School Refusal / EBSA

Emotionally Based School Avoidance, Anxiety, Attendance, SEND, Mental Health, Rights, Evidence & Support

School refusal, often better understood as Emotionally Based School Avoidance, or EBSA, happens when a child or young person 
experiences severe emotional distress linked to attending school.

EBSA is not simply “bad behaviour” or “defiance.” It can be linked to anxiety, bullying, unmet SEND, autism, ADHD, trauma, sensory 
overload, academic pressure, friendship issues, mental health 
difficulties or unsafe school experiences.

If a child is in immediate danger or at risk of serious harm, call 999.

1. What is EBSA?

EBSA describes difficulty attending school because of emotional distress.

A child may:

  • Cry, panic or become distressed before school
  • Complain of headaches, stomach aches or sickness
  • Freeze, shut down or refuse to leave home
  • Become angry or overwhelmed
  • Attend some lessons but not others
  • Struggle after weekends, holidays or transitions
  • Feel unsafe, ashamed or misunderstood
  • Become exhausted after school

The aim should be to understand what is driving the distress and provide support early.

Useful links:

 

2. Common Causes of EBSA

EBSA may be linked to:

  • Anxiety
  • Depression
  • Panic attacks
  • Bullying
  • Friendship problems
  • Autism
  • ADHD
  • Dyslexia
  • Sensory overload
  • Unmet SEND
  • Trauma or bereavement
  • Family stress
  • Academic pressure
  • Exam stress
  • School transitions
  • Fear of sanctions
  • Unsafe or overwhelming environments

Several causes may exist at the same time.

 

3. Early Signs

Early signs may include:

  • Increased lateness
  • Frequent minor illness before school
  • Distress on Sunday evenings
  • Difficulty sleeping
  • Withdrawal
  • Irritability
  • Reduced confidence
  • Repeated nurse visits
  • Avoiding particular lessons or areas
  • Drop in attendance
  • Emotional outbursts before school

Early support is usually more effective than waiting until attendance becomes very low.

 

4. What Parents and Carers Can Do

Parents and carers can:

  • Stay calm and avoid blame
  • Listen to the child’s worries
  • Keep communication open
  • Contact school early
  • Ask for an attendance support meeting
  • Request SEND review if needs may be involved
  • Keep a daily record of symptoms and triggers
  • Ask for a written reintegration plan
  • Seek GP or mental health advice if needed

Helpful questions include:

  • What feels hardest about school?
  • Is there a person, place, lesson or time that feels unsafe?
  • Are there sensory triggers?
  • Is bullying involved?
  • Is the work too hard or overwhelming?
  • Is the child masking distress at school?

 

5. What Schools Should Do

Schools should work with families to understand barriers and provide support.

Support may include:

  • A named trusted adult
  • Safe arrival routine
  • Quiet space
  • Reduced sensory demands
  • Adjusted timetable
  • Gradual reintegration plan
  • Pastoral support
  • Mental health referral
  • Anti-bullying action
  • SEND review
  • Reasonable adjustments
  • Alternative provision where legally required

The focus should be on reducing barriers, not simply applying pressure.

 

6. EBSA and SEND

EBSA is often linked to unmet special educational needs or disability.

Possible links include:

  • Autism and sensory overload
  • ADHD and emotional regulation
  • Dyslexia and academic anxiety
  • Speech and language needs
  • Social communication difficulties
  • Mental health needs
  • Learning difficulties

Parents can ask for:

  • SENCO meeting
  • SEND Support Plan
  • Reasonable adjustments
  • External professional advice
  • Educational psychologist involvement
  • EHCP needs assessment where appropriate

Useful links:

 

7. EBSA and Mental Health

EBSA may involve anxiety, panic, depression, trauma or emotional distress.

Support may include:

  • GP appointment
  • NHS mental health support
  • School counselling
  • CAMHS referral where appropriate
  • YoungMinds resources
  • Crisis support if risk is urgent

Useful links:

 

8. Attendance, Fines and Enforcement

Parents are responsible for ensuring children receive suitable education. However, where attendance difficulties are linked to mental health, SEND, disability, bullying or unmet needs, support should be considered carefully.

Parents should:

  • Keep school informed
  • Provide evidence where available
  • Request support in writing
  • Ask for barriers to be recorded
  • Ask what support has been offered before enforcement
  • Seek advice quickly if threatened with fines or prosecution

Useful links:

 

9. Medical Needs and Alternative Education

Some children cannot attend school because of physical or mental health needs.

Where a child cannot attend school because of health needs, the local authority may have duties to arrange suitable education.

This may include:

  • Home tuition
  • Hospital education
  • Online learning
  • Alternative provision
  • Reduced timetable as part of a planned return
  • Specialist provision

Useful link:

 

10. Reintegration Plans

A reintegration plan should be realistic and personalised.

It may include:

  • Small steps
  • Agreed timetable
  • Safe arrival point
  • Named adult
  • Quiet space
  • Sensory adjustments
  • Reduced transitions
  • Review dates
  • Clear communication
  • Support if the child becomes distressed

Avoid plans that move too quickly without addressing the reason attendance became difficult.

 

11. Reasonable Adjustments

If EBSA is linked to disability, schools may need to consider reasonable adjustments.

Examples include:

  • Flexible start times
  • Quiet entry
  • Reduced sensory demands
  • Safe space
  • Shortened or adapted timetable
  • Movement breaks
  • Written instructions
  • Reduced homework pressure
  • Alternative lunch arrangements
  • Adjusted behaviour expectations

Useful links:

 

12. Legal Rights

Children and families may have rights relating to:

  • Suitable education
  • Attendance support
  • SEND Support
  • EHCP assessment
  • Reasonable adjustments
  • Protection from discrimination
  • Safeguarding
  • Education during health-related absence
  • Complaints and appeals
  • Access to records

Useful links:

 

13. Evidence Standards

Good evidence can help secure support and prevent misunderstandings.

Useful evidence includes:

  • Attendance records
  • Medical letters
  • GP notes
  • CAMHS or counselling evidence
  • Parent diary
  • Child’s views
  • School emails
  • Behaviour records
  • Bullying reports
  • SEND plans
  • EHCP documents
  • Meeting notes
  • Records of support requested
  • Records of what worked and what did not

A useful EBSA diary may record:

  • Date
  • Sleep
  • Physical symptoms
  • Mood
  • Triggers
  • Attendance attempt
  • What support was tried
  • Outcome
  • What helped

Evidence should be factual, dated and child-focused.

 

14. Accountability & Complaints

If EBSA support is not adequate:

  1. Request a meeting with school.
  2. Ask for the attendance lead, SENCO and pastoral lead to attend.
  3. Ask for a written support plan.
  4. Ask for reasonable adjustments where disability is involved.
  5. Ask whether an Early Help referral is appropriate.
  6. Ask for local authority involvement if absence continues.
  7. Use the school complaints procedure if support is not provided.
  8. Seek SENDIASS, IPSEA, Contact or Citizens Advice support.
  9. Consider requesting an EHCP needs assessment where needs are significant.
  10. Contact the Ombudsman for local authority maladministration where appropriate.

Useful links:

 

15. Advocacy and Support

Families may find help from:

  • School pastoral team
  • SENCO
  • GP
  • Mental health services
  • Early Help
  • SENDIASS
  • IPSEA
  • Contact
  • YoungMinds
  • Citizens Advice
  • Local parent support groups

Useful links:

 

16. Quick Help Directory

School anxiety and refusal

https://www.youngminds.org.uk/parent/parents-a-z-mental-health-guide/school-anxiety-and-refusal/

Mental health and attendance guidance

https://www.gov.uk/government/publications/mental-health-issues-affecting-a-pupils-attendance-guidance-for-schools

School attendance

https://www.gov.uk/school-attendance-absence

Working together to improve attendance

https://www.gov.uk/government/publications/working-together-to-improve-school-attendance

Health needs and education

https://www.gov.uk/government/publications/education-for-children-with-health-needs-who-cannot-attend-school

SEND support

https://www.gov.uk/government/publications/send-guide-for-parents-and-carers

EHCP information

https://www.gov.uk/children-with-special-educational-needs/extra-SEN-help

NHS children’s mental health

https://www.nhs.uk/mental-health/children-and-young-adults/

Urgent mental health help

https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/

School complaints

https://www.gov.uk/complain-about-school

 

Key Message

School refusal and EBSA should be treated as distress, not defiance. The most effective approach is early, calm, joined-up support that identifies the reasons behind the difficulty and reduces barriers to attendance. Families should keep clear evidence, ask for written plans, involve SEND and mental health support where needed, and use complaints or legal routes if a child is not receiving suitable education or reasonable support.

 

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