Helping Children With Medical And Mental Health Conditions Get The Best Out Of School

ANXIETY BASED SCHOOL AVOIDANCE

Anxiety based school avoidance (ABSA) is when a child or young person experiences extreme difficulty in attending school.

sebastian muller 52 unsplash

SUPPORTING STUDENTS             MORE INFORMATION 

Absence from school can be for long periods and is known to parents/carers. ABSA is generally complex and is best supported through early intervention. In the UK it is believed ADSA affects between 1-2% of the school population. It is more prevalent around transition to secondary school. It equally affects boys and girls. (1)

Causes

Many children and young people may at one time or another say they don’t want to go to school for a specific reason, such as falling out with a friend or not completing homework on time. ABSA is different. It’s persistent non-attendance where the reason for absence is complex and not always immediately evident to the family or school.

ABSA is often referred to as ‘school refusal’. This term is unhelpful as it suggests the issue is located solely with the child or young person. It fails to describe the interplay between school, home and child, all of which can contribute to a child with ABSA finding it difficult to attend school regularly.

There are some features that may make a child or young person more likely to experience ABSA than others. These are generally referred to as risk factors.

Risk factors include:

School

Bullying, transition to secondary school, structure of the school day, academic pressure, peer and staff relationships.  

Child

Temperament, poor self confidence, physical illness, specific ages (6-7, 11-12 13-14), Special educational needs, ASD (unsupported/unidentified), traumatic experiences or events.

Family

Separation and divorce, parental physical and or mental health, loss and bereavement, high levels of family stress.

Reasons for non attendance are generally related to four key areas: (2)

  1. Avoiding uncomfortable feelings of anxiety experienced when in school
  2. Avoiding stressful situations such as academic demands, social pressures or aspects of the school environment
  3. Needing to reduce separation anxiety from a significant adult
  4. To participate in activities such as shopping, playing games with a significant adult

Treatments

Early intervention is crucial. The longer the problem remains the poorer the outcome. Early identification of ABSA can be difficult. Children and young people can find it difficult to articulate their feelings and distress about attending school in a way that school and family can understand. How a young person presents at home and in school may also be different. Sometimes this can lead to feelings of blame resulting in school or family feeling defensive or anxious. 

It is important that all perspectives are shared and listened to. Views need to be respected and differences acknowledged.

Initially looking at behaviour rather than cause can be helpful. Every child and young person experiencing ABSA will present differently.

After an initial assessment of the situation a plan needs to be drawn up that is devised and agreed by the team supporting the child or young person. This may include an educational psychologist, the SENDCO or identified school staff member, family members and the child or young person. The plan will be unique and will focus on the strengths and challenges faced by the child or young person.

Supporting students with Anxiety Based School Avoidance

jason leung 479251 unsplash

Identification and Planning

  • Early identification is crucial. Look for attendance patterns, changes in behaviour, and changes in family circumstances. Ask questions to find out what is happening for the child or young person.
  • Listening carefully to understand, don’t make assumptions based on the experience of other students.
  • Set realistic goals. Over ambitious plans are likely to fail.
  • Plans work best if they are gradual and build in actions for when things aren’t working.
  • Working collaboratively is important. Child or young person, Family and school all working together with the child at the centre.
  • Good communication is vital. Home-school communication is important when things are going well and when they’re not.
  • Accept there will be good and bad days but each day is a fresh start.

Interventions and Strategies

  • Assess, Plan, Do, Review. This cycle will help structure support.
  • Active teaching of skills to manage anxiety, such as relaxation, breathing, distraction.
  • Gradual re-exposure to school environment, starting with least feared to most feared spaces. This will be individual to each child and young person (For example, standing outside closed school building up to being in the dining hall.)
  • Agreed timetables, this could be part-time initially.
  • Agree and put the right support in place. This may include, an identified staff member, a time out card, access to a quiet space.
  • Teaching social skills may help some children and young people managed social situations that create stress and anxiety.
  • Use of role play to practice responding to questions about why they’re been absent or are attending school part- time.
  • Agree times and activities for the child/ young person to do with a parent or family member.

 Whole School Systems

  • Mental health support for individual children and young people works best when embedded in whole school systems that promote wellbeing and good mental health for all members of the school community. See our page on A Whole School Approach to mental health.

More Information

Information and Advice for parents & carers from Young Minds
https://youngminds.org.uk/find-help/for-parents/parents-guide-to-support-a-z/parents-guide-to-support-school-anxiety-and-refusal/

Animation from Angstvoordeschoolpoort This short film wants to give you a perspective of a young student who is struggling with school attendance.
Courtesy of https://www.teamsquarepeg.org/school-refusal

References

(1) King, N. & Bernstein, G. (2001). School Refusal in Children and Adolescents: A Review of the Past 10 years. (Journal of American Academic Child Adolescent Psychiatry) 2001 Feb:40(2):197‐205.

(2) Lauchlan, F.(2003)  Responding to Chronic Non-attendance: A review of intervention approaches
(Educational Psychology in Practice ) 2003 June 19(2):133-146

Understanding School refusal: a handbook for professionals in education, Health and Social Care. Jessica Kingsley, London, UK Thambirajah M,S., Grandison K.J., and De-Hayes L. (2008) 

Kearney, C & Albano, A. (2018) When Children Refuse School, Oxford University Press
Maynard, B. etal (2015). Treatment for School Refusal Among Children and Adolescents: A Systematic Review and Meta-Analysis  (ResearchGate)

Follow Us

Follow Us
Join the conversation
facebook instagram twitter

Newsletter

Newsletter
Sign up for our  NEWSLETTER