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SEN: School Refusal is on the Increase

  • Writer: Joanne Baldwin
    Joanne Baldwin
  • 2 days ago
  • 3 min read

There is now a substantial body of research showing that what has traditionally been called.

School refusal is usually due to Emotionally Based School Avoidance (EBSA) or School Distress. These terms recognise that most children are not refusing school out of defiance

There is now a substantial body of research showing that what has traditionally been called school refusal is usually Emotionally Based School Avoidance (EBSA) or School Distress. These terms recognise that most children are not refusing school out of defiance—they are avoiding school because attending feels emotionally or physically overwhelming. Recent UK research encourages professionals to move away from the term school refusal because it can imply choice rather than distress.


What is School Refusal (Emotionally Based School Avoidance)?

School refusal is a child's inability to attend school due to overwhelming emotional distress rather than deliberate truancy.

Children often desperately want to attend school and may feel guilty about missing lessons, but anxiety or distress becomes so intense that attendance feels impossible.

Common signs include:

  • Extreme anxiety before school

  • Panic attacks

  • Crying or emotional outbursts

  • Physical symptoms (headaches, stomach aches, nausea)

  • Meltdowns or shutdowns

  • Difficulty sleeping before school

  • Refusing to get dressed

  • Running away from school

  • Attending but leaving early

  • Attending only part-time


Reason for school refusal in children?

Research consistently shows there is rarely one single cause.

Instead, school refusal develops from several interacting factors.


1. Anxiety Disorders

This is the most common reason.

Children may experience:

  • Generalised Anxiety Disorder

  • Social anxiety

  • Separation anxiety

  • Panic disorder

School becomes associated with fear rather than learning.


2. Autism and Neurodiversity

Many autistic children experience school as exhausting.

Possible reasons include:

  • sensory overload

  • masking throughout the day

  • difficulty coping with unpredictability

  • social exhaustion

  • bullying

  • misunderstanding from staff

  • constant demands on executive functioning

Children with ADHD may struggle due to:

  • repeated failure

  • impulsivity

  • emotional dysregulation

  • overwhelming classroom demands

Many children with dyslexia, dyspraxia or dyscalculia also begin avoiding school after years of feeling unsuccessful.

Research consistently finds pupils with SEND are disproportionately represented among those with persistent absence.


3. Bullying

Bullying remains one of the strongest predictors.

This includes:

  • physical bullying

  • verbal abuse

  • cyberbullying

  • social exclusion

  • discrimination

Children frequently report that adults underestimate or dismiss bullying.


4. Sensory Overload

Modern schools can be overwhelming.

Examples include:

  • crowded corridors

  • bright fluorescent lighting

  • loud classrooms

  • alarms

  • lunch halls

  • unpredictable movement

  • strong smells

For some children, this results in constant fight-or-flight activation.


5. Academic Pressure

Children may fear:

  • making mistakes

  • tests

  • reading aloud

  • being judged

  • homework

  • not meeting expectations

Perfectionism often accompanies school avoidance.


6. Trauma

Children who have experienced:

  • bereavement

  • abuse

  • domestic violence

  • neglect

  • previous restraint

  • exclusion

  • repeated humiliation

may associate school with danger rather than safety.


7. Poor School Relationships

Feeling misunderstood can increase avoidance.

Children often report:

  • not being listened to

  • punitive behaviour systems

  • repeated sanctions

  • lack of trusted adults

  • exclusion from peers

A poor sense of belonging is linked to lower attendance.


8. Physical Health Conditions

Attendance may be affected by:

  • chronic pain

  • migraines

  • gastrointestinal disorders

  • chronic fatigue

  • Long Covid

  • sleep disorders

Repeated illness can gradually lead to anxiety about returning.


9. Mental Health Difficulties

School refusal frequently co-occurs with:

  • depression

  • OCD

  • eating disorders

  • PTSD

  • self-harm

  • panic disorder


The Cycle of School Refusal

Many professionals describe a self-reinforcing cycle:

  1. The child becomes anxious about school.

  2. They stay home.

  3. Anxiety reduces temporarily.

  4. The brain learns that avoiding school reduces distress.

  5. Returning becomes increasingly difficult.

  6. Anxiety grows with each missed day.

Breaking this cycle requires addressing the underlying causes rather than simply insisting on attendance

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