SCHOOL ATTENDANCE PROBLEMS are commonly referred to as ‘school refusal’. This describes the reaction of children who experience severe anxiety and distress in relation to attending school, often resulting in prolonged absences. Children experience a range of psychological and physical symptoms, and in severe cases suffer with depression, self-harm and sometimes attempt suicide. 'School refusal' has been acknowledged as a multi-dimensional, dynamic and diverse emotional reaction, meaning each case is individual and complex to resolve.
Differing terminology has been used over time, since ‘absence from school due to excessive anxiety’ was first noted by Broadwin in 1932. Then in 1941 the term 'school phobia' was used by Johnson, et al. to refer to: 'a type of emotional disturbance in children associated with great anxiety, that leads to serious absence from school'. Since then a variety of labels have reflected developments in thinking about underlying influences, including 'home-bound school absence' (Waller and Eisenberg, 1980); 'school refusal' (Berg, et al., 1969), 'extended non-attendance' (Pellegrini, 2007) and ‘emotionally based school avoidance' (West Sussex Educational Psychology Service, 2018).
‘School refusal behaviour’ was defined by Kearney and Silverman (1999) as child motivated refusal to attend school and / or difficulties remaining in school for the whole day. This definition related to children who want to attend school, but stay at home due to fear or anxiety and in addition, their parents know they have remained at home. There are also children who do not attend because of defiant behaviour or disinterest in school, and their parents are usually unaware of this absence, this is referred to as ‘truancy’ (Berg, 1997). However, Kearney (2018) acknowledged that the concept of truancy is problematic, as many ‘truants’ avoid school for reasons other than delinquency or disinterest.
The high level of confusion concerning the terms ‘school phobia’, ‘school refusal’ and 'truancy’ highlights tensions that exist in defining the problem and apportioning cause or blame. For instance, Fortune-Wood discussed professionals’ reluctance to use the term ‘school phobia’ because;
It would admit that the problem is in the school rather than in the family. Instead ‘experts’ will tend to opt for the label ‘school refusal’, which denies that school is the problem, denies a medical label and instead puts the onus on faulty behaviour.
Pellegrini (2007) suggests this variation happens because the problem has been 'conceptualised by different agencies' and so has tended to reflect the related clinical, medical or educational focus. In response, he suggests the term 'extended school non-attendance' would be preferable as a more neutral and less judgmental option to describe the problem.
Heyne et al.(2019) proposed an updated definition of three dominant ways of conceptualising school attendance problems - truancy, school refusal, and school withdrawal, and they add school exclusion as a fourth concept (which is significant as it now acknowledges that school-based actions can create and influence attendance problems). School exclusion is defined by Heyne et al (2019) as an absence from school or from specific school activities. This absence is caused by the school: employing disciplinary measures in an inappropriate manner; ‘being unable or unwilling to accommodate the physical, social-emotional, behavioural, or academic needs of the young person’; or ‘discouraging the young person from attending, beyond the realm of legally acceptable school policy’.
The lack of an agreed standard term or definition can be said to restrict the identification of children requiring support, and cause misunderstandings about the reasons for school absence that effect approaches used to resolve the situation. The range of terminology creates obstacles for families in getting the correct support because the focus on 'within-child' explanations deflects attention from alternative factors. This is significant as Kearney and Silverman (1990) highlighted, the crucial issue in resolving school refusal is to identify the function and need behind the behaviour.
EBSA (Emotionally Based School Absence) has become more widely used in recent years, having been introduced in guidance written by educational psychologists, however it still draws attention to a within-child explanation for absence. In contrast, barriers to attendance is a form of terminology which has grown in popularity as it does not focus the blame on the child but instead recognises that their are factors which are preventing a child from attending school.
PROSECUTING PARENTS OF CHILDREN WHO HAVE MISSED SCHOOL (2019)
Epstein, Brown and O’Flynn carried out a study of parents, and in particular, mothers, who are fined or threatened with fines for their child’s non-attendance at school. Many of the children and young people who do not attend school regularly are on the autism spectrum, or have SEND and/or moderate or severe mental health problems. Many have been bullied and have then become afraid of school and too fearful to attend.
There are parents, often of children on the autism spectrum or with anxiety disorders, who, try as they might, simply cannot get their children in to school. Many have received repeated fines and threats of prison. The authors call for a change in the law, so that parents are supported, not punished, if their children cannot attend school.
This report contains moving testimony from parents affected by this cruel law. There is at the end a useful section ‘Sources of help’ with some addresses, especially about legal advice, that many may find helpful.
Exploring the Experiences of Parents Who Seek to Resolve School Attendance Problems & Barriers (2022)
School attendance problems (SAPs) have been framed in terms of ‘truancy’, ‘school phobia’, ‘school refusal’, ‘school withdrawal’ and a range of similar terms. This variation reflects the heterogeneity of both SAPs (Kearney et al., 2019), and the varied backgrounds of practitioners conducting SAPs research (Birioukov, 2016). This longstanding discourse suggests the behaviour of absentee children is deviant or neurotic, and their parents are in some way deficient, failing, or neglectful (Southwell, 2006; Donoghue, 2011). However, this fails to address the experiences of parents who actively seek to resolve SAPs, and perceive a child is unable to attend for reasons of anxiety and distress, possibly in relation to school-based influences (e.g., Mind, 2021; Ditch the Label, 2020). These aspects of SAPs have received scant attention in the literature. Therefore, to understand this phenomenon better, this study set out to investigate the perspectives and experiences of parents in this situation.
Email-based interviews were conducted with forty members of a social media-based support group for parents seeking support for their children’s SAPs. Thematic Analysis of data led to the concept of ‘Parents Journeys’ through SAPs, setting out an overview of common experiences. This indicated how social and systemic responses to SAPs act as barriers that prevent or hinder parents’ ability to comply with their legal duty to ensure children access an education (section 7, Education Act 1996). It was noted that a tension exists where parents who participated in this study have a shared understanding of SAPs which validates their experiences, yet this is at odds with the shared reality and understanding of school staff and other professionals.
Recent research highlights the importance of holistic assessment of individual circumstances to better understand the influence of school and wider systemic factors upon cases of SAPs (e.g., Melvin et al. 2019). In this study an adapted version of Bronfenbrenner’s Bioecological Model (1979, 1998, 2005) conceptualised the social and systemic complexity of the SAPs context from the parental viewpoint. This adapted model offers a new way to understand how the successful resolution of SAPs will require multi-level changes in school attendance related discourse, practice, and policy.
School Distress in UK School Children: The Parental Lived Experience (2023)
Aims - We aim to describe the lived-experience of the parents
School Attendance Problems | School Distress | School Refusal | Mental of CYP experiencing SD in the UK, and quantify the impact of the current status quo on their physical and mental health, and lives more broadly.
Conclusions - This study highlights a bleak, adversarial lonely picture for the parents of CYP struggling to attend school. More specifically, the findings depict a system rife with parental blame; a system that appears to isolate parents through hostile, threatening, and punitive actions. A wider lack of societal understanding of the experience of School Distress further compounds this dearth of support for parents, placing parental mental health in further peril.
What can we learn from parents and caregivers of school-aged autistic children to inform current Emotionally Based School Attendance (EBSA) intervention approaches in England? (2022)
In January 2022 Dame Rachel de Souza, the Children’s Commissioner for England at the time, told the BBC that she would find the so-called ‘ghost children’, up to 100,000 children who were absent from school following the Covid-19 lockdown in 2020, and ‘get them in [to school]’ (Shearing, 2022). By May 2022 this figure had increased to over 124,000 (Education Committee, 2022) with Special Educational Needs (SEN) children being 50% more likely to struggle with school attendance (Office for National Statistics (ONS) 2021). Ambitious about Autism (2022) report that over 40,000 autistic students (31% of the autistic student population) suffered with persistent absence in 2020/21 and school attendance struggles are documented as more prevalent for autistic students (Munkhaugen et al., 2017). In May 2022 the government announced The Schools Bill 2022 with a section dedicated to school attendance giving added powers to fine and prosecute parents for school non-attendance, yet Square Peg and Not Fine in School (NFIS) (2021) report that school non-attendance is a clear message of a child’s underlying needs, and this punitive approach does not resolve the problem (Epstein et al., 2019). These statistics and the government approach paint a bleak picture for the many children struggling with school attendance as academic outcomes and achievement in adult life are poorer for these children (Pellegrini, 2007; John et al., 2022).
School attendance struggles are nothing new for families of autistic children. As the parent of an autistic ‘ghost’ child who has been unable to access a school setting since 2019, I am deeply aware of the stresses this causes the family as well as the trauma that repeatedly ‘dragging’ the child to school can cause. I find the current government focus of finding the ‘ghost children’ to bring them back to school unacceptable if the underlying difficulties of these children are not fully understood and supported. Therefore, this study is designed to understand Government and Local Authority (LA) approaches to school attendance and to supporting autistic school-aged children who struggle with Emotionally Based School Avoidance (EBSA). It then obtains the parent’s viewpoint to see what may be learnt to inform the current approach. To do this the study first examines the literature in this field before outlining how the research will be undertaken. Following this the results are examined and discussed, within the context of the literature, before concluding what we can learn from parents about the current intervention approaches for EBSA in England.
Parents’ views on EBSNA: A solution-based exploration into successful reintegration. (2022)
The aim of this mixed methods study was to further understand how professionals can support ‘emotionally-based school non-attendance’ (EBSNA), through exploring parental experiences. EBSNA is believed to impact one-two percent of children and young people (CYP), presenting as ‘severe emotional upset at the prospect of attending school’ (Berg et al., 1969). Adopting a ‘solution-oriented’ approach, this research gathered retrospective experiences of successful EBSNA support, aiming to uncover ‘what works’ when supporting children and families experiencing this difficulty. Furthermore, as well as understanding the support accessed by parents, and what was useful, this study additionally hoped to explore the impact of the Covid-19 pandemic on such support and determine if opportunities to learn from practices during the school closure period may exist. Participants first completed an online questionnaire (Phase One; n=28) following which descriptive statistics were produced, and content analysis techniques were employed. During Phase Two, participants completed semi-structured interviews (n=5), and transcripts were analysed using ‘Reflexive Thematic Analysis’ (Braun & Clarke, 2021). The resulting findings provides insight into the different forms of support accessed by parents when experiencing their child’s EBSNA, identifying areas of both success and improvement, as well as how lessons can be learnt from the Covid-19 pandemic. These have been presented as a framework for professional practice, named SPIRAL, which has implications for schools and local authorities in providing support to both CYP and parents experiencing EBSNA. Recommendations for future research are also discussed, informing developments across multiple systems, and highlighting the potential of the EP role.
An exploration into the parental experience of Emotionally Based School Non Attendance in young people: An Interpretative Phenomenological Analysis (2018)
School refusal, school phobia, school anxiety and emotionally based school non-attendance are all interchangeable terms used to describe children who experience high levels of distress and anxiety that prevents them from going to school. Emotionally Based School Non Attendance (EBSNA) in young people is a complex and multifactorial condition which can be a symptom of an underlying mental health disorder (McShane & Rey, 2001). This study explored the experiences of parents of young people aged 13-15 years old who present with EBSNA, who no longer attend mainstream school and who attend an alternative educational provision. Interviews were conducted with five parents and transcripts were analysed using Interpretative Phenomenological Analysis (IPA), leading to four superordinate themes: ‘It turns your life upside down’; Power and the battle to be heard; Loss and fear and Retrospective clarity. These themes captured the far-reaching effects on parents which impacted on relationships within the family, their own mental health and poor relationships between home and school. Parents shared their concern for their child’s future and described the need to understand the origins of their child’s condition. Implications for Educational Psychologists (EPs) and other professional agencies suggest that it is important to increase our understanding and awareness of the parental experience and consider ways of improving the quality of parental and professional relationships.
The International Network for School Attendance (INSA) exists for all those who wish to promote school attendance and respond to school absenteeism. It aims to compile, generate, evaluate, and disseminate information, assessment, and intervention strategies.
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