My most recent #DomIn60Minutes webinar for parents, earlier this week, was a fascinating conversation between me and my two guest experts, Dr Rachel Stirland, senior NHS Clinical Psychologist and Cat Taylor, an NHS trained mental health therapist for 8 to 18 year olds. We talked about school avoidance (previously called ‘school refusal’ but some parents and therapists feel that such a phrase implies that the child has a choice about going to school and are refusing to do so, rather than being so worried or stressed that they cannot go and are therefore avoiding it).

It is becoming more common

We covered a lot of ground, not least of all reassuring parents that if school attendance issues are something that they are struggling with, then they are not alone, and numbers are rising.

The official figures are that 1% of UK children struggle to attend school regularly (this is not the same as truancy, where school is avoided but parents and families are not aware), and that it is more common for boys to avoid school than girls, with the commonest age for issues being between 5-6y and 11-12y. We also discussed how times of transition can be particularly tricky and a trigger for school attendance issues, and those ages would suggest that moving into school at primary age, or into secondary school, can be very difficult for some young people.

What underlies most school avoidance?

Triggers tend to be academic worries/ exams/ perfectionism, social problems and friendship issues, bullying, autism or sensory sensitivity (schools are not usually quiet and relaxing places to be), and ADHD, as well as issues around self-esteem and appearance/ body image for any gender.

Why does it happen and what can we do to help?

It is vital to explore the trigger and underlying issues with any young person struggling to attend school, because the key to improving the situation will be through dealing with the underlying problem, not forcing them to go to school. Our education system is a little ‘One Size Fits All’ in terms of how we expect people to learn, and this can be stressful for children who learn in different ways, or who find it hard to focus and sit still, or process information in non-typical ways. If bullying is the issue or academic pressure, then working with the school to address this will be vital.

Young people who find it hard to go to school sometimes talk about feeling ‘different’, ‘trapped’ and feeling as if they are ‘wearing a mask’ to create the impression that they are ok, and coping, when in fact underneath it they are very stressed and anxious.

What might you notice?

They may try to cope by sleeping in, and not getting out of bed in the mornings (partly because they just don’t want to go, but also because some teens delay going to sleep as an attempt to delay the onset of tomorrow and are then exhausted by the morning). Others will have anger issues, anxiety, mood swings or outbursts. Physical symptoms like tummy aches, headaches, and general ‘feeling unwell’ are also caused by anxiety and school worries.

It is time to ask for professional help if these behaviours and emotions are persistent and pervasive, routinely affecting their normal enjoyment of life, and their ability (and yours) to do the things they need to do and achieve. Don’t struggle on alone. Help is out there.

Where to get help?

It is important to liaise with the school, engage their support, find a member of staff who your child connects with, and get support from their peers, if possible, e.g. a friend to meet them at the school gate in the morning to ease their start to the day. Your GP can offer the whole family support and refer if necessary.

Online Facebook or other support groups for parents are really helpful for many, providing a lifeline of support and a network for new ideas and strategies. See below for a list. Websites, resources and books can be game changing.

Home strategies

It can be very stressful to deal with school avoidance, and it will take patience, compassion and consistent messaging from parents to ensure that a routine is created and maintained whether at home or at school, sleep is protected and prioritised, and an open approach to discussion is encouraged. Even if your teen won’t talk to you, let them know that you are there for them, always happy to talk even about difficult topics, and encourage them to speak to another trusted adult if that is an option; a teacher, an aunt, a best friend’s mum, as teens are not know for chatting with their parents, and peers are not always the only source of support.

We discussed a technique to develop their ability to talk about their feelings too ('emotional literacy') that involves the 'feelings wheel'. Well worth a google and trying out the wheel at home- to help them to express themselves but also to recognise the wide range of normal human emotion.

Finally

As I mentioned in the title, one of the best comments I have heard from experts on this topic is to remember to ‘focus not on the attendance but on the needs of the child’. It is easy to become overwhelmed with trying to get them to school at any cost, but learning can happen in many ways and in different locations.

So as long as you are supported by the school, then it may not matter if they don’t attend the actual school building for a while, if they can instead learn at home, with a good daily routine that mimics school perhaps, but allows them to learn in a way that works for them. They may then, having dealt with the underlying issue, build up to returning to school in time, or you may like to check out alternative options at https://www.sense.org.uk/get-support/support-for-children/send/

Find more help here;

Websites

https://www.youngminds.org.uk/parent/a-z-guide/school-anxiety-and-refusal/

Plus https://schoolrefusal.co.uk/about-me

And https://notfineinschool.co.uk

Finally https://parents.actionforchildren.org.uk/education/school-university/coping-school-refusal/

And this book https://www.cambridge.org/gb/academic/subjects/medicine/mental-health-psychiatry-and-clinical-psychology/mental-health-and-attendance-school