Emotionally Based School Non Attendance (EBSNA)

Introduction

We receive a high number of calls from parents whose children are unable to access education because of anxiety or similar difficulties which can be linked to their special educational needs (SEN). Sometimes parents refer to it as 'school refusal' but is also known as Emotionally Based School Non-Attendance (EBSNA) or Emotionally Based School Avoidance (EBSA).

EBSNA or EBSA is a term used to describe children and young people who experience challenges in attending school due to negative feelings (such as anxiety). EBSNA is commonly associated with emotional and physical distress, and a reluctance to attend school, which can lead to reduced attendance and further anxiety regarding school.

Action plan

See your GP

Explain the difficulties your child is experiencing and ask for their help. Their help could include referring your child to Mindworks, writing to the school to confirm that your child has an anxiety disorder and is currently medically unfit to attend school, recommending that the school request the input of the Educational Psychologist (EP) linked to the school.

Keep a diary

Keep a diary/file documenting everything related to the school refusal/anxiety and school attendance. For every absence send an email to school so you have a paper trail of evidence of when and why each time. (You will need this information to prove you are doing all you can, if it goes to prosecution for non-attendance).

  • Describe what happens with your child.
  • Keep notes and records of all conversations with school or medical staff (follow up with email summaries of conversations so that you have written records)
  • Keep records of all medical appointments and any assessments.
  • Keep all relevant letters and print outs of emails.

Consider contacting the Inclusion Officer

Consider contacting the Inclusion Officer for the school and explain the situation. Tell them you want your child to attend school and that is what you are trying to achieve, but there are significant anxiety issues - explain to them how you are trying to support your child and what your concerns are. Some people find they get no help, some get help, but some get a lot of pressure to force attendance, so you need to make a decision about what you want to do, but the Inclusion Officer will probably become involved at some point if the attendance difficulties continue:

Write to the school

Write to the school using the EBSNA template letter. Personalise it to your situation and include relevant information about your child's difficulties. (Use the paragraphs you need and delete those you don't need).

Speak to the SENCo

If your child already has a recognised SEND and/or an Education, Health and Care Plan (EHCP) the school refusal/anxiety strongly indicates that their needs are not being met and the support they have in place needs adapting. Speak to the SENCo or request an urgent review of the EHCP or start an application for an EHCP if you do not have one in place.

Obtain copies of your child's educational records

It may become necessary to obtain copies of your child's educational records from the school. Ask for a copy of all records. You may need to carry out a Subject Access Request under The Data Protection Act 1998.

Check through the records carefully and look for any unauthorised absences in the attendance record. When there are gaps in the paperwork or inaccuracies send it back to be amended.

What to do when a school appears uncooperative

Although some schools have a positive approach to supporting pupils with anxiety, young people can come up against problems and sometimes be misunderstood by school staff. The school may have contacted you because they feel there is a problem with your child but this does not mean that they necessarily understand what is causing the problem.

Alternatively, you may have raised the subject with them but they do not appear to take your concerns seriously. If this is the case then this is almost certainly due to a lack of knowledge and understanding of anxiety disorders within the school.

How you approach the school will depend on what has happened prior to the school appearing to be uncooperative. If your child has just started school or has only just had their anxiety condition identified then the approach will need to be different than if there has been significant communication between yourself and the school. The latter approach will very much depend on the type of communication that has occurred, with whom and whether it has been amicable. Each individual case will be different, however, there may be some ideas which may help.

Educate yourself thoroughly on everything to do with your child's condition. It would be useful to read up on other anxiety disorders too as symptoms often overlap.

Be aware of your child's rights. Anxiety can be a Special Educational Needs and/or Disability issue (SEND), as clearly defined in the Special Educational Needs Code of Practice, since it is likely to impact on your child's ability to learn if left untreated. You can obtain copies of the school's SEND policy and complaints procedure. Schools must supply these on request, or you may find them on the school website.

The four areas of SEND

  1. Communicating and interaction – for example, where children and young people have speech, language and communication difficulties which make it difficult for them to make sense of language or to understand how to communicate effectively and appropriately with others.
  2. Cognition and learning – for example, where children and young people learn at a slower pace than others their age, have difficulty in understanding parts of the curriculum, have difficulties with organisation and memory skills, or have a specific difficulty affecting one particular part of their learning performance such as in literacy or numeracy.
  3. Social, emotional and mental health difficulties – for example, where children and young people have difficulty in managing their relationships with other people, are withdrawn, or if they behave in ways that may hinder their and other children's learning, or that have an impact on their health and wellbeing.
  4. Sensory and/or physical needs – for example, children and young people with visual and/or hearing impairments, or a physical need that means they must have additional ongoing support and equipment.

As you can see, anxiety relates to Social, Emotional and Mental Health Difficulties and is therefore applicable as a SEND if it impacts on a child's learning and progress. Many people report that schools say they don't include anxiety as a SEN. You may need to challenge this.

When a child or young person has special educational needs (1) A child or young person has special educational needs if he or she has a learning difficulty or disability which calls for special educational provision to be made for him or her. (2) A child of compulsory school age or a young person has a learning difficulty or disability if he or she— (a) has a significantly greater difficulty in learning than the majority of others of the same age, or (b) has a disability which prevents or hinders him or her from making use of facilities of a kind generally provided for others of the same age in mainstream schools or mainstream post-16 institutions.

The Children and Families Act 2014, Part 3: Section 20

Can mental health difficulties be considered a disability?

Some children suffering with mental health problems can be considered disabled under the Equality Act 2010. All schools are under an obligation not to discriminate against pupils on the grounds of disability.

Under the Act disability includes a mental impairment. The mental impairment must have a substantial and long-term adverse effect on the person's ability to carry out normal day-to-day activities.

Long term means that the symptoms have lasted or are expected to last for 12 months but this need not be consecutive. Transient symptoms may not fall within the Act.

The term 'disabled' in the Children and Families Act is the same as the term used in the Equality Act 2010 - It is defined as:

  • The child has "a physical or mental impairment which has a substantial (i.e. more than small or insignificant) and long-term (lasted more than 12 months) adverse effect on his ability to carry out normal day-to-day activities.
  • The inability to attend school is a "normal day to day activity"

Equality Act 2010

The following are examples of mental health symptoms that can be regarded as a mental impairment under the Act:

  • Anxiety, low mood, panic attacks, phobias, eating disorders, bipolar affective disorders, obsessive compulsive disorders, personality disorders, post-traumatic stress disorder, some self-harming behaviour, depression, schizophrenia.

If a child or young person falls within the definition of disability above then the school has particular obligations. Schools are under a duty to make reasonable adjustments to put disabled students on a more equal footing with pupils without disabilities. If an adjustment is reasonable then it should be made and there can be no justification for why it is not made. An adjustment may be considered unreasonable if it is very expensive and may be a reason for a school refusing to offer school-based counselling.

The duty to make reasonable adjustments is also anticipatory. This means that schools should give thought in advance to what disabled children and young people might require and what adjustments might be needed to prevent disabled students from being disadvantaged.

If you feel that a school has not complied with its duties under the Equality Act 2010, then the child's parents can bring a claim within 6 months of the incident in the Special Educational Needs and Disability Tribunal (SENDIST).

Advice

  • Put together some notes to give a 'picture' of your child from birth to present day, including how they behave when not anxious, when their condition was first noticed, and any events or triggers such as bullying. This is important because the school needs to know if they have a bullying problem so they can put a rapid stop to it, or at least be aware that your child is vulnerable.
  • Prepare the school by supplying them with as much information on your child's condition as possible. Supply any other information specific to your child e.g. if your child is gifted and talented or highly sensitive then supply information on this as well. This can be given to the class teacher and SENCo. (Special Educational Needs Coordinator) in a primary school, and to the form tutor and SENCo in a secondary school. You may also wish to give copies to support staff, or more senior teaching staff.
  • Enlist the help of others to lend weight to your child's case, such as by obtaining letters from people who have knowledge of your child's difficulties, e.g. previous school, GP, school nurse, therapist.
  • Arrange a meeting with the SENCo and class teacher to discuss your child and the provision the school can give, or has been giving. Ensure they have time to read the information you have provided before you meet.
  • Assure the school that you want to work with the school to help them help your child. Keep all communication as friendly and amicable as you can and try and help the staff feel appreciated and needed. Staff may feel at a loss as how to deal with your child, however once they understand that the behaviour is caused by anxiety, they should want to do everything they can do to help (but this is not always the case).
  • Prepare for all meetings and telephone conversations by listing in advance what you want to say and any questions you want to ask. Make notes at the meeting and confirm in writing after the meeting with the SENCo anything that has been agreed. This will avoid misunderstandings in the future. Record who was present, date and time of meetings or calls, and take someone with you as a witness if you feel it may be a difficult meeting.
  • Be prepared to compromise to some degree. Sadly, no school has the resources to re-organise everything for one child, nor do they have an obligation to do so if in doing so they would disadvantage other pupils. Do not get angry, confrontational or threaten. Try to stay as calm as possible.
  • If the school is still being uncooperative then you may need to approach the next level of command, such as the head of year, assistant head teacher, or head teacher. The school complaint's procedure should tell you who to approach and in what order.

If you are still unhappy having contacted the head teacher, then the next step would be to write to the clerk of governors. If the Governors can't help then you should contact the Local Authority.

Education for children out of school for health reasons

When a school is aware that a child is likely to miss more than 15 days of school due to health/medical reasons they are supposed to notify the Local Authority so that alternative education can be arranged. Often this does not happen because the school does not see anxiety as a medical or valid reason for absence or they do not understand or may have been misinformed about the relevant guidance.

Government guidance

Where full-time education would not be in the best interests of a particular child because of reasons relating to their physical or mental health, LAs should provide part-time education on a basis they consider to be in the child's best interests. Full and part-time education should still aim to achieve good academic attainment particularly in English, Maths and Science.

The LA should:

  • Have a named officer responsible for the education of children with additional health needs, and parents should know who that person is.
  • Have a written, publicly accessible policy statement on their arrangements to comply with their legal duty towards children with additional health needs.
  • The policy should make links with related services in the area - for example, Special Educational Needs and Disability Services (SEND), Child and Adolescent Mental Health Services (CAMHS), Inclusion Services, Educational Psychologists, and, where relevant, school nurses.
  • Review the provision offered regularly to ensure that it continues to be appropriate for the child and that it is providing suitable education.
  • Have clear policies on the provision of education for children and young people under and over compulsory school age.

Taken from - Ensuring a good education for children who cannot attend school because of health needs – statutory guidance for Local Authorities January 2013.

Does a pupil need to have a recognisable medical condition in order to receive support?

Schools do not have to wait for a formal diagnosis by a medical practitioner before providing support to pupils. If the condition is unclear then the head teacher will have to make a judgement about what support to provide to the pupil based on the medical evidence available at the time that the school is made aware of an issue.

In exercising this judgement, the head teacher must not ignore the views of the child or their parents or ignore medical evidence or opinion however, the head teacher can challenge the evidence if appropriate, bearing in mind the advice in the SEND Code of Practice, 1.24:

High quality teaching that is differentiated and personalised will meet the individual needs of the majority of children and young people. Some children and young people need educational provision that is additional to or different from this. This is special educational provision under Section 21 of the Children and Families Act 2014. Schools and colleges must use their best endeavours to ensure that such provision is made for those who need it. Special educational provision is underpinned by high quality teaching and is compromised by anything less.

SEND Code of Practice

Dealing with the Attendance Order

As a first step, you should take your daughter to your GP and explain what has been happening. If the GP (or any medical/mental health professional) feels that she isn't currently fit to attend school, ask for a letter to the local authority (LA) to be provided, explaining this. Evidence of this type would provide a documented explanation for her non-attendance. The GP should refer her to the Child and Adolescent Mental Health Service (known as CAMHS).

The second step is to write to the person or department (which is likely to be the Educational Welfare Service) who threatened you with the Attendance Order, updating them about your daughter's mental health and explaining that she has special educational needs (SEN). Suggest to them that serving an Attendance Order in these circumstances would be premature and inappropriate; and what is needed is co-ordinated action by support agencies to identify and make provision for all of your daughter's needs.

Hopefully, once everyone involved realises that your daughter's non-attendance is to do with her SEN rather than with you deliberately keeping her away from school, the decision to reassess will be taken quickly and the threat of issuing an Attendance Order will be withdrawn.

If the LA continue with the threat of serving an Attendance Order, or actually serve it, you will need to speak to a solicitor who is familiar with education law. You should check if you qualify for legal aid.

Getting temporary education put in place

Next, you should write to the LA and request they provide alternative education for her whilst she is out of school for mental health reasons.

The LA have a legal duty to provide suitable education for children of compulsory school age who are out of school "by reason of illness, exclusion from school or otherwise", under section 19 Education Act 1996. This education should be full-time unless, for reasons relating to her physical or mental health, it would not be in her best interests for full-time education to be provided.

There is statutory guidance for LAs entitled 'Ensuring a good education for children who cannot attend school because of health needs'. Full-time education is not defined in law, but the guidance states it should equate to what the pupil would normally have in school.

It also states that LAs should provide such education as soon as it is clear that the child will be away from school for 15 days or more, whether consecutive or cumulative. They should liaise with appropriate medical professionals to ensure minimal delay in arranging appropriate provision for the child

They should not:

  • Have policies based upon the percentage of time a child is able to attend school rather than whether the child is receiving a suitable education during that attendance
  • Have lists of health conditions which dictate whether or not they will arrange education for children or inflexible policies which result in children going without suitable full-time education (or as much education as their health condition allows them to participate in).

It is unlawful to withhold or reduce the provision, or type of provision, for a child because of how much it will cost. Therefore, LAs must not have policies that limit a child's education to a specified number of hours per week due to cost or availability.

There is no absolute legal deadline by which LAs must have started to provide education for children with additional health needs. However, the guidance says LAs should arrange provision as soon as it is clear that an absence will last more than 15 days and it should do so at the latest by the sixth day of the absence, aiming to do so by the first day of absence.

This should hopefully mean she will not miss out on any more education whilst she is out of school.

Amending the EHCP to get the right support in place

Clearly, the support currently in place through your daughter's EHCP is not sufficient, as she has been unable to attend school. It may be that she needs more support, or she may need to attend a different school entirely.

You should consider asking for a reassessment of your daughter's SEN. This is because her EHCP does not include her mental health needs or provision to meet those needs. It will be important for the EHCP to be updated to include this information. You should tell the LA about the threatened Attendance Order and ask them, in these circumstances, to reach a decision about a re-assessment as a matter of urgency rather than waiting the full 15 days.

If you want, you could also ask for an emergency placement to be arranged for your daughter in a special school for the purposes of a reassessment.

There is guidance for schools from the Department for Education entitled 'Mental health and behaviour in schools: departmental guidance for school staff'. This contains guidance on what schools should be doing to identify and support pupils with mental health issues.

If the LA refuse your request for a re-assessment, you have the right to appeal to the First-tier Tribunal (Special Educational Needs and Disability) (the SEND Tribunal).

Elective home education

In some cases, parents may be encouraged to make arrangements to educate their child at home and parents often feel pressured into doing this to avoid prosecution for non-attendance. However, elective home education is a serious step. Most significantly, it relieves the LA of the duty to ensure the child receives the special educational provision in Section F of the EHCP. It may be better to amend the EHCP to set out different provision and/or name a different school (or 'education otherwise than at school') rather than attempting to take on home education without support. See the section on naming a school in an EHCP for more information.

If a child in this situation does not have an EHCP, it may be worth asking the LA for an Education, Health and Care needs assessment. What is important is to get everyone involved working together to identify all of your child's needs and making sure those needs are provided for.

Useful sites

These sites may also be useful resources of information: