School phobia: Not just a refusal

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The term ‘school refuser’ sounds defiant and deliberate. It suggests a child trying to ‘get out’ of going to school. Tania Tirraoro asks us to look at the situation in a different way.

Summary

  • There are many possible causes of school phobia, such as school-based anxiety, bullying and lack of self-esteem.
  • Children can be left traumatised and branded as naughty rather than receiving the support they need.
  • There are ways in which school staff can help to tackle the problem and enable the child to return to school.

When a parent tells you their child becomes distressed, anxious or even self-harms at the thought of leaving home or going to school, it is more appropriate to term it school phobia or extreme anxiety, rather than wilful truancy. It is not a behaviour problem; it is a mental health difficulty and should be treated as such by the school.

Causes of school phobia

School phobia can manifest as feeling unwell, refusing to get up, or meltdowns when it is time to leave the house. It is vital to find out the cause rather than issue threats to the parent to force compliance, which will only make the situation worse.

Possible causes include:

  • school-based anxiety, such as feeling overwhelmed about schoolwork, friendships or relationships with teachers
  • being bullied by pupils or a staff member
  • having self-esteem or even identity worries about fitting in or about who they are.

It may equally have a home-based cause if a close family member is very ill and they’re afraid to leave them. Perhaps their parents are going through a break-up or another difficult life event and the child feels as though they have no control. These are all issues to consider.

The results

Whatever the reasons for finding school attendance difficult, children can miss weeks, months or years of school. Some parents end up home-schooling, though not by choice. Others make do with sometimes patchy support from the local authority providing just a few hours of tutor support per week.

In the worst-case scenarios, parents have had a visit from the school welfare officer or have been fined. Others have had unwelcome social services involvement with the looming fear of having a child removed.

The campaign group ‘Not Fine In School’ is exploring whether they can legally challenge the Department for Education over families being punished for their child ‘refusing’ to go to school. There is also no consistent definition of what constitutes ‘school refusal’ and no established way of measuring the scale of the problem.

“  The most valuable thing a teacher can offer a parent and child in this situation costs nothing. It is empathy. ”

Trauma

These are not just stubborn children with arms crossed saying they won’t go to school. A child with school phobia is a traumatised human being too anxious and overwhelmed to be able to go.  For a child, especially a child who may have SEND or be particularly sensitive, the pressure of exams, peer groups and just the environment of school can be too much.

Callum Wetherill, pastoral leader of Joseph Norton Academy, spoke about this subject at the Commons Education Select Committee’s SEND Inquiry hearings earlier this year. He spoke of a systemic failure in education, branding children naughty rather than recognising emotional and mental health difficulties.

Trying to source help can be impossible.

“We’re getting a high influx of students coming in with high levels of institutional trauma, rather than life-long developmental trauma”, Mr. Wetherill told the committee.

In his experience, children really are being traumatised and unsupported by schools. While many children who struggle to attend school do not act out in lessons, the anxiety and distress causes the same traumatic result.

Difficulties receiving support

When a parent seeks help from the GP for such a child, they are likely to be referred to CAMHS. They then face either a lengthy wait to be assessed – never mind treated – or are told the child doesn’t meet the threshold criteria to be seen.

The thresholds seem to get higher every year, leaving children who could have been helped back to health fairly easily, to get worse and worse until they finally do meet the criteria of perhaps being actively suicidal.

How to help

The most valuable thing a teacher can offer a parent and child in this situation costs nothing. It is empathy. Empathy is imagining that this is your child having sleepless nights at the thought of going to school, or regularly cutting themselves to relieve the stress built up inside of them.

How would you feel? What would you do?

Listen

If a parent tells you their child is struggling to attend, listen carefully to what they’re saying. Ask them what their view is of the cause. Perhaps offer to visit the child at home in their own comfortable setting to have a less formal chat.

Communication

It is important that the child does not miss out on learning so send work home via email, a sibling or a friend. If the child is out of school for 15 days, whether consecutive or cumulative, the local authority should be informed as it has a duty to make sure alternative education is provided.

GP

If the child doesn’t have a diagnosis of any kind, suggest the parent asks their GP for a paediatrician referral, not just CAMHS. As school phobia is common in autistic children, ask the local autism outreach service for input. Cognitive behavioural therapy may help, so if your school has access to a counsellor or nurture specialist, ask for their support.

Assessment

You should also contact the local authority (LA) educational psychologist for an assessment to find out if there is an educational issue that’s been missed. Girls, in particular, who may be autistic can often ‘mask’ at school, until it eventually gets too much.

“ Be on the side of the family and stay in touch so the child is still connected to school ”

What the law says

The Children and Families Act 2014, Section 100 places a statutory duty on governing bodies of maintained schools, academies and pupil referral units to make arrangements at school to support pupils with medical conditions, which includes anxiety. There is statutory guidance from the Department for Education that covers this.

You should also note that it is unlawful to remove the child from the school register without parental consent and certification from the school medical officer, even if the LA has become responsible for the child’s education.

The ultimate aim is to reintegrate the child into school, if possible. Do this with kindness and encouragement, even if at first, it’s just an hour or two a week. Be on the side of the family and stay in touch so the child is still connected to school. It may be a long haul, but you will know that you have played a positive role in ensuring the child has the confidence to eventually return to school.

Further information

Tania Tirraoro is a journalist and parent of two young men with autism. Tania is also autistic. She is the founder of www.specialneedsjungle.com, a parent-led website that offers information and resources about special needs and disabilities in children and young people. Tania is also on the Ofsted SEND Stakeholder Advisory Group.

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Tania Tirraoro is a journalist and parent of two young men with autism. Tania is also autistic. She is the founder of www.specialneedsjungle.com, a parent-led website that offers information and resources about special needs and disabilities in children and young people. Tania is also on the Ofsted SEND Stakeholder Advisory Group.

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