When children completely refuse to go to school this can be extremely distressing for all parties. It is often accompanied by melt-downs, physical complaints such as stomach aches, headaches, vomiting, rapid heartbeat, dizziness, pleading or begging to stay at home and even young people threatening to harm themselves if they are made to go to school.
The behaviours associated with emotionally based school avoidance are extremely stressful for the young person, parents and siblings, and are of concern for the school and teachers. For the young person, it has a significant negative effect on their academic and social development, and can lead to them completely dropping out of school, possibly causing significant consequences for future employment.
Paige Fujiu-Baird, Clinical Psychologist and Psychotherapist, spoke about meeting the challenges of emotionally based school avoidance at the Virtual SEND Conference to empower parents with support and guidance when seeking help for their children. Here, she outlines her approach to supporting children to engage with their education and return to school.
Emotionally based school avoidance is child-motivated refusal to attend school or difficulties in remaining in school the entire day. Emotionally based school avoidance is a condition characterised by reluctance or refusal to go to school by a child who:
Seeks the comfort and security of home, preferring to remain close to parental figures
Displays evidence of emotional upset or unexplained physical symptoms at the prospect of going to school
Manifests no severe antisocial tendencies
Does not attempt to conceal the problem from parents or caregivers
The root cause of emotionally based school avoidance is anxiety, which will look very different according to the age of the child. Younger children may be more anxious about being separated from caregivers, fear a teacher, or fear being picked on by older children. Frequently older children have concerns about academic performance, worries about making friends, eating in the cafeteria, using the school bathroom, changing for gym, being called on for class, or being made fun of by peers. For some children there are legitimate fears of being bullied, gangs, school violence, or being ostracized and ridiculed.
Other reasons may include:
A history of physical and emotional separations that create an underlying anxiety about being away from home or parental figures.
The fear of losing a parent through illness, divorce, or death. Fear of physical and emotional abandonment may make it difficult for the child to have their parents out of their sight and out of their control.
Changes in the stability of the family system at home and in the family, such as frequent deaths in the family, divorce, moves to a new house, separations, transfers to another job or community, or jealously of new siblings.
Get back into school - perhaps surprising for some, the number one factor increasing the likelihood of success with children who struggle attending school school is an early return to the physical environment of school. Identifying particular classes which the child can attend, identifying a limited time period where the child is required to be in the building, or identifying certain days which the child must attend are all legitimate strategies to employ and starting points for intervention goals and objectives.
Therapy is helpful to address the underlying mental health issues - Depending on the situation, therapy can be individual, family, or couples sessions. A 2003 study showed that 83% of children with emotionally based school avoidance behaviours treated with cognitive therapy were attending school at the one year follow-up. Other treatments may also be necessary, such as medication, family therapy, or educational interventions for learning disorders or classroom misbehaviour as appropriate and necessary. Each solution must be tailored to the needs and concerns of the child.
Parents play a crucial role in supporting their child back into school. It is important to have both parents/caregivers actively involved even when custody is split or joint.
Believe that your child will get over the problem and let them know that you believe they can handle it.
Listen to your child and encourage them to talk about their fears at times other than when you are attempting to obtain school attendance.
Be understanding, use reflective listening, don’t use shame.
Maintain good contact with school and teacher.
Make sure that the child knows you will return to pick them up or that they are provided adequate supervision after school.
Prepare them with gradual separations.
Inform them that you expect them to stay for the entire day.
Leave quickly (don’t look back or hover).
Do not reinforce the child’s distress by rescuing.
Be reliable and on time when picking up your child.
Have the other parent, relative, neighbour, or someone else who is less emotionally involved with the child take the child to school.
Let the child have something of yours to keep in their pocket i.e. a symbol or picture.
Give the child as much control as possible through providing them the illusion of control (“Do you want to wear your green sweater or red shirt when you go to school today?”)
Prolonged goodbyes don’t help the situation. A firm, caring, and quick separation is best for all concerned.
Staff in school are in a unique position to create an environment for the child at school that will substantially increase the likelihood that the child will return and/or continue to attend school. School staff, SENCOs, teachers and teaching assistants can learn about emotionally based school avoidance and understand how to support the child and the plan to return to school.
Connect the child with a teacher who understands the situation and matches the personality and learning style of the child. A good fit between a child who struggles with attendance and a teacher can be a significant factor in determining whether or not an intervention plan succeeds.
Be particularly concerned about the child’s first interactions with school staff. If the first adult that a child will encounter at school is their favourite teacher, that connection may allow the child to overcome their resistance to getting to school.
If possible, arrange for the child to be in a class with as many of their friends as possible. While the child may have great anxiety about attending school, being in the presence of their friends may help ease that anxiety.
Provide as much insulation as possible from children the child fears or insensitive, tactless children.
Customise the educational approach and curriculum to meet the child’s needs.
Help the child identify “safe people” and “safe places” in the school or classroom that they can seek out when they are overwhelmed.
Provide the student with easy access to trained staff they can talk to.
Have an arrival ritual where the child is met by a warm and supportive person.
Do not punish for late arrival at school, but rather reinforce the fact that they got to school, and the courage they are displaying by coming.
Encourage the student and parents to increase the amount of time that they are separated at home.
Provide for testing and other high anxiety activities to be done in a separate, calm location.
Carefully match the student with other students for group activities or projects.
Provide social skills training in a small group for children with similar struggles.
Provide alternatives to reduce exposure to anxiety provoking situations, i.e. recording a presentation rather than presenting in front of the class.
Coach the child on coping strategies for anxiety provoking situations.
Focus on relapse prevention strategies once the child returns to school, particularly in transitioning from one school year to the next.
If your child is suffering from school-related anxiety, struggling to attend school or anxious about returning to school, there is support out there to help. Nip in the Bud have produced a helpful video and resources for parents and teachers about returning to school.
If you are interested in finding out more about Anxiety and how therapy can help you or a loved one, you can speak to one of our experienced triage team by calling 0203 326 9160 or explore our children’s anxiety hub.