Anxiety-Based School Avoidance – Practical Advice for Schools

• ABSA is when a child or young person:
  • Has extreme difficulty attending school due to anxiety or other emotional factors, often resulting in long absences from school.
  • Has severe emotional reactions when attempting to go to school – fearfulness, anxiety, bad temper, misery, physical symptoms, low self-confidence.
  • Stays at home during school hours with parents knowledge.
  • Has an absence of anti-social behaviour – destructiveness, stealing etc.
• ABSA is different from truanting, when parents are often unaware of school absence.
• Anxiety is a normal emotion that everyone experiences from time to time.
• According to the Cognitive Behavioural Model of Anxiety anxiety is experienced via:
  • Thoughts
  • Feelings
  • Body sensations
  • Behaviour / Actions
• Historic studies show that:
  • 1-2% of the school population in the UK is affected by ABSA, although that figure may have increased substantially in 2020
  • It is more common in boys than girls
  • Rates of ABSA ‘peak’ around ages 5-6 years, 11-12 years and 13-14 years

• There is no single cause of ABSA, however the four main reasons for ABSA are:
  • To avoid uncomfortable feelings brought on by situations at schools e.g. fear of the toilets, busyness in the corridors, exams
  • To avoid social situations that are stressful at school e.g. bullying, reading out loud in class, working in groups, being left out
  • To reduce separation anxiety or gain attention from significant others e.g. family members
  • To pursue tangible reinforcers outside of school e.g. playing video games, going shopping, doing enjoyable activities
• It is helpful to think of the child in their context at different ecosystemic levels, each of which may have factors which increase a child’s vulnerability to ABSA
  • • As an individual child – factors may include: temperament, fear of failure, poor self-confidence, physical illness, age, traumatic life experiences, separation anxiety, other learning or developmental needs – especially autism.
    • In their family (microsystem) – factors may include: separation and divorce, of change in the family dynamic, parent physical or mental health problems, high levels of family stress, loss and bereavement, parenting style and family interactions.
    • In their school (mesosystem) – factors may include: academic pressures, transitions to a new school or stage, difficulties in a specific subject, structure of the school day, exams, journey to school, peer or staff relationship difficulties, of bullying – bullying is the most common school factor.
    • In their community (macrosystem) – currently the coronavirus pandemic has meant that: life has slowed down, there are lost social skills and new social rules, new expectations, uncertainties, anxieties about health and wanting family members to be safe, children may have had a positive experience of not attending school during lockdown, or may have had unequal access to learning during lockdown.

Resilience to ABSA can be developed at different levels:

• • Child or Young Person
    • Developing ambition, aspiration and motivation
    • Increasing confidence, self-esteem, self-efficacy, value in themselves
    • Developing feelings of safety, security and a sense of belonging
    • Understanding the relationship between thoughts, feelings and behaviour
    • Feeling listened to and understood
  • Family
    • Willingness to work in partnership between school, family and professionals
    • Developing parenting skills and understanding
  • School
  • • • Having positive experiences where they can succeed
      • Holding positive relationships with peers or staff
      • Flexibility of approaches within school, listening to the voice of the child

Follow the Assess-Plan-Do-Review cycle:

• • • Assess
      • Early identification – e.g. attendance monitoring, the Profile of Risk
      • Information gathering – e.g. talking to the child, the family and to colleagues, mapping the PUSH and PULL factors for the child ie; what is pushing the child away from school / pulling them towards home
      • Using tools such as the Spence Children’s Anxiety Scale
      • Working in partnership with parents/carers and school staff
    • Plan
    • • Interpret the information and plan actions
    • Do
    • • Intervention – depending on the individual child’s reasons for ABSA
      • Supporting children with their own understanding of their thoughts, feelings and behaviours – using tools such as the CBT map, an anxiety thermometer, a body map
      • Helping them manage uncomfortable feelings – using anxiety management techniques such as mindfulness, relaxation activities, distraction – using tools such as the step ladder to success (gradual exposure), timetabling, providing safe spaces
      • Helping provide positive social experiences – teaching social skills, providing real-life opportunities to practice, buddying or peer mentor schemes, role play
      • Collaborating and working in partnership with parents/carers – helping them consider their own anxiety, exploring their relationship with the child, consider ‘goodbyes’, setting up ‘special time’, limiting the attention a child receives when they do not attend school, developing morning routines to reduce anxiety, find their own support network, support them with boundaries – tools such as The Solihull Approach and The Incredible Years Programme
      • Increase ‘rewards’ for attendance and disincentives for non-attendance but with caution – this must be carefully balanced.
    • Review
    • • Review, reassess, and continue the Assess-Plan-Do-Review cycle
      • Involve all relevant individuals, especially the child, their parents/carers and key staff
      • Celebrate successes and plan for next steps
      • Consult with other agencies where appropriate.

• • Start with the following questions:
    • What are the protective factors in your school?
    • What are the risk factors in your school?
    • Where are the gaps?
    • How would a child be identified and supported currently?
  • Support a positive transition – and consider what has changed due to COVID-19
  • Beware! Anxiety is contagious…

Delegates received the session resource pack which included all the tools and templates shown in the webinar and signposted further reading and other resources. For additional information from the West Sussex Educational Psychology Service, including ABSA guides produced especially for Children, Young People, and Parents respectively, please see EBSA Toolkit and Appendices (local-offer.org)