Understanding EBSNA

EBSNA Context

Nationally and locally, there is a growing need for education and welfare provision for children with Emotional Based School Avoidance (EBSA) as a result of underlying social and emotional needs, developments within our school systems and sometimes complex home and social circumstances. All of these needs have been made more visible and potentially exacerbated by the challenges of the COVID-19 pandemic. Schools have reported increased incidences of EBSNA at both primary and secondary school. There has been an increase in referrals to both Medical PRU's and SEMH PRU's for education for students experiencing EBSNA and mental health crisis. Simultaneously SEND and Inclusion Services have identified a perceived gap in intervention/provision to support children who are presenting with complex and enduring EBSNA.

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What is ‘Emotionally based school non-attendance’ (EBSNA)

Emotionally Based School Non Attendance (EBSNA) refers to children and young people who face persistent difficulties attending school due to emotional distress. It often leads to prolonged absences and can involve physical and emotional symptoms. EBSNA differs from truancy, as the absence is due to emotional distress rather than a lack of interest in school. (e.g. Thambirajah, Grandison & De-Hayes, 2008). Researchers report ‘school avoidance’ is not a medical diagnosis but often encompasses symptoms and behaviours associated with particular diagnosis and difficulties, such as generalised anxiety disorder, separation anxiety, specific phobias, major depression, post traumatic stress disorder and more (Kawsar & Marwaha,2019;Walter et al.,2010).

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The safety of children and young people is paramount. It is acknowledged that student’s distress and absence from school may leave them vulnerable to further adverse experiences including gang membership and child sexual exploitation (which may present on the surface as ‘truanting’). Care should be taken in establishing whether a child’s absence from school is due to emotional distress experienced due to attending school, this can be identified using appendices in the toolkit.

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Potential causes of and modern approach to EBSNA

EBSA has no single cause and is driven by a complex combination of factors within the young person, their family, and the school environment (Thambirajah et al, 2008). This guidance support a move
away from the outdated "within child" model, which placed the responsibility to change solely on the child. Instead, there is understanding that a child's inability to attend school results from a convergence of experiences and environmental factors. This approach recognises that school absence is a symptom
of broader challenges and calls for adjustments at home and school, alongside goal setting for the child. Bronfenbrenner’s Bioecological model of Human Development supports this perspective by highlighting the effect of multiple systems on a child’s development. This model can be used to identify and address wider factors impacting upon a child’s development and their ability to engage with school.

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 Kearney and Silverman’s (1990) review of the literature suggests four main reasons for school avoidance:

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1. To avoid uncomfortable feelings brought on by attending school, such as feelings of anxiety or low mood.

2. To avoid situations that might be stressful, such as academic demands, social pressures and/or aspects of the school environment.

School has significant power to identify triggers and make adjustments

 

3. To reduce separation anxiety or to gain attention from significant others, such as parents or other family members.

4. To pursue tangible reinforcement outside of school, such as going shopping or playing computer games during school time.

Family has significant power to identify triggers and make adjustments

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All reasons require treatment and change within or for the child/young person, however the balance of power to enact change by school and families is illustrated above.