Emotional based school avoidance (EBSA)

What is emotional based school avoidance?

Emotional Based School Avoidance (EBSA) is a term used to describe a child or young person who has severe difficulty in attending school due to emotional factors. This can result in prolonged absences from school.  

EBSA can present differently across individuals, but can show as:  

  • low or intermittent attendance
  • high sensitivity or reactivity
  • low mood and anxiety (fear of talking to teachers, fears around academic performance)
  • social isolation
  • signs of emotional distress that affects their ability to function at school, such as difficulties forming relationships with teachers and peers
  • developmental differences that fundamentally shape perception and action in ways that cause significant challenges in emotional self-regulation and social functioning (autistic spectrum disorder, ADHD). 

What isn’t EBSA?

It is crucial to have a clear and accurate understanding of EBSA to enable accurate identification of children or young people experiencing EBSA.  There is a clear difference between those children or young people that are absent from school as a result of EBSA as opposed to parentally condoned absence (where a caregiver deliberately keeps or supports keeping a child or young person away from school for various reasons) or truancy, which is linked to non-anxiety-based absenteeism.

For situations such as this there are other routes of support and challenge that schools should take.     

Why does EBSA happen?

EBSA can occur suddenly or develop gradually over time.  Behaviours can also range from occasional reluctance to attend school to complete avoidance resulting in non-attendance.  EBSA should not be thought of as a deliberate act of defiance as it is a complex issue with no single cause.     

Reasons are often complex and multi-faceted across environmental factors (both at home and school) as well as individual child factors.  

Any identified factors are unlikely to be static and fixed.  What led to the initial school avoidance may not be what leads to persistent avoidance and non-attendance.  What appears to be the cause of the issue may be the consequence. 

Risk factors

There are a number of risk factors that can influence EBSA.  These can include, but are not limited to, difficulties with managing and regulating emotions, low levels of self-confidence or self-esteem, high levels of family stress, relationship difficulties or academic demands.  It is often the interaction between risk factors (across school, family and child or young person) that results in EBSA behaviours.   

Resilience factors

While risk factors have been identified that place children at greater risk of EBSA, it is important to also consider, identify and build areas of strength or resilience available for the child, family and school. These resilience factors help to protect children and young people from maintaining EBSA behaviours, and promote successful school inclusion.  Resilience factors can include, but are not limited to, emotion regulation strategies, motivation for change, willingness to work in partnership and an openness and commitment to trying to understand how the child or young person may be different and how this may affect them at school.  

Push and pull factors

Risk and resilience factors can also be separated into push and pull factors. EBSA is most likely to occur when the risks overwhelm the resilience, and when the pull factors (that encourage school avoidance) take over the push factors (that encourage school attendance).

Anxiety

EBSA is often associated with feelings of anxiety in children and young people. Think of anxiety as the brain's alarm system being overly sensitive (very sensitive to breaking news). It's constantly guessing that something bad might happen, even when there is no real danger. It's like your body sending a red alert that something is not right (an error), but you're not exactly sure what the problem is.  This could make a child or young person feel worried, nervous, or scared more frequently than usual. It's like their brain is seeing shadows in the dark and interpreting them as monsters, even though they are safe in their bedroom.

For children and young people who are going through this, these feelings might be so strong and unpleasant that they start to worry about how to make them less intense. Just like how you might feel nervous before a big test or game, it's normal for everyone to feel anxious or unsure at times. But for children and young people who struggle going to school because of their anxiety or experience of error, these feelings are not just a little bit nervous or unsure – they are very intense and uncomfortable and frequently uncontrollable.

Some children and young people experience such heightened levels of anxiety that it negatively impacts on their ability to attend and cope in school.  Children and young people's avoidance of school reflects an attempt to preserve emotional security by shielding themselves from the stress, threats or social isolation they feel at school.  Their avoidance may increase the certainty of feeling better away from stress and reduce the uncertainty about dealing with challenges at school. However, it also makes it increasingly difficult to return because it strengthens their beliefs about experiencing unpleasant feelings, which cause much distress and limits the opportunities to gradually overcome their difficulties. Moreover, the social network weakens, the academic gaps grow, and the fear of returning to school takes over. The complex context of school feels less and less safe and predictable as a result.

Anxiety may be the triggering, but also a maintaining factor of EBSA. The greater the avoidance of situations that cause fear or distress, the more difficult it will become to deal with it.   With each individual situation, it is therefore crucial for schools and involved agencies to work together with the child or young person and their family and as early as possible to understand why the child or young person is reluctant to attend school.  Lincolnshire’s Emotional Based School Avoidance (EBSA pathway) enables this to happen.