Nip in the Bud® Podcast - The children's mental health health charity

Nip in the bud nuggets with Naomi Fisher: How can we support children through Emotionally Based School Avoidance (EBSA)?

• Nip in the Bud Children's Mental Charity

Share episode

This clip is from my longer podcast in which I speak to clinical psychologist Dr Naomi Fisher on supporting children through (EBSA), and how teachers and parents can meet the developmental needs of children effectively.

Do you have, or know, a child who has started illustrating new behaviours around school attendance? 

Are you noticing rising numbers of children who are struggling to get into school? Have you got a child in your class who has started to show growing trends of non-attendance? 

Keep listening to this clip to hear some explanations around EBSA and some practical ways you can work with the child  to get them back into school and back to being a happy and effective learner again.

Nip in the Bud - Where to get help

https://nipinthebud.org/where-to-get-help/




00:00:03.181 - Alis

In these short podcast clips, we offer nuggets of information from our longer podcasts that give advice and quick tips to help you, as teachers, recognize children's needs and respond more efficiently, empowering you to adapt teaching effectively. This clip is from my longer podcast, in which I speak to Clinical Psychologist Dr. Naomi Fisher on supporting children through EBSA. Are you noticing rising numbers of children who are struggling to get into school? Have you got a child in your class who has started to show growing trends of non-attendance? Keep listening to hear some explanations around emotional-based school avoidance and some practical ways you can work with the child to get them back into school and back to being a happy and effective learner again. Emotionally-based school avoidance. Could you tell us what's meant by that, first of all?



00:01:04.961 - Naomi

So that's a bit of a controversial term in itself. Basically, this is an area of lots of controversial terms so yes, when I was younger, it would have been called school refusal or school phobia. Now, people often talk about emotionally-based school avoidance and what that essentially means is young people who aren't going to school because of the way it makes them feel. So that's the emotional element to it. So they find school distressing, and as a result, they are reluctant to go and some people are also now moving towards using school distress, or others are using emotional-based school non-attendance. So there are many different arguments. The other language that people sometimes use is barriers to school attendance, because the problem with the term emotional-based school avoidance is that it locates the problem in the child. So it says 'this child has EBSA,' or whatever you're saying, rather than looking at the interaction between the child and the school, which would be how I'm always thinking about it, what's going on between this child and this school, which is meaning that things aren't working.



00:02:11.561 - Alis

What would you rather use as a term to describe this?



00:02:16.061 - Naomi

I think school-related distress I find quite helpful, also because when we talk about school-related distress, it helps to see the non-attendance as a kind of peak of the iceberg. There's a lot of focus in the press and in the general media about persistent absentees, problems with attendance. It's often talked about as if attendance is a problem in itself, separate from other things and actually, in my experience, difficulties with attendance are what you get after a long buildup of distress. Then it gets to the point where actually it's not happening anymore, the child is reluctant to go to school. But there's usually lots of school distress before that. I think it's more helpful to see it as the peak of what we see, but actually, there's lots of other things going on underneath.



00:03:08.361 - Alis

Okay, that makes sense to me. Would you say that this is a growing phenomenon across the country?



00:03:16.881 - Naomi

Well, I think the evidence seems to show that there are growing numbers of persistent absentees, so children who aren't attending school consistently. I obviously have a particular position because people get in touch with me if their children are having this issue, so it's hard for me to know whether it's growing. I know that I am inundated with people asking for help. I think from my experience, it seems to me something that's growing. Something that I have really noticed recently is that often when I'm talking to people who don't have anything to do with my work and who haven't contacted me about my work, they will often either have a child who's distressed by school or they will know someone who's distressed by school so It has this feeling of being something that a few years ago, maybe people wouldn't have known others who are going through it, now it feels like most people seem to say, 'Oh, yes, that's happening to my neighbour's daughter,' or, 'Oh, yes, actually, my son's going through that.' That is something I've really noticed an increase in just in the last year or so.



00:04:19.301 - Alis

Do you think there's any correlation between this and COVID and the lockdown situation?



00:04:25.881 - Naomi

Yes, I do think there is. I think COVID had a huge impact on everybody, of which we probably haven't really come to terms with, but I do think that one of the things that happened during COVID is that this idea that school was always there and that whatever happened, school was there and open, just suddenly stopped, didn't it? I think that was quite earth-shattering for a lot of us. I think certainly the idea that the government could simply say, 'Right, from Monday, schools are shut,' was quite, just, mind-blowing. I think that for children, the whole experience of COVID was far more significant than it is for adults and the reason for that is that children have shorter memories. They don't have the same basis for expectations about their life that adults do. They are much more in the moment. I quickly noticed that the children in my life, after six months or so of COVID, their memories had faded of what things were like before COVID. They would say things like, 'Did we use to be allowed to go into people's houses?' Because there was that whole period where you had to stand on the front door, or even if you saw them, or you had to meet them outside, or 'Did it used to be okay to stand close to people?' It's like, wow, for them, that's the distant past now and two years is a long time in the life of a child, much longer. I think that children got a very strong message during COVID, Keep away from other people, Other people aren't safe. You have to stay at home, you have to keep yourself and your family. And then it was suddenly like, now that's all over, back to school. So I think that did have an impact. I also think that for some children, lockdown was a relief. So I talked to some families who say, 'lockdown was just this blessed relief from how distressed they were by school and when we saw that and we saw how different it was, we couldn't then carry on because before, we didn't really know just how different things could be.' So I think there was that and I think there was also the aspect that some parents got a closer eye on what their children were doing in school and how much perhaps their children weren't very excited by what they were doing in school. And that also changed how some of those parents felt about school. So I think lots of things came together with COVID.



00:06:49.201 - Alis

What about schools? What could schools do to help? If they're noticing any changes or they're not noticing, but parents are coming in and saying, 'I'm having these real struggles, I think there's this real distress linked to school.' What advice could you give to schools?



00:07:06.691 - Naomi

I think there are certain things that parents tell me cause their children distress, which schools are often bringing in without necessarily being aware that they can cause distress. So recently, I've had lots of parents contact me about behaviour apps, for example, where their children's behaviour is monitored via apps and they are sent notifications of their behaviour all the time. I've also talked to children about schools that have very punitive behaviour systems where you get a behaviour point for something like having your shirt untucked or having too many pairs of earrings in. And if you get three in a day, then you're in isolation the next day. I'm consistently hearing from young people and parents that those things actually are pushing their children towards distress and non-attendance. Schools tend to be quite resistant to that message, and I can understand that because these are behaviour systems that they've put in place. But it's my sense that there isn't anybody really doing risk assessments when these things are introduced, these apps are introduced, that they're businesses, usually the apps in particular, and that nobody is actually looking at the impact on the young people, and that perhaps for quite a significant minority, these things like this, this level of scrutiny, doesn't have the positive effect that the school is hoping. Instead, it has a negative effect so what I'm really meaning there is that I think listening to parents about things like that can really make a difference, and evaluating anything like that that you've brought in, thinking that could that be causing problems as well? Attendance awards are another thing I hear about a lot, that young people are struggling with attendance. They often say there's going to be a prize for 100% attendance. And what that means is that a young person who's been struggling with their attendance gets to the end of the term and everybody else is celebrated and they're not. It contributes to them feeling negative. But the number one thing I think that schools can do is to think about the relationship that they have with that child, because that's the thing I hear, the positive thing I hear about most. People will say things like, 'It was this one teacher who really took an interest in my daughter and would say, "Hello, how are you?" At the beginning of the day, that was the thing that made the difference and kept her coming in.' In contrast, what I hear from other parents will be, 'It was a really big effort to get her in and the first thing they said to her was, "You've got an extra pair of earrings in. That's a behaviour point."' And that's the opposite, so I think how you react to a young person when they come in through that door just can make all the difference as to whether they feel welcome and that they belong there or whether they feel actually, 'Why did I bother? I'm just going home.'



00:09:52.591 - Alis

I love that term belong. That feeling of belonging is so key. As you say, they spend a lot of hours in that school and they've got to feel like it's theirs.



00:10:02.881 - Naomi

Yeah, and they want to feel welcome. We want them to feel that it matters to us that you're here.



00:10:08.111 - Alis

Yeah, absolutely. What advice would you have for the children themselves and the young people themselves? So starting off with primary children, What could you say that might help them recognize that that tummy ache or that headache is actually them starting to feel a little bit distressed about going to school?



00:10:28.341 - Naomi

The way that I talk about these things with children is usually actually by encouraging parents to talk about their own emotional reactions. Children don't like to be put on the spot, particularly if they're anxious about something. I think we can help children reflect on what's going on for them if as parents, and teachers as well, actually, but adults around them, we say things like, 'I'm meeting someone new at work today. That's making me feel a bit anxious. When I feel like that, I feel a bit of pain in my tummy but then I meet them, and actually, they were really nice and it was okay.' So you can tell little stories all the time and I talk about this with parents as it being like you're opening up for children the inside processes that go on for you because young children don't know that everybody else has the same processes as them. They think it's just them who has all these emotions and things, and particularly adults, they think adults are just calm, collected, don't have the same emotions. So we can open that up for them and say, 'It's completely normal, you'll feel a bit anxious. Maybe Monday mornings, you feel a bit worried because it's the beginning of the week again, and then we feel a bit better and it's okay.' I think that's the most non-direct the way I know of doing it so that the child doesn't go, 'No, it's not like that at all.'



00:11:50.191 - Alis

It sounds like you're suggesting creating a language, if you like, a vocabulary that they can feel familiar with. It's okay to admit these feelings and I've words that I couldn't necessarily have thought of before.



00:12:03.561 - Naomi

I think that a lot of young people who are currently struggling with school either already have a diagnosis of autism or get a diagnosis of autism in the process of struggling to go to school. I think that we are recognizing more and more how many of the ways that school is set up, difficult for lots of kids, but they're particularly difficult for autistic children, that schools are very complex environments with loads of people in them. They are sensory nightmares if you are someone who's sensitive to noise and to smells, all of those things can be particularly difficult for autistic children. Also, lots of the behaviour things that I was talking about earlier, the apps and the micromanagement of behaviour, many autistic children become extremely anxious about those, really acutely anxious about those so I think that for many autistic children, school is a particularly challenging environment. I think we're only really starting to recognize that actually. As I say, when I did my PhD on autism, it didn't even occur to me to look at the young people who were out of school.



00:13:15.431 - Alis

What things could schools put into place to meet those needs and make it so it's less of a challenge for them to be in that environment?



00:13:28.031 - Naomi

I think, again, schools vary hugely in what they do. I hear about some great practice that schools have. Some schools have things like sensory circuits in the playground that children can go and do when they need to do it, when they want to do it. Some schools have learning hubs that children can go to, which are like a place to decompress, really, where you can go and be there for a while. Some schools have school dogs that you can go and walk if you need a bit of time out. So providing ways that children can regulate themselves, so basically, if a child is able to say, 'Actually, I need a bit of a break here. There's somewhere for me to go.' Then that could make the difference between that day at school being successful or that child's behaviour escalating and perhaps them ending up in detention or isolation and everything going down a very different route. So it's like putting in these things beforehand, putting in these little breakpoints almost beforehand so that there are options for the child to step out or do something else, so that things don't escalate.



00:14:31.341 - Alis

I think that goes back to your earlier point about relationships and how important that is as schools really knowing the child and being able to pre-empt rather than wait until there's an explosion, but actually have those strong relationships where you know what that child needs.



00:14:48.851 - Alis

I hope you enjoyed that Nip in the Bud nugget. If you want more, why not go back and listen to the whole episode with my guest? If you enjoyed this episode, please share it with others and visit our website for more information, advice, and resources.