

It can be a relief to talk, but ongoing anxiety is not solved with just one conversation. Let them know they can speak to you again. Explain that you will look at how you can help them. Never leave this kind of conversation without agreeing next steps, this will help the child to realise that you are working with them to move things forward.

A support plan can be used to support your child/young person think through how support can be individualised to support their own needs. This can be completed independently, with a parent/carer, trusted adult or with friends. This plan can be shared with school/college to help create a package of ongoing support.

It is crucial that all adults, at home and in school, work together to understand the reasons for EBSNA and find solutions together. As soon as signs are spotted parent/carers should tell the school there is a problem and request a meeting.

If you have a younger child who is experiencing anxiety with accessing a pre-school environment you may find the NHS Learning to talk resources following resource helpful to support the development of language.

Activities outside of an education setting

You may like to look at encouraging participation in activities outside of an education setting to support social interaction and reduce isolation. Some suggestions of how to do so include:

The Local Offer Directory contains details of both one off and ongoing leisure and social activities.

Club 4 holiday activities run during the longer school holidays and offer healthy food and fun activities for eligible children aged 5 to 16. The Club 4 website also includes a number of holiday ideas for children.

The video below aims to support parents and carers to develop plans to manage the anxiety of getting into school.

Who can you contact for support?

There are a number of services who can offer support if and when you feel you need it.

Support from School or education setting

It is important to communicate any concerns regarding EBSNA with your child's school/setting. They can help to find out what's worrying your child and what you and they can do to help. A support plan can be created that could include:

Home-school meeting to understand the reasons for the non-attendance.

An allocated named key adult who can maintain daily communication, to include a wellbeing check and ensure work is set, if not in class

Meeting with the pupil to gain their views around the non-attendance or participation

Jointly creating a support plan with you, your child and the school/setting.

Making reasonable adjustments according to your child's needs and the reasons for their non-attendance/participation.

Schools in Surrey can take a Surrey Healthy Schools approach to wellbeing and health and can access a range of resources and services to support your child. Support can include mental health support, counselling, and access to a School Nurse, they can also ask Specialist Teachers for Inclusive Practice (STIPs) to assess your child's difficulties.

Children and Young People with Additional Needs

An underlying Additional Need or Disability can contribute to anxiety levels; this can include Autistic Spectrum Conditions, ADHD, Sensory Processing Disorder or Dyslexia. These can make school feel like a difficult place to be for a child, even if they do want to attend school. It is worth noting that additional needs includes Social, Emotional or Mental Health Difficulties. These can affect a child's ability to make friendships and cope with strong emotion.

You may therefore also wish to discuss with the school if they feel an assessment of your child for any relevant additional needs is required.

If you need a bit more help

There are times when the challenges of family life become more difficult, and families may need some personalised support for a period of time. Targeted help focuses on the specific needs of the family to help them make positive changes. Requests for support (we used to call these referrals) can be made by all health, education and social care practitioners. Parent/carers can also request support via the Children's Single Point of Access (CSPA).

Helpful resources and services

You may also find the information and support offered by these services is helpful to you. The details of further services can be found on our Local Offer Directory.

Define Fine
A small UK parent led organisation that support families affected by EBSNA.

Not Fine In School
A UK based organisation set up to support parents, young people and professionals impacted by EBSNA: They also have a family support group on Facebook.

Young Minds
Have a parent's guide to School Anxiety and Refusal.

Every Mind Matters- Children's Mental Health
This is important for children of all ages, but in particular if the child is transitioning from one school to another, or to another class, which may make them more anxious about school.

SEND Advice Surrey
Offer impartial, confidential, free advice and support to parents/carers of children and young people with special educational needs and/or disabilities.

Family Voice Surrey
Champions the needs and rights of SEND families in Surrey: families with children or young adults up to the age of 25 who have special educational needs, chronic illnesses, including mental health conditions, or disabilities.

The National Autistic Society Surrey Branch
Is a volunteer-run support group founded by parents to support other parents. Volunteers offer a variety of local support group meetings, talks, parent programmes and activities for families that include autistic children or adults.

Are safe spaces for young people to drop into to talk about worries and mental health confidentially. There is also a phone service and virtual workshops operating alongside the face-to-face sessions. The opening times and phone number are listed on their website. They also offer two daytime projects for young people who aren't in school called 'Slow Grow' and 'Forests Skills'.

Children and Family Health Surrey

Have a number of sensory video workshops, on their website.

Your Child's GP can offer support which might include a referral to a Paediatrician or Mindworks who provide advice, help and support to children, young people and their families through a wide range of emotional wellbeing and mental health service,

You can also speak to your child's school nurse. The video below describes what a school nurse does and how they can help.

EBSNA information for young people

Everyone feels anxious or worried about school or college sometimes. This is normal, Anxieties are part of life and learning to deal with them is part of growing up However, sometimes anxiety or constant worrying can become a problem especially when it stops us doing what we want or need to do. If you have high levels of anxiety and worry about attending school, you may be experiencing Emotionally Based School Non-Attendance (EBSNA).

You most definitely are not alone and there is lots of useful information which can help you to find the best ways to help support yourself with this.

Some signs of EBSNA

Getting head or stomach aches

Feeling unsure

Feeling bad tempered

Worrying about relationships

Struggling to sleep

Feeling scared

Feeling depressed

'Autistic Burnout'

Remember you are not alone many children and young people feel this way.

We understand that it can be hard to start a conversation about how you are feeling sometimes as you may be worried about the reaction you will get. You may be surprised to know that your parent/carer or teacher may already have an idea that you are finding things difficult and it may be an easy conversation to have. It's important to tell your family and school how you feel so they can support you. There is no wrong way to do so and you might like to write a letter or send a text to say how you are feeling.

You may wish to complete a support plan which can be used to support you think through how support can be individualised to support your needs. This can be completed independently, with a parent/carer, trusted adult or with friends. This plan can be shared with school/college to help create a package of ongoing support.

You can also let them know about this webpage so they can come and look at the resources for parent/carers and schools.

Some of these services might also be able to help you:
Please remember, in the case of an emergency, call 999 or 112 from a mobile.
How can you support a child with EBSNA you are working with?

EBSNA is a complex issue, staying curious, feeling confident to try a different approach, remembering that no one is to blame for the situation, along with a culture that promotes staff and student well-being, can all support a successful reintegration.

It is important to remember most school-anxiety/ school refusing children do WANT to attend school however their difficulties and anxiety are overwhelming. They care about their education and want to succeed; however, they need understanding and support at home and at school to do so. They may need adjustments to their daily routines, timetables, or their school environment. Pressures to focus on attendance rather than the child's needs can make things even harder to 'fix'. As soon as concerns are raised, a designated member of school staff should reach out and connect with the parents/ carers. Preferably staff with a trusting relationship.

Many of the factors associated with positive outcomes will already be present within your education settings existing good practice and include:

Developing a Surrey Healthy Schools approach to wellbeing, health, inclusion and achievement

Early Intervention

Working with parents and staff as well as the child or young person

Working flexibly with a focus on understanding the function of the child or young person's avoidance behaviour

A focus on a rapid return to an education setting alongside intervention, support and adaptations within the school and home environment (be mindful that a focus on rapid return will not be appropriate for all children and young people).

Implementation of the 'Assess, Plan, Do, Review' Four part cycle:

Assess

As part of the 'Assess' phase you can identify EBSNA signs and risk factors, education setting push and pull factors to gather information to build a rich picture of the situation. You can use Surrey's Early Help Assessment form and Early Help Assessment practitioner guidance.

Plan

As part of the 'Plan' you can bring together all the information gathered and use it to inform a co-authored action and support plan.

Do

The 'Do' strand should describe strategies and interventions that have been effective in supporting the reintegration of a child or young person who is experiencing difficulties coming to an education setting. Carry out additional High Quality Teaching strategies and note differences made. Refine delivery of strategies to maximise the effect they have. Ensure that additional provision is delivered as it is meant to be. Think about what you need to adjust considering initial observations and feedback.

Review

Using assessment measures to monitor the progress of an intervention and adjust the plan for next steps will be part of your 'Review.'

Where can I receive advice or support with EBSNA?

Training and Webinars

Surrey Educational Psychologist Service and Mindworks School Based Needs Services are continually delivering training. The training is underpinned by research and provides extensive resources. Training for schools/settings can be booked on the training section of the Surrey Education Services. Third sector and wider partner EBSNA webinars have been uploaded to the Surrey Youth Focus webpage.

There is a progressive programme of training and support for schools to assist in the development and maintenance of a supportive and inclusive school culture. For more information visit Surrey Healthy Schools

Effective Family Resilience incorporating Early Help Assessment training is bookable through the Surrey Children's Services Academy: Training covers how to use the Family Resilience Windscreen and identify the range of services available to support families.

Resources

Individual support for children and young people

A Profile of Risk of EBSNA has been developed that looks at 5 key risk areas for EBSNA. The checklist is for use alongside the usual attendance monitoring systems in education settings, e.g., SIMS and consideration of patterns of attendance, to screen for possible EBSNA in relation to non-attendance. If the resultant profile suggests to you that the pupil is at risk of emotionally based school non-attendance, the next step is to obtain the views of the pupil, parent/carers and other staff within a setting. A support plan should be co-produced with the pupil, parent/carers and education setting using the EBSNA support guide for settings and the EBSNA Support Plan template provided by Surrey County Council and partners.

If the family need resources to be made accessible e.g., no access to technology or are not confident using it, are visually impaired or have English as an additional language you must ensure the resources available to families can be made accessible and families are supported to use them.

As part of any plan to support the child to attend well, education settings should facilitate relevant pastoral support. This should be done with the clear aim of improving attendance as much as possible while supporting the underlying EBSNA issue. The Department for Education have published examples of effective reasonable adjustments.

You may also like to refer to the Department for Education's summary of responsibilities where a mental health issue is affecting attendance.

Additional Support Services

The Inclusion Service provides support to schools, parents and young people in providing services on behalf of the Local Education Authority and deals with non-attendance, child Protection and making enquiries about children missing education.

Surrey's Education Psychology Service offer a weekly helpline for education settings that operates in every quadrant every Wednesday from 1-4pm (including school holidays).

Surrey County Council are developing a new support pathway for EBSNA via our Learners Single Point of Access (L-SPA), this will allow referrals for support to be made direct to our multi-professional team. More information COMING SOON

Whole School best practice

By asking "can we create an environment where EBSNA doesn't exists?" schools are already employing many strategies that support CYP who may experience school related anxiety. We suggest that schools develop a Surrey Healthy Schools approach to wellbeing, health, inclusion and achievement and use the Self-Evaluation Tool and training to assist the leadership and management of these areas. This can help to foster a compassionate, respectful and anxiety friendly environment.

Surrey Healthy Schools presents an opportunity for schools to actively promote physical, emotional and mental health and wellbeing. It is a commitment to encouraging personal, social and health development and supports the links between health, behaviour and achievement. It is not aimed merely at pupils' health or school curriculum development but centres around the whole school environment and all aspects of school life.

By looking at the systems already in place and creating opportunity for open discussion, you will develop a solid foundation that works for your school.

Where can you find support and advice?

This EBSNA Padlet website has an EBSNA resource bank designed for professionals.

Surrey Educational Psychology Service EBSNA Whole School Initial Audit Tool for Schools is a useful tool to gain a whole school understanding of EBSNA awareness and will help to identify areas of development.

Graduated Response Early Years information and documents to help special educational needs coordinators (SENCOs), early years practitioners, home-based childcarers and playworkers support children with Special Educational Needs and Disabilities (SEND) and their families.

Surrey Inclusion & Additional Needs service schools a document designed to schools and settings understand Surrey County Council service offers available to support schools to meet pupils needs as they emerge.

Ordinarily available provision (schools) this guidance aims to support settings, practitioners, families, and carers to work together to ensure that children's additional needs are met at the earliest opportunity.

Surrey Wellbeing Partnership (SWP) is a formal joint venture of local and national charities of various sizes with a common goal: to work with children and young people in the community to improve wellbeing and mental health so that they can live full, fun and confident lives.

Mindworks School Based Needs Team: offers advice and signposting for children, young people, parents and school staff, 1-1 support and group work for children, young people and parents (both within school and out of school settings).

Mindworks - Complex Mental Health Needs Teams (Community Teams)- work across Surrey and are made up of health and social care professionals. These multi-disciplinary teams promote good mental health and provide assessment and treatment to children and young people up to the age of 18 with a mental health condition. The teams assess and treat children and young people who are struggling with difficulties associated with neurodevelopment conditions where these are having a significant impact on the child's development and quality of life and causing them and/or their carers distress.

Mindworks - Mental Health Support Team for Specialist Schools in Surrey - a school-based service, which supports the mental health of children and young people in specialist schools across Surrey. The team offer support and advice to key people (teacher and or parent/ carer) around the child or young person to enable them to identify any concerns, understand what has happened for that child or young person and support any developing mental health needs.

The Mindworks 24/7 mental health crisis line, is available for children and young people who are worried about themself, a friend, or for parents worried about their child or young person. It can be contacted on 0800 915 4644, is open all day and all night, seven days a week.

Transitioning from primary to secondary school or changing schools in-year is a particularly significant change for children. Learning about change and how to cope with it will help them with transition and prepare them for many other changes and challenges they will face in life. Young Minds have a section of resources related to supporting school transitions.

Youth Engagement Scheme (YES) - is an early intervention for young people, between the ages of 13 and 16, who are struggling with one or more of: school attendance, low self-esteem, lack of self-confidence and/or are at risk of becoming involved in anti-social behaviour and the criminal justice system.YES is an early intervention for young people, between the ages of 13 and 16, who are struggling with one or more of: school attendance, low self-esteem, lack of self-confidence and/or are at risk of becoming involved in anti-social behaviour and the criminal justice system. You can email yes@surreycc.gov.uk for more information.

You may also find the details of further services who offer information and support on our Local Offer Directory.

# data[].attributes.attachment_link.title
Emotionally Based School Non-Attendance (EBSNA)

# data[].attributes.attachment_link.description
Emotionally Based School Non-Attendance (EBSNA) refers to children who are unable to attend school, rather than choosing not to attend because of increased feelings of fear and anxiety that may make school feel unsafe. Support for EBSNA is available.

# data[].attributes.attachment_caption
School Access Assessment Scale scoring - Kearney

# data[].attributes.body
Score the SAAS to develop your understanding of the picture for a young person at home.

# data[].attributes.attachment_link.title
School Access Assessment Scale-R scoring

# data[].attributes.headline
School Access Assessment Scale (Parent/Carer)

# data[].attributes.subject
School Access Assessment Scale (Parent/Carer)

# data[].attributes.body
Use in combination with CYP's response.

# data[].attributes.body
When a young person is struggling to meet with you, this is a tool that could be used online or could be completed by anyone. It is important to remember that first a trusting relationship should be built with the child before considering gathering their views on school specifically. This should be used in combination with the other assessment scales to build a holistic picture.

# data[].attributes.body
The ESP cards are used to create a storyboard of a child’s day, in order to help them to explain which parts of the day they find difficult, and to help them to reflect on what happens at those moments. These cards may be particularly useful for working with children who find it difficult to tell you how they perceive situations, or to explain what happens when things go wrong for them. There are some rating scales included, so you can use the cards in the most accessible way.

# data[].attributes.attachment_link.readable_text
To improve your experience, this website uses cookies to collect a small amount of geographical data, it will help me to think about what I can do in the future. There are no adverts on this website but If I ever decide to put ads on the site in future I will change this notice.

Within the website there are some affiliate links to Amazon which pay a small amount to help keep this resource active and my techniques fees down. If you do not agree with this, you can search for the book directly on Amazon.

Subscriber email addresses are only used for our Newsletters. Your contact info is not shared and you can unsubscribe at any time.. More information

# data[].attributes.attachment_link.description
To improve your experience, this website uses cookies to collect a small amount of geographical data, it will help me to think about what I can do in the future. There are no adverts on this website but If I ever decide to put ads on the site in future I will change this notice.

# data[].attributes.attachment_caption
Surrrey EPS Guidance on Graded Exposure Ladder

# data[].attributes.body
A great place to start with a young person can be setting a goal and deciding together which small manageable steps you can take to reach the goal. This guidance document can support you to help a young person with managing small steps towards a larger goal.

# data[].attributes.body
Take a look through to remind yourself of the stages of change. This can be useful to consider with both the young person themselves and parents, sometimes parents can be at a different stage on the wheel in comparison to a young person.

# data[].attributes.body
These are a paid for resource which can be used to support a young person think about their strengths and successes. In your schools, you may have a different set of strengths card or another tool that you can use, you could even make some strengths cards at a whole class level building resilience across the school.

# data[].attributes.attachment_link.readable_text
These pack of cards help pupils to identify the resilience they already have in their lives and recognise why building resilience is vital to coping with difficulties. They can be used in 1:1 settings or with small or large groups.

Each pack contains 1 instruction card and 31 prompt cards featuring a resilence statement.

Suitable for Primary School. Our Secondary School pack is available here.

We offer both standard and express delivery, read our returns, postage and packaging information for delivery times, costs and terms and conditions on returning items.

# data[].attributes.attachment_link.description
These pack of cards help pupils to identify the resilience they already have in their lives and recognise why building resilience is vital to coping with difficulties. They can be used in 1:1 settings or with small or large groups. Each pack contains 1 instruction card and 31 prompt cards featuring a resilence statement.

# data[].attributes.body
If you have the capacity to use a tablet this can be a fun way of pupils have control over the task and demonstrating their worries about school.

# data[].attributes.headline
Anxiety in Autism (Autism Research Group)

# data[].attributes.subject
Anxiety in Autism (Autism Research Group)

# data[].attributes.body
This is a comprehensive guide based on evidence gathered by the Autism Research Group. You could use it as a resource to dip into when you come up against questions or uncertainty.

# data[].attributes.body
We often find that Monday's can be particularly tricky for young people experiencing early signs of EBSNA, it can be helpful for them to have a Sunday and Monday plan with their parents to support with this. The next few resources provide parents with a guide for how to create this.

# data[].attributes.attachment_link.readable_text
Dr Tina Rae is a Child Psychologist and award winning author specialising in the mental health and wellbeing of children and young people.

She has recently produced a set of resources aimed at parents of children who struggle with the transition from home to school. This was a huge issue for many parents before 2020 but this year has gone further to exacerbate an already difficult situation. Many individuals came back to school very positively to start with but unfortunately for some, this positive start is beginning to waver.

The following ideas describe how parents can prepare for this transition with practical tips that include the importance of self care. I am delighted to be able to share these resources with you. Please also scroll down for details of other resources and Dr Tina's YouTube channel. You can catch up with her on Twitter as well: @DrTinarae.

Sunday evening:

Soothe- do some calming activities and make the last things at night soothing - gentle music, story for younger ones, soft lighting, talk about 3 good things before bed.

Understand- make sure you let them know that you do understand their feelings and you do not negate of dismiss them - you understand how hard it is but it will get better in time! Develop your script for this if appropriate.

Neutralise- record any worries in a worry book and then talk through each one helping the child to see a solution/where they are catastrophising and show them the evidence against any irrational thoughts/thinking patterns.

Decide- on a plan of action and go through it step by step - this is what we will do tomorrow. Work out the schedule and ensure that everything is ready - book, bag, PE kit etc and laid out for the next morning. Make the plan visual if needed.

Attend- be vigilant to the child's emotional state and give more time if they need it so that they feel nurtured and safe. Give reassurance and a transitional object for younger children.

Yourself- look after yourself and make sure that you are regulated and feel calm yourself. Engage in some relaxation and take time out after the bedtime routine for you to build up your own resources and remember that it is ok to feel worried but don't let it overwhelm you.

Monday Morning:

Manage- manage yourself FIRST! This is not selfish. This is not selfish. You cannot support a child or young person who is unregulated and stressed if you are too. Take time to sort your own needs and then manage your emotional state by using your usual stress management tools e.g. grounding/time alone/Mindfulness etc.

Organise- get everything ready ( by getting up earlier ) so the bags are in the hallway, the breakfast is set up and you own things for work/whatever you need are all organised. This means that you can attend to the child and do so in a regulated manner.

Neutralise- spend some time with your child talking through any worries and again helping them to see a solution/where they are catastrophising and show them the evidence against any irrational thoughts/thinking patterns.

Decide- this is the plan - make it clear to them that you have a plan to get to school, how you will get here, what music you might listen to in the car/stories you might tell to each other on the bus/as you walk/who else might be with you etc so that it all becomes clear and they feel prepared for each step.

Accept- accept the child's emotional state and give them reassurance that you love and care for them so that they feel nurtured and safe. Give reassurance and a transitional object for younger children. It is okay to feel anxious, but we all need to manage it and I will help you. I am with you
and will stay with you while you need me.

Yourself- again look after yourself and make sure that you are regulated and feel calm yourself. Engage in some relaxation and remember that it is ok to feel worried but don't let it overwhelm you. keep using the script - if I stay calm, I will make him/her feel safe.

Find your calm plan:

Focus on what you can control to reduce your anxiety
Identify 3 positives at the end of each day and revisit them at the start of the next day
Neutralise those negative thoughts by reframing them into more effective ones and remember a thought is not necessarily true
Develop a self-care plan and stick to it! Write it down and follow it each day and remember self-care is not selfish and you cannot pour from an
empty vessel
Yourself first - Attend to your own needs for calm so that you can share it with your child and remember you cannot regulate others if you are unregulated.
Observe your breathing and take deep breaths when it becomes shallow or tight and Put your hand on your heart and just PAUSE.
Understand that it is normal to feel anxious when we are in uncertain times and try to remain hopeful knowing that this too shall pass.
Regulate regularly and use Grounding, Best breathing, Mindfulness and exercise to soothe your nervous system - practice really does make it better!
CO-regulate with your child and show them how you do it - MIRROR.
ME - copy my breathing - 'Let's visualise together, lets draw out the worries or dance/jog them out together!'
Accept yourself in the moment and have some self-compassion - you cannot always get it right and it's okay to take some time out to vent.
Look and learn from what happens and the mistakes you and others make and be solution focused identifying what DID work well or better and problem solving instead of being problem focused.
Moderate and manage your self-care plan and adapt and be flexible in the moment knowing that finding your calm daily will only benefit you
and yours!

Share your calm plan:

Share and focus on the things your child can control - hand washing, keeping the rules around safety, not catastrophising but celebrating being safely with friends and learning again!
Help them to identify 3 positives at the end of each day and make up a good news book and revisit it at the start of the next day.
Acknowlege and do not dismiss their worries or concerns - listen and be there for them - 'I am here for you and I am going to make sure we are safe together' and support them to reframe those negative thoughts and remember a thought is not necessarily true.
Regulate together and show them how to use key tools from Mindfulness, Grounding, Deep breathing and Visualisation - let's do it together now!
Exercise regularly and help them to see the benefits of those feel good chemicals on their nervous system.
Yourself first - take the time you need to find your calm so you can share it effectively and let you child know that you need to do this too!
Observe your child's breathing and prompt them to take deep breaths when it becomes shallow or tight - use 5 finger breathing.
Understand that it is normal for us all to feel anxious and normalise this for them reinforcing that things will get better and we must not lose hope.
Regulate regularly at key points in the day - before and after school and during lessons/breaks etc and help them to keep a self-regulation diary/log -
see what works best and use it again!
Comfort your child when they need it - cuddles and kind words always help.
Accept your child in the moment and encourage them to have some selfcompassion - give the message it's ok to be scared or angry and to vent but not ok to bottle it all up.
Look for the positives and identify what DID work well or better every day and keep a list to remind them that happy moments stay with us and can be revisited.
Manage and develop their well being plan and support them to engage in happy relaxing activities on a daily basis - factor in the fun whilst regulating the nervous system!

Dr Tina also has a YouTube channel with a wealth of topics included in her Webinars such as emotional literacy and self-esteem. Click subscribe on her channel to stay to to date.

This webinar recognises the need for self care in the context of the new uncertainty of Covid-19. Defining the links between adult and child dysregulation and recognising the potential for vicarious trauma is also a key focus. There is also an opportunity to consider how to set up personal and whole school systems to effectively manage stress and anxiety as part of a holistic self care plan.

Finally, Dr Tina has also worked closely with Nurture UK ( https://www.nurtureuk.org/) to and produced The Wellbeing Toolkit. This is a training programme to build knowledge and skills in supporting the emotional health and mental wellbeing of children and young people. The key aims are to allow professionals and staff who work with children and young people to:
- Learn relevant therapeutic approaches and skills;
- Feel confident that they have developed the appropriate skills and knowledge base to identify at-risk students;
- Help prevent the escalation of any perceived difficulties and problems; and
- Fulfill Inclusion (Section 4) of the National Curriculum (2014) - by enhancing the emotional wellbeing of students and providing particular support for those experiencing social, emotional and/or behavioural difficulties, lessons can be planned to ensure that there are no barriers to every pupil achieving.

Find out more by clicking here: https://www.nurtureuk.org/news/wellbeing-toolkit-0

Thanks for reading,

Lynn

# data[].attributes.attachment_link.title
Back To School Blues: Supporting school anxiety and reluctant returners with resources by Dr Tina Rae

# data[].attributes.attachment_link.description
Dr Tina Rae is a Child Psychologist and award winning author specialising in the mental health and wellbeing of children and young people. She has recently produced a set of resources aimed at parents of

# data[].attributes.body
This guidance focuses on changes that can be made to the classroom environment to support young people to manage their emotions. It may be useful to discuss some of these ideas with a young person to see what they might feel comfortable with.

# data[].attributes.body
This site contains a range of resources to support you to feel confident in coaching young people in developing skills to communicate their emotions, which can be a helpful and supportive way to start conversations around EBNSA.

# data[].attributes.attachment_link.title
Emotion Coaching Resources for Professionals

# data[].attributes.attachment_link.description
Resources available for Emotion Coaching Professional practicioners

# data[].attributes.attachment_caption
Brené Brown's short video explaining empathy and sympathy

# data[].attributes.body
Remind yourself of how empathy can look in conversations.

# data[].attributes.body
Emotion Coaching is a lovely way of helping children to recognise and understand their emotions before supporting them to express their emotions in positive ways.

# data[].attributes.body
Watch the video for a pick-me-up, and a really good example of emotion coaching in action.

# data[].attributes.headline
School Wellbeing Risk and Resilience Cards

# data[].attributes.subject
School Wellbeing Risk and Resilience Cards

# data[].attributes.body
This set of cards provides some examples of reasoning for EBSNA or possible emotional barriers to school which young people can be in control of sorting to demonstrate their experience of school attendance. Be mindful, these are a paid for resource!

# data[].attributes.attachment_link.readable_text
The EBSA Horizons course for Educational Psychologists, presents an alternative model of Emotionally Based School Avoidance, in which the child's voice is at the heart of assessment and intervention, and emphasis is placed on understanding EBSA in the context of interacting, child, home and school-based factors.

# data[].attributes.attachment_link.title
School Wellbeing Risk and Resilience Card Set

# data[].attributes.attachment_link.description
Providing invaluable insight into how the young person views and makes sense of their experience of school and places their voice at the centre of any planning.

# data[].attributes.body
This is a fun creative way to understand what a young persons dream school would look like and what they feel would help them have a positive experience of school. This could be the start of a conversation to discuss support that may be possible to implement to help them feel safe in school.

# data[].attributes.body
It can be helpful to create a map of safe spaces at school for a young person. This can start discussions with a CBT approach to consider thoughts, feelings and behaviours in areas of the school which do not feel so safe and what changes could be implemented to make those areas safer.

# data[].attributes.attachment_caption
Cognitive Fusion and Defusion in ACT (Acceptance & Commitment Therapy) YouTube video

# data[].attributes.body
This video focuses on a specific strategy to consider and change negative thoughts. This video may be helpful to build your repertoire of ideas to try when supporting a young person change their thought patterns, but it also may be helpful to show to young people who like to talk about their thoughts and how they experience thinking.

# data[].attributes.attachment_link.title
Cognitive Fusion and Defusion in ACT (Acceptance & Commitment Therapy)

# data[].attributes.attachment_caption
CBT and Reframing Thoughts With Cognitive Restructuring YouTube video

# data[].attributes.body
If you are working with a young person who shows an interesting in self-reflection and understanding why they are feeling as though they are, this may be a useful video to watch together. It discusses principles of psychology which can help to normalise how a young person might be feeling and give them a better understanding of themselves. It might prompt some ideas of what they could do to begin to want to change.

# data[].attributes.attachment_link.title
CBT and Reframing Thoughts With Cognitive Restructuring

# data[].attributes.body
Using the CBT informed approach, this short video focuses on understanding and normalising automatic negative thoughts which we all experience. It is a playful way of exploring the consequences of these, as well as providing a strategy for coping with negative automatic thoughts. This could be interesting to watch with an older young person and have a discussion together about how they might like to use some of the strategies suggested.

# data[].attributes.body
This document provides some questions to support you to take a CBT informed approach to initiating change in a young person. Remember you are not expected to be a therapist, so these questions are a guide to help you open up a conversation with the young person and encourage more balanced thoughts.

# data[].attributes.attachment_caption
CPD Dr Tina Rae on Motivational Interviewing

# data[].attributes.body
Watch this 1 hour webinar to build a deeper understanding of the stages of change and the kinds of language and conversations you could have with a young person. The focus here is on using child-led conversation to encourage positive change.

# data[].attributes.attachment_link.title
CPD Coffee time with Dr Tina Rae 24 Motivational Interviewing

# data[].attributes.headline
Drawing the Ideal Self (for CYP with ASD)

# data[].attributes.subject
Drawing the Ideal Self (for CYP with ASD)

# data[].attributes.body
This is the same activity, which may be useful to adapt for CYP with a diagnosis of ASD.

# data[].attributes.body
To gather an understanding of a young person's view of themselves, this may be a helpful tool, which is alao not specific to school, but it may help you unpick the EBSNA. Remember to first establish a trusting relationship with the young person, this activity can involve sharing very personal thoughts.

# data[].attributes.body
This tool can be used as a follow up assessment after an intervention or change to school approaches have been completed to review progress, set new goals and action points to continue to support pupils emotional wellbeing.

# data[].attributes.headline
Whole School Initial Audit Tool (Surrey EPS)

# data[].attributes.subject
Whole School Initial Audit Tool (Surrey EPS)

# data[].attributes.body
Use this to gather an understanding of where your school is at currently with regarding to social, emotional and mental health needs and set action points based on the findings.

# data[].attributes.body
Using the life chart is a way to understand a young person's journey to the point they are at currently and perhaps help you unpick what function their EBSNA may be serving.

# data[].attributes.attachment_link.readable_text
Lessons about inclusion from autistic adolescent girls who stop attending school

Dr Moyse used a type of free-form timeline (from a design by Majid, 2021) with the participants in her study. This enabled each girl to record the events and experiences from her school years that were of most significance to her.

Dr Moyse produced questions for each individual based on their own chart, which the girls received before the interviews. These timelines, or life charts, facilitated conversation, thematic analysis by the girls and the co-production of knowledge based on recommendations drawn from their own experiences. A template and example life chart are provided here, together with FAQs for a young person and brief guidance for an adult who may wish to use the technique. Please contact Dr Moyse directly if you wish to discuss the process in more detail.

# data[].attributes.attachment_link.title
Rewriting the Narrative - Life Chart Resource - NDTi

# data[].attributes.attachment_link.description
Dr Moyse used a type of free-form timeline (from a design by Majid, 2021) with the participants in her study. This enabled each girl to record the events and experiences from her school years that were of most significance to her.

# data[].attributes.headline
Rewriting the Narrative: Lessons from Autistic Girls Webinar

# data[].attributes.subject
Rewriting the Narrative: Lessons from Autistic Girls Webinar

# data[].attributes.body
This webinar and materials may be useful if you are working with young people experiencing EBSNA who additionally have a diagnosis of autism. We know higher proportions of EBSNA are seen in autistic young people, so understanding their experiences may give you some ideas of how to support them best.

# data[].attributes.attachment_link.readable_text
Lessons about inclusion from autistic adolescent girls who stop attending school

A subtitled video of the webinar from May 2021 by Dr Ruth Moyse.

Children who stop attending school are often called truants or school refusers, placing the reason for their absence as a problem within the child. This session proposes a different way of interpreting their absence, by sharing lessons learnt from research with 10 autistic girls who stopped attending mainstream secondary schools.

It presents some of their experiences, strategies that helped and those that did not, and their recommendations for change. Their narratives are contextualised with findings from an analysis of secondary data retrieved from the Department for Education (DfE) and the autism assessment team of an NHS Trust.

Although focused on the views of autistic young people, the findings may be relevant for other young people with neurological differences who stop attending school, and for the staff working with them.
"Placing greater emphasis on sharing the CYP and parent voices with schools." "Have more conversations with schools around the agency that girls are actually showing and how we can use that as the basis for discussions around problem solving with girls."
Learning and recommendations will help support people to remain in school and at home and reduce the likelihood of admission to hospital, as part of a person-centred plan.

Attendees of the session commented on how the session will impact their practise:

And that it was "So refreshing to hear research being presented from the young person's perspective and using their voice."
@mum2aspergirl
Please share these resources with your teams and networks.

Dr Ruth Moyse

# data[].attributes.attachment_link.description
Lessons about inclusion from autistic adolescent girls who stop attending school A subtitled video of the webinar from May 2021 by Dr Ruth Moyse. Children who stop attending school are often called truants or school refusers, placing the reason for their absence as a problem within the child.

# data[].attributes.headline
West Sussex EBSNA and Autism: Guidance for Parents/Carers

# data[].attributes.subject
West Sussex EBSNA and Autism: Guidance for Parents/Carers

# data[].attributes.body
If you are working with a young person with an autism diagnosis, this may be a useful documnet for you to refer to as well as share with parents to build a shared collaborative understanding of the young person and their EBSNA.

# data[].attributes.headline
Rewriting the Narrative: Lessons from Autistic Girls Poster

# data[].attributes.subject
Rewriting the Narrative: Lessons from Autistic Girls Poster

# data[].attributes.body
If you don't have time to watch the webinar, check out this poster for some quick ideas and insights into working with autistic young people and EBSNA.

# data[].attributes.body
Some short and quick to read example phrases of how you might form an empathic response when conversing with not just young people, but anyone! It is important that you use phrases which feel genuine and authentic to yourself, so have a read, but also think about how you already communicate and what phrases you use to show the young person you are truly listening.

# data[].attributes.body
We know that staff wellbeing is just as important as pupil wellbeing particularly when supporting pupils with emotional regulation difficulties, so in any whole school audit it is important to understand where staff are currently with their emotional wellbeing.

# data[].attributes.headline
Wellbeing Measurement Framework for Secondary Schools

# data[].attributes.subject
Wellbeing Measurement Framework for Secondary Schools

# data[].attributes.body
Gather an understanding of the stengths and challenges your pupils are facing regarding their emotional wellbeing using these short questionnaires. This can be a useful starting point to then go on to implement appropriate support for the challenges being faced.

# data[].attributes.body
This may be more useful for younger pupils, to print out and visualise on a table together their school experience.

# data[].attributes.body
This tool can be helpful to understand which elements of the school day the child is particularly struggling with. It can help to understand what might be underlying their unique experience of EBSNA.

# data[].attributes.headline
Resources for Young People (West Sussex EPS)

# data[].attributes.subject
Resources for Young People (West Sussex EPS)

# data[].attributes.body
This booklet created by the West Sussex EPS contains some valuable exercises and questions that young people (targeted at secondary age) can take a look at themselves to explore their EBSNA experience.

# data[].attributes.headline
Exercises for Children Experiencing EBSNA (West Sussex EPS)

# data[].attributes.subject
Exercises for Children Experiencing EBSNA (West Sussex EPS)

# data[].attributes.body
This resource booklet contains resources for younger children (primary age) to explore their EBSNA for themselves or with a trusted adult if they feel comfortable to.

# data[].attributes.headline
West Sussex Educational Psychology EBSNA Website

# data[].attributes.subject
West Sussex Educational Psychology EBSNA Website

# data[].attributes.body
There are lots of handy resources on the West Sussex EPS website, including Return to School questionnaires, might provide you with a wider variety of ideas about how EBSNA can be explored with young people and families.

# data[].attributes.attachment_link.title
Emotionally Based School Avoidance | West Sussex Services for Schools

# data[].attributes.attachment_link.description
*New Updated Version of the EBSA Guidance and Return to School Planning Tools Now Available*

# data[].attributes.body
This framework can be useful to think about specific factors which might be impacting a young person's resilience and provides ideas for how to target factors which may be negatively impacting resilience and celebrating those which are positively impacting resilience.

# data[].attributes.attachment_link.readable_text
The Interactive Resilience Framework

Using our latest Resilience Framework, we have written an Interactive Resilience Framework which is designed to be user-friendly, allowing you to click on areas that interest you to find out more. It was developed especially for working with schools, holding the children and young people in mind, and is one of the resources from the Academic Resilience Approach.

Each link takes you to a glossary section with further information about that particular approach, including expanding on what it is, why it is important and how it could be achieved in a school context, what young people themselves think about it, and examples of relevant research evidence with further references.

We know teachers and school staff are incredibly busy, so we've tried to keep it short and sweet, allowing you to dip in and out depending on what you want to know, and giving you a starting point if you want to find out more. You can preview it below, or you can download the full version of the Interactive Resilience Framework pdf file to use the hyperlinks.
Interactive Resilience Framework

# data[].attributes.attachment_link.authors[].name
CRSJ / Boingboing / ResilienceRevolution

# data[].attributes.attachment_link.title
Interactive Resilience Framework - Boingboing

# data[].attributes.attachment_link.description
The Interactive Resilience Framework Using our latest Resilience Framework, we have written an Interactive Resilience Framework which is designed to be user-friendly, allowing you to click on areas that interest you to find out more. It was developed especially for working with schools, holding the children and young people in mind, and is one of the resources from the Academic Resilience Approach.

# data[].attributes.body
Sometimes it can help to visualise your ideas on paper, so this worksheet can help you to record your thoughts around potential ways to boost a young person's mastery, bonding, meaning and skills.

# data[].attributes.headline
Wellbeing Measurement Framework for Year 4, 5, 6

# data[].attributes.subject
Wellbeing Measurement Framework for Year 4, 5, 6

# data[].attributes.body
Check where your pupils are with their resilience and wellbeing using this set of online questions. The results may help you decide on the most appropriate support for a pupils on whole class or group levels to promote positive wellbeing.