Autism & Emotionally Based School Avoidance (EBSA)

EBSA stands for emotionally based school avoidance, it is a relatively new term used to describe children and young people who have severe difficulties attending school due to a number of emotional factors. It is a complex issue and its prevalence seems to be on the rise. Research around the links between EBSA & Autism remains limited. However, we do know that children with special educational needs are 50% more likely to have difficulties with school attendance.

As research continues to explore the signs, causes and potential impacts of EBSA it seems likely that links between reduced school attendance and both learning difficulties and neurodivergence will become more clearly established’

If you are concerned that speech, language or communication difficulties may be contributing to your child’s EBSA, please don’t hesitate to contact our highly experienced team for advice and support’.

What are the signs my child might have emotionally based school avoidance?

Children who present with EBSA have very high levels of anxiety and fear related to school attendance. There is unlikely to be a single reason for these feelings and instead it is commonly a combination of a range of interacting factors. Ultimately, the child or young person believes that the stress and demands of attending school is more than they can physically cope with.

These stresses can present as physical symptoms – headaches, stomach aches or other physical complaints that typically disappear when the child stays at home. In children of all ages, there might be tears, tantrums and even physical displays of emotion.

This all makes it incredibly difficult for parents and schools to know how to move forward and help the child feel safe and happy in the school environment.

The first step is trying to understand why…..

What can contribute towards EBSA?

Anxiety Disorders: Generalised anxiety disorder, separation anxiety disorder, and social anxiety disorder are common underlying conditions.
Stressful Life Events: Changes such as moving to a new school, bullying, academic pressure, or family issues can trigger EBSA.
School Environment: Unfavourable school conditions, including negative teacher-student relationships, large class sizes, or an unsupportive school culture can contribute.
Family Dynamics: Overprotective parenting, family conflicts, or parental anxiety can exacerbate EBSA.
Previous Trauma: A history of trauma or adverse childhood experiences can increase the likelihood of EBSA.
Academic Challenges: Learning difficulties or low academic self-esteem often play a role.

The link between ESBA & Autism

There are well documented links between autism and anxiety, and although we do not yet know and understand all of the reasons for this, the following are likely to contribute to a higher rate of EBSA in neurodivergent pupils:

Difficulty navigating social situations; a sense of being misunderstood and a fear of unintentionally upsetting others.
Challenging sensory environments that increase overall levels of stress and can trigger a ‘fight/flight/freeze’ response.
A feeling that they need to mask or camouflage their true self in order to ‘fit in’.
Difficulties understanding, recognising and managing their own emotions.
Difficulties managing changes to their routine, especially when unexpected.

What is the impact of missing school?

The education charity ‘Beyond Autism’ states, “Pupils that are out of school are more at risk of poor mental health, blows to their self-esteem and missing out on important learning experiences. There is also a risk of a negative impact on the resilience of the whole family.”

Below are the 3 main impacts:

Academic: Chronic absenteeism can lead to falling behind academically, affecting grades and long-term educational outcomes.
Social: Missed school means fewer opportunities for social interaction, which can hinder the development of social skills and peer relationships.
Emotional: Prolonged avoidance can exacerbate mental health issues, leading to a cycle of increased anxiety and avoidance.

In ‘Can’t Not Won’t: A story about a child who couldn’t go to school’ – Eliza Fricker tells the story of her journey with her own autistic child and their difficulties with school attendance. Fricker reflects that “right now it is a system of fitting in, with the onus on the child, not the environment”.

You might recognise this and the associated feelings of social isolation, anxiety, blame and hopelessness. There is also a huge amount of fear for your child’s future that is overwhelming and exhausting.

What can we do if your child has emotionally based school avoidance?

First of all, know that you’re not alone. In 2022 around 124,000 children had significant, ongoing difficulties with school attendance. Not all can be attributed to EBSA but for those that are, a careful functional assessment should examine the barriers to a child’s attendance as well as their individual strengths and motivations.

Children, young people and their carers need specialist, individualised support that focuses on building trust and a genuine ‘feeling of safety’ to allow a return to school without the risk of further trauma and/or burn-out.

5 Positive Steps to tackling EBSA & Autism

Early Identification: Early detection by parents, teachers, and healthcare professionals is crucial for successful intervention.
Collaborative Approach: Involvement of parents, teachers, school counsellors, and mental health professionals is essential.
School Support: Accommodations such as a modified schedule, a designated safe space, or a gradual re-entry plan can help ease the transition back to regular attendance.
Consistency: Consistent routines and expectations at home and school can provide a sense of security and predictability.
Specialist Support: Assessment and diagnosis of specific learning difficulties, and tailored support plans.

Research shows that there is a higher level of prevalence of EBSA amongst children with learning difficulties and/or autism, in addition to anxiety disorder. Obtaining a relevant diagnosis can be instrumental in getting a child additional support to enable them to build a more positive relationship with school.

For children who may be academically able with no ‘obvious’ additional educational needs, but who are experiencing EBSA, we can offer a neurodevelopmental assessment if this is considered appropriate

Conclusion

Addressing EBSA requires a comprehensive, empathetic approach that considers the individual needs of the child. By understanding the underlying causes and implementing supportive strategies, schools and families can help children overcome their avoidance behaviours and succeed academically and emotionally.

If you think your child’s reluctance to go to school might be related to a specific learning difficulty and/or autism, please get in touch.

At ISLTS we offer a range of assessment and support services for children and young people. Our team of highly experienced Speech and Language Therapists can have an important role in identifying specific developmental challenges and how these needs can best be met.

We also offer private autism assessments which will lead to a better understanding of your child’s strengths and challenges and give you the tools to access wider resources and support.