Emotionally Based School Avoidance (EBSA)

Many children and young people worry about school. Anxieties are part of life and learning to deal with them is part of growing up. However sometimes a child’s worries may lead to difficulties attending school. If your child has high levels of anxiety and does not want to attend school, they may be experiencing Emotionally Based School Avoidance (EBSA)

My child has anxiety and needs additional help, can I ask for SEN Support?

When considering whether a pupil needs additional support, educational settings should focus on the four broad areas of needs, as identified in the SEND Code of Practice

5.32 Special educational provision should be matched to the child’s identified SEN. Children’s SEN are generally thought of in the following four broad areas of need and support – see Chapter 6, paragraph 6.28 onwards, for a fuller explanation:
• communication and interaction
• cognition and learning
• social, emotional and mental health
• sensory and/or physical needs

Social, emotional, and mental health may include a range of mental health difficulties such as anxiety, depression, eating disorders or physical symptoms which are medically unexplained. If your child's anxiety is causing a substantial and long-term negative effect on learning and their ability to engage in day-to-day activities, it can be considered a disability under the Equality Act 2010. The Definition of SEN and Disabilities

Schools are required to support all pupils through high quality teaching, with appropriate reasonable adjustments in place. If a child’s needs are not being met with high quality teaching then additional special educational needs support will need to be considered. This is called SEN Support. Your child does not need to be struggling academically in order to access SEN support.

There are many options available when considering which school-based interventions could be provided and whether these need to be scheduled, provided on a flexible basis, or both. There are a wide range of possible reasonable adjustments, different for each child's needs, and any interventions should be based on the child or young person’s strengths, learning styles and having gained the views of everyone involved.

For children with special educational needs, anxiety or sensory overload are common factors affecting behaviour and attendance. These are not always immediately identified. If you think there may be underlying needs, discuss and explore with school how these might be identified and supported.

You can read more about One Planning and the Graduated Approach and Raising concerns.

How should school settings support a pupil with EBSA?

You can arrange a meeting with the school (SEN Co-ordinator, Pastoral Support Advisor, Attendance Advisor, Class Teacher or Deputy Head) to devise a plan in conjunction with you and your child. The plan should identify any special educational needs and how your child will be supported when they are at school as well as what the next steps will be. Difficulties should be anticipated and solutions found.

The school should keep an optimistic approach and offer support to you in getting your child to school. If your child fails to attend school on one day, start again the next day and keep in close communication with the school. You can ask the school for a key member of staff to liaise with as you will need to report any attendance difficulties immediately. It is also important to remember there is likely to be more difficulty after a school holiday, period of illness or after the weekend.

When you meet with school to discuss your child's support plan, you can ask about support options, for example...

meet and greet by a trusted member of staff at the start (sometimes during or at the end) of the day;
adult-led approaches – regularly checking with a child that they are okay;
help to understand and manage their feelings and emotions;
positive praise (for getting through a lesson - replacing sanctions for challenging behaviour);
'time-out' card for when feeling overwhelmed in lessons;
lesson breaks (to allow some calm down time);
changes to timetable if particular lessons a trigger;
learning away from the classroom, in a dedicated area or room sometimes known as a 'safe space';
lunching away from the dinner hall which might be by attending a lunchtime club (crowded dinner halls can cause anxiety);
1:1 or small group interventions, support programmes, anxiety or friendship groups;
leaving lessons or school 5 minutes early to avoid crowded corridors;
counselling or mentoring/peer led support.

You can also ask the school:-

if they have gained your child or young person's views;
if they have they spoken to the local authority about your child and if so, were there any suggestions or recommendations;
If they are considering involving any outside agencies or services for support, or any referrals to specialists;
to consider a reduced timetable;
to consider alternative education provision;
suggest a multi-agency meeting – a way of working with families and assessing needs and involving outside services;
where support options available to school have been exhausted, a request to the local authority to carry out an EHC needs assessment.

You may feel tempted to change schools, however research tells us that often difficulties will re-emerge in the new school and whenever possible it is normally better to try and resolve the issue in the current school.

You can also read our information on Supporting Medical Needs and EOTAS (Section 19 Education Act)

The Department for Education statutory guidance ‘Working together to improve school attendance‘ says:

Supportive approaches are most effective when they are put in place as early as possible and therefore it is essential all partners work together in a timely manner. If a pupil’s absence requires support from an outside agency which is not provided quickly (e.g. subject to a waiting list), schools and/or local authorities should consider other avenues of support or other temporary solutions whilst waiting. (22).

The Department for Education has further guidance for schools and local authorities ‘Summary of responsibilities where a mental health issue is affecting attendance’. The guidance makes clear the expectations placed on school staff as well as academy trustees/governing bodies, parents/carers and Local Authorities (LAs) where there is a pupil experiencing social, emotional or mental health issues that are affecting attendance.

The guidance sets out the school’s responsibilities to

support positive mental health across the school

to identify possible difficulties with going to school and act early

to put support in place if a child is not attending school

work with parent carers

to make reasonable adjustments to support a child in school

The guidance also gives some good practice examples, showing how schools have supported children to build up their confidence and feel more able to be in school regularly.

Lets Talk - We Miss You Guidance - good practice for schools

The Essex Local Authority have developed a toolkit for ‘Maximising School Attendance’ to provide schools with resources and information to help support pupils with their attendance. This is an Essex initiative written to provide school staff and other professionals with a first port of call guide on preventing pupil absence and identifying and supporting pupils who have school attendance difficulties. An Attendance Difficulty Assessment form can be completed by the child/young person and the parent to help scale and identify the reason for the school refusal, and the resources toolkit will help the school to find solutions and targeted support for the child or young person.

You can read the family edition Lets Talk We Miss You Family Edition

Can the local authority provide any advice and guidance on managing attendance?

Sometimes the school can consider reaching out to their local authority professionals for expert advice and guidance.

Engagement Facilitators will work with children and young people, their families and the team around the family. They can support with meetings such as One Planning to ensure the right processes are being followed. You can ask the school to involve an Engagement Facilitator to help promote a collaborative approach between school, parent and young person.

Also, Inclusion Partners (IPs) will work in close partnership with colleagues in SEND Services, and in particular, Educational Psychologists, to support early years settings, schools and colleges to develop their inclusive practice and deliver improved outcomes for children and young people with SEND.

Attendance Specialist Teams help schools to develop strategies in relation to school attendance and offer advice and guidance. Schools have access to a number of supportive guidance opportunities to encourage improved attendance to school including ‘Let’s Talk, We Miss You’ resources. Schools consult with the Attendance Specialist Teams on individual cases to find positive solutions to attendance concerns.

It may be helpful to check if the school are getting advice from their local Inclusion Partner and/or Attendance Specialist on how to manage a pupil's social & emotional needs and managing attendance.

You can read more about these professionals on our Local Authority Services and how they can help

Can I ask for a reduced timetable?

In exceptional circumstances and where it is in the pupil's best interest, schools may decide to propose a reduced timetable to support a pupil's individual needs. A parent can also ask the school to consider a reduced timetable for their child.

The aim of a part-time timetable is to help the child return to full-time education. It should be limited for 6-8 weeks and form part of a Pastoral Support Plan or One Plan.

In relation to pupils experiencing EBSA, a reduced timetable might be useful in order to allow:

time for rest and recovery from significant anxiety;
reasonable adjustments, for example, to allow your child to avoid the lessons or situations they find most challenging.

There must be a clear reason and some evidence as to why this approach is needed. You can read our information on Reduced Timetables Guidance.

Can I request for an Education, Health & Care Needs Assessment?

You can make a parental application for an Education, Health & Care Needs Assessment at any time or the school can do this for you. If you are considering requesting an EHC Needs Assessment, it is always a good idea to talk to the school or early years setting before making the application.

Education settings must identify and assess the child’s needs and then plan support based on this information in a continuous cycle (assess-plan-do-review). Where school have identified what a child needs, this should be put in place. You can ask your child's school how it uses its SEN funding to support your child and whether it has enough to cover all the provision they need.

If progress is not being made despite SEN Support or there are gaps in knowledge (it is not known what the needs are and an assessment is the only way to determine these) or the school need help from the local authority to provide what is needed, an EHC needs assessment might be the next step. You can ask the school if they have exhausted their resources and if there is anything further they can try to help.

If a local authority (“LA”) is requested to carry out an EHC needs assessment by a parent, young person, school or college, they must consider:

whether the child or young person has or may have special educational needs (“SEN”); and

whether it may be necessary for special educational provision to be made for the child or young person in accordance with an EHC plan.

If the answer to both of these questions is yes, they must carry out an EHC needs assessment. This test is set out in the law (section 36(8) of the Children and Families Act 2014). This means these are the only questions the LA should be asking when considering whether or not to carry out an EHC needs assessment. You can read about the legal test for an assessment and how to apply here

How should the school be recording any absences?

Schools must record absences as authorised where it is not possible for a pupil to attend due to illness (both physical and mental health related).

The Department of Education Working Together to Improve School Attendance August 2024 states that in the majority of cases a parent’s notification that their child is too ill to attend school will be that evidence and can be accepted without question or concern. Only where the school has genuine and reasonable doubt about the authenticity of the illness should medical evidence be requested to support the absence.

If you are asked to provide evidence this does not need to be a letter from your doctor or consultant and doctors will not usually provide such letters. It can, instead, be appointment cards, prescriptions or notes of previous consultations (including from the NHS App).

Code I: Illness (not medical or dental appointment)

62. Medical evidence for recording absences should only be needed in a minority of cases (see Code I). Where a pupil’s health need means they need reasonable adjustments or support because it is complex or long term, schools can seek medical evidence to better understand the needs of the pupil and identify the most suitable provision in line with the statutory guidance in supporting pupils at school with medical conditions or arranging education for children who cannot attend school because of health needs.

365. Schools are not expected to routinely request that parents provide medical evidence to support illness absences. Schools should only request reasonable medical evidence in cases where they need clarification to accurately record absence in the attendance register, i.e. making a decision that code I is the absence code that accurately describes the reason the pupil is not in school for the session in question. In the majority of cases a parent’s notification that their child is too ill to attend school will be that evidence and can be accepted without question or concern. Only where the school has genuine and reasonable doubt about the authenticity of the illness should medical evidence be requested to support the absence.

366. Where medical evidence is deemed necessary, schools should not be rigid about the form of evidence requested and should speak to the family about what evidence is available. Schools should be mindful that requesting additional medical evidence places pressure on health professionals, their staff and their appointment system unnecessarily, particularly if the illness is one that does not require treatment by a health professional. Where a parent cannot provide evidence in the form requested but can provide other evidence, schools should take this into account. Where a parent cannot provide any written evidence the school should have a conversation with the parent and pupil, if appropriate, which may in itself serve as the necessary evidence to record the absence.

Absence for 15 days or more, whether consecutive or cumulative

If your child is unable to sustain regular school attendance for reasons relating to an ongoing physical or mental health need, or other circumstances beyond parental control, a Section 19 referral should be considered for alternative arrangements to best support your child.

Parents, schools and other professionals may make a request for Section 19 support. You can ask your school to make a medical referral to the Education Access Service for support. You can read our information on alternative provision and/ Emotionally Based School Avoidance

We encourage you to talk through all the options with the school and the professionals supporting your child. If these conversations do not resolve things, parents can contact the Local Authority directly at section19@essex.gov.uk. Ipsea also provide a template letter for parents wishing to request for alternative provision Getting temporary education put in place, Template letter 22: asking the local authority to arrange alternative education (IPSEA).’

My child's school is threatening a penalty notice, what should I do?

Arrange an attendance meeting with all relevant school staff, such as SEN Co-ordinator, Pastoral Support Advisor, Attendance Officer, class teacher and/or Deputy Head to talk through some of the difficulties and barriers to attending education your child or young person is experiencing.

If your child or young person has SEN and or is having any difficulties around their mental health, this should be shared with the school so they can consider how they can help. Make it clear to the school that you are keen to work closely with the local authority, health professionals and other agencies to identify and support your child's needs as an effective way forward.

If you have not done so already, make an appointment to speak with your child’s GP or Children's Mental Health Service to explain your child’s difficulties and ask for a letter to evidence that you have involved health professionals and are seeking help. This may support your conversations with the school.

The Department for Education Working Together to Improve School Attendance Guidance states

Successfully treating the root causes of absence and removing barriers to attendance, at home, in school or more broadly requires schools and local partners to work collaboratively in partnership with, not against families.

It also outlines that the prosecution of parents should take place where all other routes have failed or are not deemed appropriate. This could include making the case for a community or parenting order where the parent is convicted to secure engagement with support.

My child has an EHC plan, what should I do?

If your child is too unwell, or refusing, to attend the school named in their Education, Health and Care plan you could contact the local authority to request an early annual review.

An annual review will provide you with the opportunity to let the local authority know about the attendance difficulties, discuss progress being made towards outcomes, ask for further assessment and/or request any amendments you would like to make to the plan.

You will also have an opportunity to request a particular school to be named, if the local authority decide to amend the plan following review.

Guidance on Medical Referrals

If a pupil is unable to sustain regular school attendance for reasons relating to an ongoing physical or mental health need, or other circumstances beyond parental control, a Section 19 referral should be considered.

What is a medical referral?

The local authority, Education Access Team, has responsibility under Section 19 of The Education Act 1996 (as amended by the Children and Families Act 2010) for commissioning suitable education for pupils who are unable to attend school.

The Education Access Team commissions support for the following:

pupils who have been permanently excluded from school
where physical/mental health prevents attendance at school,
where pregnancy prevents attendance at school.
pupils unable to attend school due to emotionally based school avoidance,
pupils who are not in school due to other exceptional circumstances.

Schools should make appropriate referrals to the Education Access team for children who are unable to attend school due to ongoing physical or mental health needs, or other circumstances beyond parental control. Referrals should be made where a child will be away from school for 15 days or more, whether consecutive or cumulative.

The school will need to demonstrate they have made all the necessary reasonable adjustments and have involved the appropriate services or professionals for advice and guidance. It is good practice guidance for schools to follow the Lets Talk We Miss You Guidance and for One Planning to be in place.

It will be necessary for parents to share with the school any medical advice from involved health professionals i.e. if your child is under a consultant then they should provide the medical advice rather than your local GP. Where possible, it is helpful for the advice to offer a view on how the medical condition is impacting on school attendance and suggest what interventions/ adjustments are needed to support. If your child is too unwell to receive education, then this would need to be clearly stated. If parents/carers are struggling to obtain medical advice, schools should not delay making a referral to the Education Access team but should clearly outline how your child’s medical condition is currently being supported.

The Local Authority will engage with families throughout the Section 19 process and will confirm, in writing, the outcome of the referral. If the Section 19 referral is agreed, the Local Authority will work in partnership with families, schools and professionals to determine what is the most appropriate support.

You can read more from the Essex County Council Advice for Parents/Carers on Medical Referrals September 25

What is the Section 19 Duty?

Section 19 of the Education Act 1996 outlines the legal duty for the local authority to secure suitable, full-time alternative education or otherwise than at school (EOTAS) for those children of compulsory school age who, by reason of :-

illness is preventing them from being able to attend school
they have been permanently excluded from school or otherwise, or
may not for any period receive suitable education unless such arrangements are made for them

When a Section 19 referral is appropriate

If a pupil is unable to sustain regular school attendance for 15 cumulative days or more, relating to a physical or mental health need, or other circumstances beyond parental control, a Section 19 referral should be considered.

As part of the triage process, schools will be expected to demonstrate that they have made all the necessary reasonable adjustments and have involved the appropriate services or professionals for advice and guidance, such as:

Have the school considered if the pupil has SEND needs and if they require SEND support?
If SEND needs have been identified, One Planning or Pastoral Support Plan should be in place and regularly reviewed.
The local authority provide training and resources to help school manage attendance effectively. The 'Let's Talk We Miss You Toolkit' should be followed and reasonable adjustment considered.
A reduced timetable can be implemented, if in the child's best interest.
The school can reach out to Local Authority Professionals for advice and guidance on managing attendance, such as Inclusion Partners or Engagement Facilitators
School can liaise with their quadrant Attendance Specialist Team for resources, training, advice and guidance.
Supporting evidence is generally needed for the referral to be made, from the GP or involved health professional, outlining that your child’s medical need is preventing them from accessing their mainstream school and giving details of how they may be able to access education, e.g. online or in small group settings.
If the school are recording the absence as 'unauthorised', the referral may not proceed to Education Access. If the school are recording the absence as unauthorised they will need to seek advice from the Attendance Specialist Team on how they are recording medical absences.

Can parents refuse the provision offered?

If a Section 19 referral is accepted, the local authority will listen to parents views but the local authority's duty is to provide what they deem to be 'suitable' provision and they will ultimately determine the provision that will be offered.

If parents refuse the provision offered, this may lead to the Section 19 referral closing and the case being referred back to the school to discuss alternative options.

If your child is not on a school roll, the local authority may then apply for a School Attendance Order under section 437(3) Education Act 1996. The order will require the child’s parents to register the child at a named school. Failure to comply with a School Attendance Order amounts to an offence which the parent can be prosecuted for.

Can I request Alternative Provision for my child?

In the first instance, you should speak to your child's school and discuss options with all professionals involved. You can discuss the option of alternative provision and take a look through the Essex Alternative Education Directory

We encourage you to talk through all the options with the school and the professionals supporting your child. If these conversations do not resolve things, parents can contact the Local Authority directly at section19@essex.gov.uk.

If you have contacted the local authority directly but experience any difficulties with your request, IPSEA provide a template letter for parents to request alternative provision Getting temporary education put in place

Is there a duty for local authorities to provide alternative provision for pupils aged 16-18?

No, Local authorities have a discretionary power (not a duty) to arrange education provision, where not already available, for pupils aged 16-18.

Does the Section 19 duty apply to children if they are not on a school roll?

Yes, but only if the child is of compulsory school age and who, by reason of :-

illness is preventing them from being able to attend school

they have been permanently excluded from school or otherwise, or

may not for any period receive suitable education unless such arrangements are made for them

Supporting evidence must be provided to show that your child meets the Section 19 duty for the local authority to arrange alternative provision.

Parents can contact the Local Authority directly at section19@essex.gov.uk.

IPSEA provide further information on What support should the LA give me if my child is out of school for any reason?

IPSEA also provides a template letter for parents wishing to request for alternative provision Getting temporary education put in place.

You can read more on the definition of Section 19 'Otherwise'

What are the legal definitions for "full time" and "suitable"?

There is not a statutory definition of what constitutes "full time"

The Department for Education Alternative Provision Guidance states

7. While ‘full-time’ is not defined in law, pupils in alternative provision should receive the same amount of education as they would receive in a maintained school. Full-time can be made up of two or more part-time provisions.

Section 19(3A) Education Act 1996 makes an exception for children who, “for reasons which relate to [their] physical or mental health”, it is not considered to be in their best interests to be provided full-time education.

There is a requirement that the education provided is "suitable".

Section Section 19 of the Education Act states

The education to be provided for a child in pursuance of arrangements made by a local authority under subsection (1) shall be—

(a)full-time education, or

(b)in the case of a child within subsection (3AA), education on such part-time basis as the authority consider to be in the child's best interests.

For post-16 education, local authorities have the power to provide alternative provision rather than a duty to provide it.

What does Hospital education mean?

Hospital education means education provided at a community special school or a foundation special school established by a hospital, or education provider, under section 19 of the Education Act 1996.

The decision to provide hospital education is made by a medical practitioner. Example – Children’s Hospital School at Great Ormond Street Hospital (GOSH) and University College Hospital (UCH).

Hospital education will need a medical professional to state the child cannot attend school due to a medical condition.

Useful links

Child Views

To help capture a child's views on emotional based school avoidance

Young People's Views

A school stress survey to help capture a young person's views

Advice on Medical Referrals

Essex County Council Advice for parents on medical referrals and what to expect

Alternative provision

Government guidance from the Department for Education

Getting temporary education put in place

We would encourage you to fully explore all the available options with the school and local authority professionals involved but if you are unsuccessful with these conversations, Ipsea provide a template letter for parents wishing to request for alternative provision

Ipsea

School anxiety

School Focused Anxiety

A video from Essex County Council on School Focused Anxiety

SOS! SEND

My child cannot attend school

Summary of responsibilities where a mental health issue is affecting attendance

from the Department for Education

Understanding and supporting school attendance difficulties

A learning video from the Essex Local Offer

Young Minds

My daughter couldn’t go to school: what I wish I had known