School refusal

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This article is based on our experience at CSAWS and will hopefully provide some information, advice and guidance for school staff. As a team of experienced attendance and welfare officers, we frequently work with children, parents, families and schools with cases of school refusal and we are aware of the challenges this area of work presents

Summary

  • The impact of school refusal on individual children cannot be overstated, both in terms of current and long-term emotional well-being, academic attainment, achievement and future options. 
  • The impact on families and parents can be devastating. There are practical issues, such as the implications for work and childcare, and the day-to-day challenges of managing the school day for siblings. There is also an emotional challenge of witnessing your child distressed and refusing to attend school. In our experience of working with many families, we know that the pressures of trying to get their child to attend school and then waiting for the child’s refusal at home can leave parents feeling anxious, frustrated and powerless. They may also feel like they have failed as parents.
  • From the school’s perspective, there is usually an attendance officer, school pastoral lead or headteacher who feels that they need to find the solution. 

What is school refusal?

School refusal occurs when a student will not go to school or frequently experiences/exhibits severe emotional distress related to attending school. The term ‘school refusal’ can capture a range of issues/conditions, including anxiety, school phobia, separation anxiety and/or social anxiety. School refusal can be short term, triggered by, or related to, a specific issue; or it can become long term, intermittent or a continuous period of refusal.

The reasons for school refusal are complex and need to be understood in individual cases to enable appropriate strategies and support to be put in place. There are times when a period of school refusal is triggered by a specific ‘easy to identify’ issue. For other children and young people, the reasons can be complex, multi-faceted and difficult to unpick.

Some of the specific triggers you may come across are loss and bereavement, parental ill health, family breakdown, bullying, unidentified special educational needs/mental health needs, changes at school or at home, times of transition, academic pressure or social anxiety. This is not an exhaustive list and if these issues aren’t present it doesn’t make that child or young person’s emotional distress, anxiety and refusal any less valid.

The characteristics of children who refuse to attend school in our experience are varied, and include pupils in primary and secondary school, children from all backgrounds, children who may have identified SEN or health issues, children who are academically strong and have no presenting behaviour concerns.

Early identification and interventions

Early identification of school refusal and intervention is key, school refusal can become a self-fulfilling cycle that rapidly escalates and becomes entrenched. The non-attendance/erratic attendance of a child or young person initially avoiding/refusing to attend school will create new problems which will cause new/further levels of anxiety and worries about attending school; for example, falling behind with learning, missing shared experiences with friends leading to social isolation, reduced self-esteem and confidence.

Some of the early signs or indicators include:

  • crying/protesting/reluctant every morning
  • physical symptoms, such as headaches or tummy aches, frequent visits to school first aiders, requests to be sent home, complaints of feeling unwell
  • erratic attendance patterns such as odd days absence/absence on certain days of the week
  • frequent late arrival
  • absences or late arrivals after the weekend/school holidays
  • vague reasons for absence/repeated reasons for absence
  • reluctance to go into lessons
  • distress/upset on arriving at school
  • clinging to/refusing to leave parent
  • information shared by parent or pupil regarding difficulties/anxieties about school
  • information from previous schools/settings.

Early identification requires good systems for monitoring attendance so that concerning patterns are noticed quickly. There needs to be good communication with pupils and parents about school attendance and awareness should be raised with all teaching and support staff.

Assessment

Interventions and support needed will be dependent on the cause of school refusal. This can be difficult to determine, as children and young people may find it difficult to explain and express why they are refusing to attend school.  It is important to invest time trying to gain an understanding of the causes. All assessments and plans need to consider the views and needs of parents and families and should include:

  • talking to the child and young person: Using scaling, breaking down aspects of the school day/timetable, exploring ways for them to express their concerns and worries
  • talking to parents: When did they notice changes? What has the child shared with them? What are their observations, and have there been previous incidents? Have there been any changes in the child’s life?
  • talking to previous schools/settings.

If the child or young person isn’t attending school, some of these conversations/activities may need to take place in the family home (if there is capacity to make those visits). Maintaining a home-school link while a child is refusing to attend school is important.

Support plan to increase attendance and access to education

All interventions need to be planned, managed and agreed with both parent and child. Plans should be written, shared and communicated clearly to all relevant school staff and the importance of being adhered to reinforced.  A written record of any plan will help to evaluate the impact of any interventions, highlight successes and understand where interventions haven’t been effective. This documentation will help provide evidence for any additional services/support or referrals.

The plan will be different for each child, and will consider the issues identified and the level of refusal. There are a wide range of strategies and interventions that schools can consider including in plans.  These will need to reflect the resources available and local services, protocols and procedures (suggestions are included in resources). Timescales should be agreed toreview the plan and should include identifying what went well, any actions that were not completed or successful and why? Next steps should be agreed, including formalising a further action plan and timescales for review.

To support a child or young person’s attendance at school, reduce levels of anxiety, or to reintegrate them after school refusal may mean using a reduced or part-time timetable. The use of a reduced or part-time timetables needs to be documented (some local authorities will have written protocols or guidance) and should be used alongside other interventions and need to be a short-term intervention. Registers should be marked appropriately with the ‘C’ code for sessions the child/pupil is not expected to attend (‘X’ code for non-statutory school-age pupils) and the relevant attendance or absence code for all other sessions.

Some pitfalls to avoid when agreeing plans and strategies include the following.

  1. Do not rush to increase timetables or make changes due to external pressures.
  2. Do not change the planned interventions without discussion with parent and child, even where things appear to be progressing well. 
  3. Never use force to secure school attendance. 
  4. Do not minimise or disbelieve a child’s concerns.

Medical evidence and pupils medically unfit to attend mainstream school

The question may arise as to whether the child or young person, at this time, is medically fit to attend school. Local authorities have a duty under section 19 of the Education Act 1996 to provide an education for children who, due to illness, exclusion or otherwise would not receive a suitable education. These responsibilities are detailed in the DfE statutory document ‘Ensuring a good education for children who cannot attend school because of health needs’ (2013).

This document statesthat local authorities must:

‘Arrange suitable full-time education (or as much education as the child’s health condition allows) for children of compulsory school age who, because of illness, would otherwise not receive suitable education.’

Local authorities should provide education for children who will be absent for 15 days or more (consecutive or cumulative). 

It is recognised that not all children with health needs require the intervention of the local authority to access an appropriate education. Some children can be supported in school with additional support, as detailed in this article. Others will receive a suitable education via alternative provision arranged by schools.

Individual local authorities must have their own written policy statement and will have procedures/pathways for accessing services for children and young people unable to attend school due to health needs. This will include an expectation that medical evidence is provided and will usually be from a consultant or a CAMHS psychologist/psychiatrist. 

Dealing with school refusal and the question of medical evidence can raise some specific challenges. There is often a waiting list for children and young people to see the relevant medical professional. There can be difficulties engaging children and young people who may be not only refusing to attend school but refusing to leave home. The child/young person may not accept or recognise that they need any intervention. School staff and parents can be left with the dilemma of how to support the child/young person to access an appropriate education while they wait for assessment with the specialist service. This complex area was highlighted in a recent case where West Sussex Council was criticised by the local government Ombudsman for ‘failing to consider alternative provision for a child suffering anxiety and school phobia’.   

Children who do not receive education from the local authority due to health needs must remain on the school roll. Schools should work closely with the local authority to ensure that children and families are able to remain in touch with them and be prepared to plan for the child’s re-integration when well enough to attend.

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About Author

Joanne Sierzega

Joanne Sierzega worked for almost 16 years in local authority education welfare. Since then she has established CSAWS (Central School Attendance and Welfare Services Ltd) with two partners. CSAWS comprises a team of education welfare officers who are committed to achieving better outcomes for children by securing regular attendance at school.

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