1. Czone
  2. Health and wellbeing
  3. Mental health and emotional wellbeing (MHEW)
  4. Emotionally based school avoidance (EBSA) toolkit
  5. Further information around EBSA

Further information around EBSA

1. Overview

How common is EBSA?

EBSA and anxiety

‘Anxiety is what we feel when we are worried, tense, or afraid – particularly about things that are about to happen, or which we think could happen in the future. Anxiety is a natural human response when we perceive that we are under threat. It can be experienced through our thoughts, feelings, and physical sensations’ (Mind)

Anxiety is often a big part of EBSA. Feeling anxious is a normal part of growing up, and in small amounts, it can be helpful. It’s the body’s way of responding to stress, helping us stay alert and handle challenges. But for some children and young people, anxiety can become so intense that it makes everyday life, including school, very difficult.

Young Minds found that 1 in 6 young people will experience serious anxiety during their school years, which means about five students in a class of 30. Research also shows that nearly half of young people who don’t attend school regularly may have an anxiety disorder.

Anxiety triggers a natural body reaction called the ‘fight, flight, or freeze’ response. This response is helpful when we face real danger, but when anxiety becomes too strong, especially about going to school, it can cause problems. Some kids may feel sick, shaky, or really scared days before they need to go to school.

This anxiety can lead to:

- Avoiding the situation altogether
- Trying to hide their anxiety to fit in
- Refusing to get ready, leave the house, or go to school
- Acting out or getting angry to avoid what feels like a threatening situation.

These are ways children may try to deal with anxiety when school feels overwhelming.

All behaviour is communication and in supporting EBSA, the possible function of the behaviour needs to be understood. Anxiety may be the triggering, but also maintaining factor of EBSA. The more avoidance there is of situations that are feared, the more the fear can grow so contributing to the maintenance of EBSA over time. As demonstrated in the anxiety cycle below:

An illustration showing unaddressed anxious feeling become 'pull' factors overtaking 'push' factors that encourage school attendance, described below

It is crucial that consideration is given to the child or young person’s perception of their ability to cope, including perceived social and academic competence. Negative thoughts about one’s ability to cope can lead to feelings of worry and if not addressed will undermine any attempts to improve attendance (Heyne & Rollings 2002).  

EBSA and additional needs

Young people with special educational needs (SEN) are more likely to have emotional difficulties because:

  • They might find it hard to explain their feelings
  • They can feel frustrated about what they can and can’t do
  • They may see the world as unsafe or unpredictable
  • Sensory environments can overwhelm them
  • They may feel they have less control over their lives
  • Change and transitions can be harder for them to handle

Research by the Foundation for People with Learning Disabilities

shows that people with learning disabilities often have emotional difficulties for similar reasons. It’s usually their families who can spot changes in their emotions, often by noticing changes in behaviour.

Lack of Protective factors

Children with learning disabilities may have a harder time using strategies to help their emotions. They might have fewer friends, find it tough to get along with others, and struggle to solve problems. Many also live in poverty and have health issues.

All of these factors are known to have a negative impact on emotional wellbeing, putting people with learning disabilities at greater risk of developing mental health problems (BOND a consortium led by Young Minds - Children and young people with learning disabilities - understanding their mental health). 

Getting help when you have a special educational need.

Sometimes young people with SEND can have their emotional wellbeing difficulties overlooked, through diagnostic overshadowing. This is where difficulties such as anxiety are said to be attributed to the diagnosed special educational need. If you think your child is anxious, it is always a good idea to seek advice and use strategies to help to reduce their anxiety.  

Neurodiversity and EBSA

There is little research into the prevalence of neurodivergent children and young people who are experiencing EBSA. However, the evidence suggests that due to the level of anxieties that many neurodivergent children and young people experience there is an increased risk of EBSA. However, it is important to appreciate that anxiety is not simply a part of being neurodivergent and can therefore be supported separately.  

There are often additional challenges in school that are faced by neurodivergent children and young people, trying to meet the expectations of neuronormative society, leading to increased and more persistent feelings of anxiety about school. Neurodivergent individuals may perceive the world as more uncertain and unpredictable, leading to more persistent states of anxiety that interfere with day-to-day functioning. This can lead to an overload and ‘over-flowing’ level of anxiety.  

Imagine a bucket that starts to fill up when feeling stressed about things such as: 

  • Poor concept of time 
  • Does not know / understand rules. 
  • Anxious about failure 
  • Sensory difficulties 
  • Literal interpretation of situation 
  • Difficulties with communication 
  • Unsure what is going to happen. 
  • Changes in routine 

These factors our into the bucket and can feel overwhelming. 

Recent research has supported the identification of key factors contributing to a heightened feeling of uncertainty and unpredictability which can be difficult to tolerate: 

  • Sensory processing differences. The school environment is full of sensory experiences which can be difficult to tolerate but can also make the world very unpredictable. 
  • Difficulties understanding emotions. When emotions are not understood, the world can feel uncertain and unpredictable and in turn make it more difficult to regulate own emotions.  

The intolerance of uncertainty is believed to cause the anxiety. It is therefore important to unpick what the individual is finding difficult to tolerate when signs of ESBA are showing. 

Here are some examples of Sensory Processing Disorder, described in the first person. 

I have sensory processing disorder: 

  • I hate having my hair brushed, washed, or cut. 
  • I hate being tickled or cuddled. 
  • I am a picky eater; I resist new foods and textures. 
  • I seem to be unaware of normal touch and pain, I often feel others too soft or too hard. 
  • I chew on everything. 
  • I have poor gross motor skills, such as running or riding a bike. 
  • I have poor fine motor skills, such as handwriting and cutting. 
  • I have trouble focusing / concentrating. 
  • I’m overly sensitive to loud sounds. 

A transition guide for parents and carers was developed by ESCC in 2023 which provides advice and guidance to help families and young people plan for their journey after Year 11. 

 A Guide for parents and carers – Transitioning into College and Adult life for young people with Special educational Needs and Disabilities - Post16 Parent Carer Booklet - 1 (pagetiger.com) 

EBSA and SEND

Young people with special educational needs are often at greater risk of emotional wellbeing difficulties for several reasons. These might include:

  • communication difficulties in describing what they are feeling.
  • feelings of frustration regarding things they can and cannot do.
  • perceiving their world to be an unsafe and unpredictable place
  • overwhelm from the sensory environment.
  • feeling that they have less control and more restraints on them.
  • greater difficulty managing uncertainty including change and transition.

Research by the Foundation for People with Learning Disabilities identified that people with profound and multiple learning disabilities do experience emotional wellbeing difficulties very often for reasons similar to those of the general population. However, it can be harder to identify the signs of changes in emotional wellbeing and we often rely on behavioural changes to alert us to a child’s distress. The family are best place to recognise changes in a child’s emotional wellbeing.

Lack of Protective factors

Having a learning disability can make it harder for young people to use strategies that support their emotional wellbeing. They may find it difficult to make friends, have fewer social connections, and struggle to get along with their peers. Learning disabilities also reduce their ability to come up with creative solutions to problems.

Children with learning disabilities are more likely to live in poverty and have additional health problems, which can negatively affect their emotional wellbeing. All these factors put them at higher risk of developing mental health issues.

(BOND a consortium led by Young Minds - Children and young people with learning disabilities - understanding their mental health).

Getting help when you have a special educational need

Sometimes young people with SEND can have their emotional wellbeing difficulties overlooked, through diagnostic overshadowing. This is where difficulties such as anxiety are said to be attributed to the diagnosed special educational need. If you think a child you are working with is anxious, it is always a good idea to seek advice and use strategies to help to reduce their anxiety.

Neurodiversity and EBSA

There isn't much research on how often neurodivergent children and young people experience EBSA, but evidence shows they are at higher risk due to the anxieties they face. However, it’s important to note that anxiety isn't just part of being neurodivergent and can be managed separately.

Neurodivergent students often face extra challenges at school as they try to fit into a world that isn't designed for them. This can make school feel more stressful and unpredictable, leading to persistent anxiety that disrupts their daily life, sometimes causing them to feel overwhelmed.

Imagine a bucket that starts to fill up when feeling stressed about things such as:

  • Poor concept of time
  • Does not know / understand rules.
  • Anxious about failure
  • Sensory difficulties
  • Literal interpretation of situation
  • Difficulties with communication
  • Unsure what is going to happen.
  • Changes in routine

These factors our into the bucket and can feel overwhelming.

Recent research highlights key factors that increase feelings of uncertainty:

  • Sensory issues: The school environment can be overwhelming due to loud noises, bright lights, or other sensory triggers.
  • Trouble understanding emotions: When kids can't understand their own feelings, it makes the world feel more confusing and harder to manage their emotions.

The intolerance of uncertainty is believed to cause the anxiety. It is therefore important to unpick what the individual is finding difficult to tolerate when signs of ESBA are showing.

Here are some examples of Sensory Processing Disorder, described in the first person.

I have sensory processing disorder:

  • I hate having my hair brushed, washed, or cut.
  • I hate being tickled or cuddled.
  • I am a picky eater; I resist new foods and textures.
  • I am unaware of normal touch and pain, I often feel others too soft or too hard.
  • I chew on everything.
  • I have poor gross motor skills, such as running or riding a bike.
  • I have poor fine motor skills, such as handwriting and cutting.
  • I have trouble focusing / concentrating.
  • I am overly sensitive to loud sounds.

A transition guide for parents and carers was developed by ESCC in 2023 which provides advice and guidance to help families and young people plan for their journey after Year 11.

 A Guide for parents and carers – Transitioning into College and Adult life for young people with Special educational Needs and Disabilities - Post16 Parent Carer Booklet - 1 (pagetiger.com)

 

EBSA and Safeguarding

When a child is missing school frequently, it's crucial to notify the school’s Designated Safeguarding Lead (DSL) or Deputy Designated Safeguarding Leads (DDSLs). These staff members will review if the child is already considered at risk or if their absence might increase any existing safety concerns for the child or their family. This information helps in deciding the right actions to support the child.

If there aren’t any known safety issues, staff should still investigate why the child isn’t attending. The absence could be due to bullying, abuse, neglect, exploitation, or mental health issues. Any concerns about these potential issues should be reported to the DSL/DDSLs according to the school's procedures.

When a child is not in regular attendance at school, the school still maintains safeguarding responsibilities for the child and must follow the guidance in Part One and Annex B of Keeping Children Safe in Education in regard to responding to children who are absent, including ensuring all staff:

Key Points for School Staff:

  • Understand Attendance Support: Know the school’s processes for encouraging good attendance and preventing absences.
  • Be Aware of Safeguarding: Understand how to handle cases where students miss school often or for long periods. This could be a sign of a safety issue.
  • Recognize Warning Signs: Regular or long-term absences can indicate problems like abuse or neglect. Be alert to these signs.
  • Conduct Welfare Checks: Ensure checks are done, and keep communication open with the child, their family, and other professionals.

Why It’s Important:

Increased Risk: Missing school regularly can make children more vulnerable to neglect and abuse.

Shared Responsibility: Everyone involved with the child must work together to ensure their safety and well-being.

Key Actions:

  • Identify Risks: Make sure all professionals know the child’s vulnerabilities and any risks.
  • Stay Curious: Investigate why the child is missing school and whether it might be due to safety issues.
  • Communicate: All professionals should share information and work together to protect the child.
  • Follow Safeguarding Policies: Ensure that safeguarding procedures are followed if there are any concerns about the child’s well-being.

Systemic Approaches

Understanding and Addressing School Avoidance:

Different Influences: A child's behaviour is shaped by many factors, like family, school, and community. Understanding these helps us address issues like school avoidance.

Helpful Models:

  • Ecological Model: Shows how different parts of a child’s life affect their behaviour. It helps us see how school avoidance might develop and how to support the child.
  • Bronfenbrenner’s Model: Highlights that the relationships children have with their close adults (like family and teachers) are very important for their well-being.

3. Systemic Approach:

  • Look at All Factors: Consider how all parts of a child’s life interact to understand their school avoidance.
  • Find Key Issues: Identify which parts of their life are most affecting their school attendance.
  • Work Together: Collaborate with parents, teachers, and other professionals to help the child.

In short, to help a child who avoids school, understand all the factors affecting them and work together with everyone involved in their life.

EBSA and Transitions

Most children and young people can transition to a new setting successfully by adapting to their new environment. However, some may find this more difficult, particularly those at risk of EBSA. Risk of EBSA tends to peak at periods of transition e.g. from primary to secondary and secondary to Further Education.

For some children starting in Reception, this may be the first time that they have been away from their parents for extended periods of time, and they may struggle to follow the routine of the school day. These children may find the transition into school difficult, and you may see behaviours related to separation anxiety.

With secondary school and transition into Post 16 settings the following changes can have an impact:

  • Increase in the size of the setting, number of classrooms/buildings and layout.
  • Increase in the number of students/classes size.
  • Increase in workload and academic expectations e.g. GCSE’s, A Levels
  • Changes in timetabling (including having lessons with different peers each time)
  • Having to adapt to different teaching styles and the ways subjects are taught.
  • Increased expectations in independence
  • Transitioning from being the oldest in the educational setting to the youngest
  • Changes in pastoral support arrangements
  • Changes in attendance management (particularly in Post 16 education)

Primary schools are particularly good at sending information about specific children with a cause for concern to the relevant secondary schools. To support this further, a list of children identified as being at risk of EBSA could be sent alongside information about the risk factors and plans in place.

Sharing information to the relevant education setting that the young person is transitioning into is imperative to support the successful transition for them. It can help the Further Education setting plan and prepare the right support to safeguard the young person and support their needs effectively.

Schools and Further Education providers should follow the information sharing for vulnerable learners’ guidance. Transition for pupils with SEN | Czone (eastsussex.gov.uk)

The Vulnerable Learners Protocol is a document that was developed in partnership with schools, FE providers and the Youth Employability Service (YES) to ensure that secondary schools and further education providers are working together to identify vulnerabilities and ensure that additional planning for young people is in place from year 9 onwards. The protocol outlines the roles, responsibilities and activities needed in supporting a successful transition for young people.

 (further information can be found in the Post 16 Appendix)

Robust transition plans are needed for all children and young people, with additional support put in place for vulnerable children and young people. Staff will need to ensure that they monitor students for attendance issues and anxiety.

As part of the school or colleges Whole School/College Approach (WSCA) to Mental Health and Emotional Wellbeing and Attendance (MHEW), all school and college staff should be made aware of the risk of EBSA and signs and indicators, particularly important around transition points to ensure that this is identified and addressed early, to prevent it becoming a longer-term problem (see Post 16 Appendix)

The following ideas may also support in addition to normal transition :

Primary school recommendations:

  • Devote time in the summer term to talking about secondary school in positive terms, debunking myths and solving problems with humour.
  • Work through a transition preparation programme in collaboration with the secondary school.
  • Help children with organisation skills, including explicit skills to:
  • Find their way around a map and floor plan.
  • Follow different styles of timetables.
  • The organisation of bag packing, equipment and so on
  • Study skills.
  • Organise their time management for independent study (including homework)
  • Provide extra visits to the secondary school.
  • Provide information on wellbeing/pastoral leads in the school, with contact details.
  • Provide the parents with an information pack on expectations for the first term and who to contact with any worries or concerns
  • Facilitate visits by year 7, 8 and 9 students to primary feeder educational setting s to have informal discussions with Y6 pupils.

 

Secondary school and Post 16 Education recommendations

  • Nominate staff members to welcome new students; meet and greet, hold check-ins etc.
  • Facilitate visits for children and young people on reduced and flexible timetables or who are home educated and experiencing EBSA.
  • Hold an open evening allowing students to walk around the setting and meet key staff at quieter times.
  • Consider how you share information re: open days/tasters, particularly for young people who are persistently absent and for their parents and carers.
  • Take photos of areas of the setting, visual map, and key staff for familiarisation over the summer holiday
  • Provide a dyslexia friendly colour coded timetable to students
  • Provide a map and an exemplar timetable for familiarisation over the summer holiday.
  • Highlight the positive aspects of the secondary school or the Post 16 setting.
  • Identify the young person’s interests and aspirations (e.g. vocational profile), supporting them to identify pathways that are the right fit for them
  • Explore Buddy/Mentor Systems
  • Provide personalised transition (or soft starts) and taster visits during the summer if .
  • Prioritise wellbeing at the start of the term, creating a sense of safety and security for the young person.
  • For Year 10 & 11 transition activities into Post 16 education should be started early collaborating with the parent/carer and young person to organise personalised tours and transitions with the Post 16 setting.
  • Ensure the Vulnerable Learners Protocol (VLP) is embedded into policies and procedures and that all staff are aware of their responsibilities in relation to this. 
  • Share the parent/carer transition into college & adult life for young people with SEND guide Post16 Parent Carer Booklet - 1 (pagetiger.com)

Parent carer recommendations

  • Talk in positive terms about the transition to secondary school/Post 16 education.
  • Discuss it in terms of a ‘fresh start’ for young people that have not experienced a positive time in educational setting.
  • Help your child/young person develop independence skills by encouraging them to organise themselves with small aspects of their day during the summer break.
  • Look at and talk about the floor plans / timetables / key staff/ quiet spaces.
  • Walk past or drive to the new educational setting to familiarise your child/young person with the building and entrance and local area.
  • Practise catching the bus/train if this is what your child will be expected to do.
  • Help your child budget for lunch and drinks if they have any shopping or visits with friends during the summer.
  • Check your child has emergency contact details available if needed.
  • Ensure that your child has the correct uniform and the various equipment stated on any paperwork sent by educational settings.
  • Ask for key information on the school or colleges pastoral lead/wellbeing team.
  • Ask about personalised tours, tasters, and transition activities.
  • Familiarise yourself with the settings policies and procedures, particularly in Post 16 settings which may differ to schools
  • Familiarise yourself with the parent/carer transition into college & adult life for young people with SEND guide Post16 Parent Carer Booklet - 1 (pagetiger.com)

Further information and resources for supporting children and young people can be viewed here: