Generally all the students we support have stopped attending school at some point in their education. Some despite the efforts that were put in for them, and some because it appears no effort was made for them at all. Many of our students have had years of incredibly low attendance rates, like 20% to 35% attendance or no attendance at all, which has led to gaps in their education.

All of them are labelled as EBSA, or Emotionally Based School Avoidant. EBSA is a relatively new term in education, which refers to children who do not attend school not for medical reasons, but because of what is generalised as an emotional barrier to attendance. It replaces the old label of school refusal, which implied that a student could but chose not to attend school. The key difference with the EBSA description is that it recognises that children can’t, not won’t, attend school. There’s a lot of debate around the causes of EBSA and how best to approach it in schools but one thing is certain is that the number of children who are deemed EBSA is growing year on year.

I know that some local authorities have put together EBSA groups or task forces that work with students and schools and families to try and improve student attendance, however, we all know that funding within education is very tight and the work that needs to be done with EBSA students isn’t a quick fix and can be quite costly, which has resulted in many of the EBSA departments being reabsorbed into the general educational or SEN services.

The actual process of a student becoming school avoidant can be gradual, building up slowly, or it may happen all at once as the student hits an emotional wall and simply cannot continue to attend school.

My current setting works with students who fall into that EBSA category. In my experience, students who are referred to my setting will generally be one of three types. Firstly, students who are neurodiverse, usually ASD and/or ADHD. Students who are anxious. And thirdly, students who have traumatic backgrounds and home lives. And today, I’d like to talk about the first of those three groups, students who are EBSA because of neurodiversity. Most typically students with autism spectrum disorder or ASD.

Now, this isn’t to say that children with ASD can’t also have experienced trauma, in fact many have been traumatised by their school experiences, or that they aren’t anxious also. Many of our ASD students have diagnoses of anxiety disorders, whether that be OCD, social or separation anxiety, or even generalised anxiety disorder. There can be a great deal of overlap between the three groups, but in my experience, the approach you take with a neurodiverse student will be different to that of an anxious or traumatised student.

I’m not a diagnostician or a psychiatrist. I am an educator, and so will be drawing on my experience of what has helped the neurodiverse EBSA students in my school, and what they have related to me is difficult for them to cope with. This isn’t a one size fits all solution, but hopefully will give you an indication of what’s going on for your neurodiverse child in mainstream school and hopefully give you some ideas of how to help support your child.

As the majority of EBSA cases tend to begin in secondary school, I will be talking from that perspective. However, if your child is still in primary school and struggling, I hope that you will still find aspects of this podcast series useful.

Episode 1: EBSA and the neurodiverse student.

There is an enormous change between primary school and secondary school. Aside from the size difference between a one form entry primary school with a maximum of 210 children, and a secondary school, which could be nearly five times larger, there are also many other changes for our children to navigate, changing from being based in one classroom with one class and one or two regular teachers to at least 12 or more teachers of different subjects in different classrooms, in different parts of the school building, and with different students in your class, where some schools still stream classes for core subjects, means that the people in your sphere of influence increases from 30 or 40 to 70 or 80, or even more.

A high turnover in staff, with many teachers leaving the profession, also impacts the amount of change that students are expected to cope with. Additionally, there are teachers doubling up or covering other subjects, which can be very difficult for our ASD students to understand because they like to compartmentalise and know who does what precisely. Different adults taking over different sessions can make it doubly hard for ASD students to establish relationships.

Then there are environmental factors. Worries about getting lost, school uniform, which in my experience is considered smarter and therefore tends to be more restrictive than primary school uniforms, the homework and so many other things. Is it any wonder, then, that our children begin to struggle.

ASD students are typically routine bound, thriving in an environment where they can predict what will happen next, where they have well-developed relationships with the adults in their classrooms, be that with the teacher or teaching assistant, and where they know what is expected of them and when.

Generally, aside from the usual worry about making a change from one school to another, our ASD students have had the additional worries that stem from four other sources.

Firstly, a great number of ASD students also struggle with sensory processing difficulties. Secondly, they find it difficult to cope with unexpected events. For example, behaviours from other students or substitute teachers taking over sessions or changes to routine. Thirdly, social communication is for our children at best exhausting and at worst bewildering and overwhelming and it’s closely linked, along with the first stressor to the fourth source of stress, which is food and eating at school.

Our ASD children cannot always articulate what it is that they find difficult about school. Generally saying I don’t like it or it’s too hard, if they say anything at all. And it takes some detective work to figure out what the crux of the problem may be. For many of our students, it starts at home before they even head into school. Try and imagine a school day from your ASD child’s perspective. You know that school is important. This has been drummed into you since you started at age four. You have rules in your head that you use to navigate your life. Some of these rules are generalised around things like how you treat friends or how to behave in an assembly, and other rules are more personal, relating to what you expect of yourself in school, how hard you push yourself in your subjects, and how you don’t want to stand out from the crowd.

A lot of ASD children struggle to sleep at the best of times, and now you’re worrying about school. This impacts on the little sleep you get, meaning you wake up tired. Your resilience, which should be at 100%, is starting at 80% because you’re exhausted and find waking up at 7am too hard. It’s far too early to eat breakfast, so you either skip it or force yourself to eat it. Both of which have an impact on your start to the day. Your resilience is now at 70%.

Added to this, you must now contend with the school uniform. Not all schools are the same, but the majority of secondary schools, in my experience, require students to wear uniform and generally the uniform requirements include a blazer and a tie, both of which can feel constricting and both of which have rules around where and when and how they need to be worn. If you factor in difficulties around the feelings of fabric, the seams in clothing, the feel of trouser or skirt waistbands, stiff collars on shirts, the scratchy feeling of layering jumpers or blazers over shirt sleeves, as well as the rules around the place of where you’re allowed to take off your blazer or not, or when you have to take your coat off. That can make for a very difficult start. This then plagues you all day long, like a pebble in your shoe that you cannot remove, and your resilience is now at 60%.

Then there are also restrictions in terms of what you aren’t allowed to wear that may have helped you cope with sensory overwhelm, like headphones, for example, that help block out outside noises but also allow for a bit of distraction with music being played.

Hats, gloves, soft and snuggly fabrics, comfortable shoes or trainers rather than harder leather school shoes are also generally restricted. Some schools have rules around things like whether children are allowed to wear their coats inside the building or not. So there comes with it temperature fluctuation difficulties. Whether you’re either too warm or not warm enough. The weather also has a part to play in this, including getting rained on when you walk to school and then being damp and uncomfortable all day.

This all contributes to the stress that you are feeling before you even get yourself out the front door and on your way to school, and your resilience level is sitting at 50%.

So now, if you add to the tiredness and uniform difficulties and overcrowded school bus or train with elevated noise levels and different and stronger smells, some youngsters begin to indulge their love of perfume and body sprays in secondary, and this can quickly become overwhelming to our ASD students.

Car journeys can also be tricky to navigate. Too much chat or the wrong sort of music, or aggressive driving styles, or even heavy traffic can all add to the tough start. And bear in mind a lot of ASD students find it difficult to travel. Getting travel sick quite easily. All of this adds up and sets you up for a fairly rough start to the day before you’ve even arrived at school, and your resilience level is at 40%.

Once at school, you are now part of nearly a thousand other students moving through halls, moving through passageways, crowded, overwhelming, being barged past, feeling restricted, before you go into different classrooms where teachers have different expectations of you that haven’t been made clear or explicit. Some control classes by raising their voices and shouting, which lead children to raise their voices to be heard, and the noise level in class can become quickly overwhelming. Or perhaps the teacher talks too quickly, or expects students to make eye contact or talk to assigned partners, which may be uncomfortable or, worst of all, cold call students for answers.

Students can also be triggering with poor behaviour, outbursts, or unpredictable mood swings or responses.

Bullying also plays an enormous role in EBSA, and sadly many of our children experienced bullying in their time at school.

Additionally, you are also now responsible for sorting your own books and resources for school. Teachers expect you to manage and organise yourself and keep track of your homework, taking it home, finding the time to do it, and remembering to hand it back in. Suddenly, your resilience is at 20% and you haven’t even made it to lunchtime yet, which brings its own difficulties.

So by the time you finish the school day, you are exhausted and emotionally battered and bruised. You’ve had to contend with mood swings and outbursts of other students, navigate the murky waters of friendships, as well as the sensory horrors of the lunch hall and your own packed lunch or school dinner.

So many of our ASD children struggle socially. Girls especially mask particularly well in primary school when socialising. And then, as relationships become more and more complicated throughout secondary school, the mask slips and they begin to struggle more and more. Break and lunchtimes in school can be just as much a source of stress as the lessons that students have to face. There suddenly seem to be a million new social rules that no one explains to you, and that everyone else seems to understand.

Some students in your class can seem to get away with outrageous remarks and statements, and yet others cannot. Popularity and social standings change and move on what can feel like a daily basis. For neurotypical teens, friendships begin to hold a new power, appearing to replace family bonds as students develop their friendships and relationships and make their move towards their developing independence.

Puberty kindly adds in a whole different layer to interactions, where attraction is suddenly added to the mix and a new language emerges around liking someone and like liking them. These changes are difficult enough for a neurotypical student to navigate, and when you consider facing those situations as a neurodiverse teen, it can be even more bewildering.

You will be able to see how the gaps grow socially between your ASD child and their peers, especially when puberty hits, as it doesn’t happen to everyone all at once, and you can see how their friendships might fracture as the people around them develop at a different rate.

Puberty also causes difficulties for our children as their bodies change. Physical changes can be very distressing to our students as they change from how they’ve always perceived themselves to be. This can feed into their sensory difficulties, especially for girls when they begin to have their periods. Coping with spots, greasier skin and hair, having to shower and wash more frequently all adds to the stresses and difficulties that our children experience at school.

Teens become very self-conscious about their bodies and how they look, and for students who are already experiencing sensory difficulties with their eating, this can lead to more restrictive patterns too. Old wives tales about chocolate causing spots, for example, can render a previously safe food inedible. For those ASD children who struggle to adapt their washing regimes to their newly smelly bodies, this can also lead to them being socially excluded or bullied for how they look and smell.

Our children try and maintain their behaviour as per the rules they’d previously established in primary school, but suddenly they aren’t secure anymore, and the rules they figured out before don’t seem to help as much now. Trying to blend in with the continually changing masses is a full time job. An exhausting full time job. Now they’re finding themselves in situations which were always fairly tricky for them before, but where the insecurity they’re experiencing has increased by an enormous factor. To make matters worse for them, they have to eat their lunch with everyone. They feel judged on their lunchbox and what they have in it. Maybe they struggle with sensory aspects of food, only liking dry textures or crunchy or spicy foods. Maybe that only want soft or bland or beige food and suddenly it becomes harder for them to eat anything that they previously found safe because someone makes a comment about it.

When you’re in school, whether you’re an adult or a child, everybody discusses lunch at lunchtime. They discuss what you eat, how much you eat, or that you eat the same food day in and day out. If you have to queue up as a child to get your school dinner, that can be a trial in itself. There’s jostling in the queue, you’re worrying that they will still have the choice you want by the time you get to the front. Having sufficient time to get your food and eat it before the next session.

As parents with our children enduring that throughout their school day, we see our child slowly but surely lose their sparkle, their energy, and any joy they previously had for learning and socialising. Our children are tired and they begin to dread school, overwhelmed by the pressures of every day and not having enough time between each school day to recover fully before they have to start all over again. We try and talk to them about it, but they’re so unbalanced by everything that’s going on, they can find it difficult to identify what’s wrong.

ASD children can also struggle with something called alexithymia, which is the inability to recognise or describe their emotions. They might know something is wrong, but have very little idea of what it actually is, potentially impacting social interactions and emotional regulation. Children often try to make sense of that wrongness as either sadness or anger. This anger then spills out in some very difficult to manage ways. Previously, calm and loving children can suddenly become storms of rage and cutting remarks. Your child’s behaviours can change. They can withdraw or become extreme risk takers, all of which is their way of coping with the exhaustion and powerlessness that they are feeling.

Some of our children may be able to articulate the things they find difficult, and we pounce on that information, trying to solve each hardship for our child. For all our children, the ones that recognise their feelings and the ones that do not, as loving and increasingly desperate parents, we try and fix it and make it better for them. But that comes with its own difficulties too.

Our children are very aware of not wanting to stand out any more than they already do with their struggles. To our children, their peers look like they have everything under control. They seem to know exactly what they’re doing and how they’re doing it, and they don’t see that there are children who are struggling as much or more than they are. Our children don’t want to stand out and be different, so they don’t want to make use of over-ear ear defenders to cut out noises. They don’t want to be seen and spoken to by the teachers, as the attention and focus on them can feel excruciating and be also hugely confusing as they don’t know how to answer the questions asked to them, even if it is just, “how are you?”. They don’t want to be checked in on because it makes them feel othered and different when they already feel very othered and different. And this all feeds into a cycle where children begin to feel like an imposter, and that they cannot cope with their school day.

However, remember those rules your child has internalised? They know they need to go to school, and they know they are expected to try their best. So despite having very little or no resilience left at the end of each day, they tighten their helmets and they pedal faster and harder to get through school, and they push themselves into a situation where they’re heading for burnout.

The children who can’t identify their feelings begin to spiral, and you may begin to worry that they’re becoming bullies or a mean girl, if you have a daughter, in their anger with the world around them. They may also begin to lash out at school, getting into verbal or physical altercations with adults and other students. But when confronted with their behaviours and asked to explain themselves, they have no answer. They just know something isn’t right. Other children may withdraw. They may stop interacting with others, become loners, or hang out on the periphery of a friendship group, accepting unkindness and teasing because they know that to be without friends and secondaries is to be a target. These children may start showing their pain in different ways, sometimes sadly, through self-harm or restricted eating and risky behaviours. Engaging in anything they can that fights the numbness that they feel.

Others know that they are struggling. They know that they are feeling overwhelmed and they want it to be different, but they haven’t got any other internalised rules that can help them navigate this situation. So they try even harder. As a parent, you watch in heartbreak as your child pours more and more energy into trying and you reach the point where it hurts to see it. Often, your child will spend the entire school day trying and masking so much that when they return home, there’s the inevitable explosion of stress and anger and angst and fear that your child has bottled up for the whole day. And this is incredibly distressing for both parent and child. And it’s usually at this point that parents make contact with the school SENCo or inclusion team if they have one. Additionally, you may have tried to speak to the class tutor or year head, and schools differ in so many ways in terms of how they respond to parents who reach out to them with their worries and fears for their children.

Some schools respond with nurture and care, and others with punishment and consequences. Both parents and students can find that they don’t always feel heard or understood by the school, leading to them feeling even more isolated. Often for the children who are spiralling downwards in a cycle of fear and rage, the response is punitive, with exclusions becoming the order of the day. These children become numb to the impact of their behaviour systems, whether that involves demerits or negative points, going on to report or having a teacher sign off on your behaviour at the end of each lesson, or where students in your internal isolation or exclusions.

Often, for these students, they tip into learned aggression because getting cross, saying the wrong thing, triggering someone is easier and a lot less painful than having to cope in the classroom. Their fear feeds into their anger, and it becomes a very difficult cycle to break, and they find themselves trapped in it. Eventually, those students reach a point where, for their own safety or for the safety of the students around them, they are shuffled off to a pupil referral unit or alternative provision to work with them and try and change their trajectory.

The cycle of self-harm and withdrawal is similarly difficult to break, but much like the child that continues to try at their own expense, it’s harder to get real actions put in place as they often fly under the radar in class, quietly struggling their way through each minute of the school day. Schools often don’t put support in place for these quiet students, because they don’t see the fallout from the masking and the attempts to cope.

Often with schools that do try and provide support to the EBSA ASD students in the lead up to them avoiding school, they see that the students are struggling quietly, but they do still put steps in place to provide respite and support. The majority of secondary schools have breakout spaces, generally called different things like hives and hubs, where students can go during school time to recover their equilibrium, and these quiet spaces may be accessed with a pass or a codeword, sometimes only at a particular time during the day or when needed by the student. The quiet space is generally manned by a teaching assistant, who can either give the students some room or support them with their learning, or engage them in regulating activities like colouring or card games.

Additionally, schools may give students a hall pass or corridor permit, which allows a student to leave class a few minutes early so as to avoid the busy corridors and floods of students at change over times. Toilet passes, time out cards, nurture group support, key workers, counselling. There are many ways that a good school will attempt to alleviate your child’s distress. The difficulty comes in, though, in the administration of those mitigations.

As with all ventures involving people, some are simply better at their jobs and others. Some people are more empathic than others. Some care about their students and others their subjects. It can be extraordinarily difficult for a school to be completely consistent in applying the mitigating measures they put in place for your child. And we know that our ASD children need consistency over all other things.

All it can take is one teacher, one comment to pressurise your child into flying completely off the handle or buckling under and attempting to comply at the expense of their emotional wellbeing.

Our children are emotionally fragile when they reach the point that their school begins making concessions, and it needs to be handled sensitively. If one teacher tells a student attempting to make use of a safe space to just, “complete the task, and then you can go”, or, “you look fine, why do you need to skip class?”, both of these are examples of what teachers have said to some of our students, it can be enough to reengage those rules that your child has internalised – listen to the teacher, don’t miss out on learning, try your best – which can then result in your child not making use of the systems of support that have been put in place for them.

Another difficulty can appear if your child has a friendship group. Often you’ll find that a well-meaning friend can make a really damaging comment. “Oh, don’t go to the safe space. You’re leave me alone in geography”, or, “you always go to the safe space in drama. You’re missing out on all the fun”. And comments like these can make your child feel pressured to stay in class out of loyalty to friends, or from a fear of missing out. Remember, our students have that internalised pressure to attend, listen, try their best, and achieve, and only the slightest of external pressures can push them to fall back into the unhealthy coping strategy of trying to power through their difficulties. And this is where students then begin to struggle to attend school.

If it’s a case of gradual withdrawal from school, it may start with a child reaching their limit of being able to cope and either feeling ill or begging their parent not to make them go. At this point, a parent feeling their child’s distress may well give in and let the child have a day off school. The intense relief that that child feels from avoiding the stress and hardship of school buoys them up for a while, sometimes meaning that the child can then force themselves to go back into school for a few more days, but eventually their energy and ability to force themselves to go back in slowly dies down, and their days off become more and more frequent until the child is at home more often than they are at school.

Sometimes, though, children can seem to be okay and then just break, and suddenly they are not able to face going into school no matter what bribes, cajoling, threats, or conversation their parents may employ. And that’s the child that has hit burnout. Their tank is empty, and they have nothing more to give.

Generally, at this point, when a child’s absence has reached concerning levels, the school may try one of two options. The first is a far more nurturing approach, which looks at supporting children back into school, either through a flexible or reduced timetable. The difficulty with these timetables is that, whilst they acknowledge that the student is struggling to attend full time, they don’t change the difficulties that the students are experiencing. If a student is overwhelmed by the chaos of the corridors or the triggering behaviours of some of their classmates, reducing exposure helps a little, but not nearly enough to allow the child time to rebuild themselves sufficiently to cope with the school load.

There is also an unfortunate but understandable focus on attending core subjects for those students. Schools are concerned that students are going to miss out on their learning. And for those children who are in Yr.9 and 10, missing out on their learning ahead of their GCSEs. However, the core subjects English, maths and science tends to be very academic and your child, having already missed out on many lessons, will find the gap between themselves and their peers growing even wider. And this in turn adds pressure to the problem and the child finds themselves withdrawing further.

Additionally, it’s often in the softer subjects that a child can actually rebuild themselves. In art, design tech, food tech or PE if they are so inclined. And sadly, these subjects are usually the first to be dropped from the reduced timetable. Our children’s confidence can be severely damaged as they progress through school, sometimes because the reduced timetable means they aren’t able to continue to excel in the subjects they previously did, or because they are struggling to keep up with the things they previously felt they were good at. And that then creates a dissonance with their internalised rules which tell them what they’re like and what they’re good at, and it makes it harder for our children to continue to try.

Children who’ve reached this point in their EBSA journey begin to struggle with their self-esteem. They feel like failures. They can’t do school like their friends and peers. They become even more different and other than before.

The second approach that some schools adopt is punitive. The schools begin to badger the parents. Attendance officers get involved and start insisting that parents bring their children to school. Parents are threatened with fines and court action for not making their children attend, while simultaneously trying to cope with a child who is in great levels of distress, who might be self-harming or engaging in suicidal ideation at the mere prospect of having to return to school.

Home visits are made for welfare checks, where children are badgered about attending and reminded that their life choices are becoming more and more limited the closer they get to GCSE times without attending school.

Enormous pressure is brought to bear on families who are trying to cope with a complete emotional breakdown of their child. Parents often have additional stress in the form of who has to stay at home to look after their EBSA child. Financial pressure comes to bear as jobs are reduced or given up. Parents can end up feeling very judged and inadequate when dealing with their children and any of the issues that they have. And this impacts the relationships they have with their children, but also the relationships they may have had with the school staff.

Often, parents end up being encouraged, quite illegally, to take the children off role and homeschool them. And often this happens when parents feel they have no other choice. And it’s at this time that you can start to see your ASD child’s desperate attempts to regain a sense of self and some control over their emotional based school avoidance. You will witness your child attempting to wrest control of their day, asserting to you that they will never return to school, or deciding which activities they will participate in and which they will not.

For our ASD students, they can rather ironically become very demanding will simultaneously becoming extremely demand avoidant. Once they’ve reached the point of school avoidance they will need a fairly significant amount of time to rebuild themselves and recover from the journey that led them to this point.

For a lot of parents, this is where they really struggle to access support for their children. Schools will offer the things they’ve offered before, but our children have slipped beyond those measures now, and for a large number of our ASD children, they just need time. Time to unmask, to get back to being themselves. Opportunities to deep dive into their special interests and a chance to engage in sensory regulating activities. Things that differ for each individual.

Schools would genuinely, at this point, offer to make a referral to the mental health services available, their anxiety and depression pathways. But the waiting time for an assessment and support is hideous and of little use at the time your child needs it, which is after they’ve had a chance to rest and recover. For many parents that only realise how seriously impacted their child has been when they reach the point of school avoidance. But for others who recognise the signs that their child is struggling, there’s still an opportunity to slow the spiral or perhaps even reverse it in close partnership with your child’s school.

You, as a parent, will know your child best. You will know if they are able to recognise their own feelings and emotions or not. You will know whether they’re the type of child who will push themselves beyond their capacity to cope.

Hopefully, you will have some idea of the internalised rules for living. And knowing these things about your child will give you the insight into whether they’re struggling to keep afloat at school, and they can guide you in terms of what you can do to support your child.

I’ll be talking about the other types of students who struggle with EBSA, and will then move on to focusing on what parents can do to support their children when you notice signs of them struggling emotionally in school. As well as a piece on what you can expect a school to do for your child if they’ve started to struggle.

Most importantly, it’s very easy to feel as if you are the only family that this is happening to. It can be incredibly isolating for parents and children who are trying to cope with emotional based school avoidance. Please know that you are not alone. Your child is not the only child to struggle and suffer, and it isn’t an irredeemable situation. There are many different options out there for supporting your EBSA child and they can get back to accessing the wider world.