Can’t, not won’t: Rethinking school avoidance

Archbishop Desmond Tutu once said, 'Language is so powerful that it can destroy or heal. When words are both true and kind, they can change our world.' This sentiment is critical when discussing Emotionally Based School Avoidance – the language we use to describe these challenges matters profoundly. The term EBSA has gone through many iterations, often not fully actually describing the difficulties associated with it. Over time, we have used terms like school refusal, school phobia, delinquency, truancy, laziness or even 'not bothered'. These phrases not only miss the complexity of the issue but also stigmatise the child. They imply blame, intentional defiance, or even moral failing, obscuring the real emotional struggle at play.

EBSA isn't a diagnosis, but rather a term used to describe children and young people who struggle to attend school due to emotional or mental health needs, characterised by both high anxiety and non-attendance at school (see Sussex EPS, 2018). (In fact, I prefer to say 'emotionally based school non-attendance', which feels truer to the heart of the issue.) For these young people, school is not just a place of learning but a source of overwhelming distress. 

Whilst it is difficult to fully assess the prevalence of EBSA in UK schools (due to differences in definition/threshold used and how absence is registered by school), it is estimated that EBSA leads to missed schooling in approximately 1–5 per cent of students in the school population (Elliot & Place, 2019). In fact the number is likely to be much higher, especially given some children will likely experience emotional distress at school but continue to attend despite these difficulties.

Research shows there is marked distinction between students who are absent from school due to truancy and those who find it difficult to attend school due to emotional distress (Thambiriraiah et al., 2008). In other words, EBSA reflects the 'can't', not the 'won't' of school attendance. It's not a deliberate and defiant act, an active choice for a child – instead, it's often the only viable option for students experiencing overwhelming emotional distress. Using emotionally-based language fosters a reflective, trauma-informed approach, helping to create a safe space for young people to share their struggles without fear of judgment or shame, improving outcomes and the likelihood of re-engaging with school (see Gregory & Purcell, 2014; Pellegrini, 2007). There is a growing focus on the emotional and mental health challenges associated with school non-attendance, highlighting the importance of understanding these difficulties rather than casting judgment.

What causes EBSA?

EBSA doesn't occur in isolation. As Educational Psychologists, we often turn to Bronfenbrenner's Ecological Systems Theory (to understand the interconnected factors influencing a young person's development).  This theory reminds us that a child's experiences aren't shaped by one factor alone but by multiple, interacting systems in their environment:

• Microsystem: Immediate environments, such as family and school. A child experiencing bullying or teacher conflict may develop anxiety about school, leading to avoidance. 
• Mesosystem: Interactions between environments, like parents and school staff. Poor communication here can leave emotional struggles unaddressed, but collaboration can support tailored interventions. 
• Exosystem: Indirect influences, such as parental work stress, which may reduce a caregiver's capacity to provide emotional support at home. 
• Macrosystem: Cultural and societal factors, like stigmas surrounding mental health or pressures to achieve academically. 
• Chronosystem: Life transitions, such as moving schools or family upheaval, which can trigger or gradually intensify EBSA. 

Using this framework helps us see EBSA not as a single, isolated challenge but as the outcome of a complex interplay between individual and environmental factors, such as predisposing factors, a precipitating event or changes in a child's circumstances related to school, family and the child themselves (see Lester & Michelson, 2024). This aligns with the principle of B = f(P × E), which emphasises how behaviour (B) arises from the interaction between personal (P) and environmental (E) factors (Lewin, 1935). 

Risk factors for school non-attendance

These challenges don't arise in a vacuum. Many factors can either increase the risk of EBSA or serve as protective resilience factors, helping children manage their emotional struggles in a way that enables them to attend school. I want to focus in on two risk factors that increasingly come up in my work and are also receiving more coverage in recent studies.  

Research increasingly highlights the heightened risk of EBSA among neurodivergent children, particularly those with autism (e.g. McClemont et al., 2021; Munkhaugen et al., 2017). Children on the autism spectrum often face sensory overload and social challenges that can make school an incredibly overwhelming experience. For these children, the combination of loud environments, sensory sensitivities, and social complexities can cause heightened anxiety, making it more difficult for them to engage with the school environment in the way that others might.

The transition from primary to secondary school is another significant risk factor for EBSA (Corcoran & Kelly, 2023; Nuttall & Woods, 2013). This transition marks a huge change in a child's academic and social world, with new expectations, unfamiliar environments, and an increase in social pressures. For many children, especially those who may already struggle with anxiety, the jump to secondary school is a stressful and daunting experience. It can often be further complicated by the influence of puberty, not only increasing stress and anxiety but also causing significant changes in motivation, behaviour, and social interactions (Blakemore et al., 2010).

The function of EBSA

As Educational Psychologists, we regularly ask a critical question: what function does this behaviour serve? All behaviour is communication after all, so all behaviour must reflect an underlying need – something we must explore, not dismiss. 

Although referring to school refusal, Kearney (2002, 2008) discussed how children may not attend school due to positive and negative reinforcers. Avoiding school may remove a distressing stimulus – whether it's academic pressure, sensory overload, or social anxiety. The relief of 'not being there' can provide temporary respite, and make avoidance feel like the only option. On the other hand, by not being in school, 'tangible reinforcers' can be pursued, such as having access to more comfortable environments, nurturing relationships, or pleasurable activities for example. 

When exploring the function of school non-attendance for a child, and areas to intervene, it is important to gather information on factors that 'push away' a child from home and 'pull towards' to school; and consequently 'push away' from school and 'pull towards' home. 

• Push from school: Academic pressure, social challenges (e.g., bullying or exclusion), unmet special educational needs, sensory overload, and conflict with staff.
• Pull toward School: Positive relationships with peers or trusted adults, opportunities for success, school structure and the desire for social interaction. 
• Push from home: Family tensions, parental mental health struggles, or difficult home environments. 
• Pull toward home: The comfort of being with family, reduced stress, or access to pleasurable activities. 

Crucially, the young person themselves is often the best source of insight into these factors. Listening to their voice – without judgment – allows us to co-create solutions that feel achievable and meaningful. 

Is EBSA on the rise? 

Recently, I encountered the term 'EBSA epidemics' being used in discussions around school attendance. This evokes a sense of urgency and danger, as though EBSA were an infectious outbreak to be contained. Applied to EBSA, it seems both unhelpful and misleading: although it is true that EBSA is a significant concern in schools, this framing may inadvertently escalate the fear and anxiety instead of helping people to understand and explore the concern better.

Lester and Michelson (2024) point out that the conditions that led to the increase in EBSA during and after the Covid-19 pandemic weren't a sudden crisis, but rather the convergence of psychological and contextual factors that compounded existing risks. The pandemic created a 'perfect storm', exacerbating feelings of loneliness and isolation, disrupting vital social interactions, and severing relationships between home and school. These disruptions, combined with the broader societal upheaval, created an environment where mental health – for both children and parents – deteriorated rapidly. For many students, this made school attendance even more challenging as schools reopened. Harking back on Bronfenbrenner's Ecological Systems Theory, it's clear that the pandemic wasn't just a singular event but a significant societal force that rippled across all layers of a child's environment: from the immediate family and school interactions (microsystem) to the broader community and societal influences (macrosystem). The long-term impacts on EBSA are still spreading.

A deeply influential thought experiment for me came from Dr Naomi Fisher's (2023) article on the side effects of schooling. She emphasised how traditional school systems often overlook the emotional and psychological needs of students, focusing heavily on academic achievement, comparison, and removing autonomy. This can often create an environment that feels more overwhelming and stressful than supportive or growth oriented. In today's world, where schools are under pressure from Ofsted, exams, and performance metrics, there's a growing sense that education has become too focused on grades and outcomes (Lakhani, 2020; Ball, 2021). Given these pressures, it's easy to see why more children are struggling with EBSA, as the system may sometimes not always account for, or support, the emotional struggles they face.

What can we do?

Supporting children with EBSA is a complex challenge, and there is no shortage of resources and strategies out there. However, a few particularly effective principles were shared by Hertfordshire County Council (2021), emphasising the importance of: intervening early, working with families, actively involving the pupil, developing a personalised and holistic action plan, and regularly reviewing progress. When schools, families, and communities collaborate, we create a supportive network that helps students move from avoidance to re-engagement.

This, at its core, follows a whole-systems approach, which centres on creating a safe, predictable, and supportive environment for children. Psychological safety is paramount, achieved through consistent routines, familiar faces and being 'held in mind'( which refers to feeling remembered, valued, and considered by someone, even in their absence).  But beyond that, children need nurturing relationships – connections based on trust, autonomy, understanding, and care – not just academic performance. These relationships are essential to help students feel safe enough to return to school. 

A good friend once said to me, 'There's no point in chasing a person to make them run a mile. You need to give them a reason to run.' This captures exactly how we should approach supporting children with EBSA. While awareness of the challenges these students face is growing, a consistent, unified approach is still lacking. Despite clear legislation that states mental health-related absences should be authorised, many families still find themselves facing fines for their child's school avoidance. To address this, a whole-school approach is essential – one that focuses on providing the support and structure needed for each child to gradually re-engage with school. This means developing step-by-step plans tailored to their individual needs, with clear, achievable goals and regular reviews to monitor progress.

If there's one thing I've learned from working with children experiencing EBSA, and also with the adults and schools supporting them, it's this: they're not 'refusing' education, they're overwhelmed by it. By understanding the emotional roots of school avoidance and creating environments that feel safe and supportive, we can begin to bridge the gap between home and school, and fully support the children and young people growing up today. 

Language matters. Listening matters. And above all, compassion matters. When we commit to these principles, we help young people rediscover not just their place in school but also their belief in themselves. 

• Meg Fairclough is an Educational Psychologist working for Southwark Council.

References

Ball, S.J. (2021). Response: Policy? Policy research? How absurd? Critical Studies in Education, 62(3), 387-393.

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Lakhani, P. (2020). Inadequate: The system failing our teachers and your children. John Catt Educational LTD. 

Lester, K. J., & Michelson, D. (2024). Perfect storm: emotionally based school avoidance in the post-COVID-19 pandemic context. BMJ Ment Health, 27(1).

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McClemont, A. J., Morton, H. E., Gillis, J. M., & Romanczyk, R. G. (2021). Brief report: Predictors of school refusal due to bullying in children with autism spectrum disorder and attention-deficit/hyperactivity disorder. Journal of autism and developmental disorders, 51(5), 1781-1788.

Munkhaugen, E. K., Gjevik, E., Pripp, A. H., Sponheim, E., & Diseth, T. H. (2017). School refusal behaviour: Are children and adolescents with autism spectrum disorder at a higher risk?. Research in Autism Spectrum Disorders, 41, 31-38.

Nuttall, C., & Woods, K. (2013). Effective intervention for school refusal behaviour. Educational Psychology in Practice, 29(4), 347-366.

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Thambirajah, M. S., Grandison, K. J., & De-Hayes, L. (2008). Understanding school refusal: A handbook for professionals in education, health and social care. Jessica Kingsley Publishers