The prevalence of Emotionally-Based School Non Attendance (EBSNA), also known as emotionally based school avoidance (EBSA) or school refusal has risen dramatically in recent years. For parents and educators, how to solve it is a growing concern.
Understanding the emotional and psychological reasons behind EBSNA is crucial. For those who have welcomed new technology, telepresence solutions have emerged as a promising tool to support students with school related fear or anxiety
Uniting expert opinion and real experiences, this blog post shares best practices for implementing telepresence technology to help students reintegrate back to school.
Understanding EBSNA
Definition and Prevalence of EBSNA
EBSNA is a term used to describe the difficulties some school aged children have in attending school due to emotional factors, often accompanied by severe anxiety.
Somerset Council's Support Services for Education highlight that some anxiety is normal and good for us; “We actually perform better when we experience some challenge as it makes us more alert and task-focused.”
However, it’s a problem when these challenges outweigh the ability to cope with the challenges life throws at us, impairing our thinking and ability to reason rationally.
Anxiety can feel different for different people. These are some examples of what it can do to our body and mind:
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Anxiety affects a significant number of students nationwide, with prevalence rates varying across regions and demographics. Recent studies indicate a rising trend, emphasising the need for effective intervention strategies.
Sarah Johnson is an education consultant (via Phoenix Education Consultancy). With multiple books published and keynote speeches under her belt, she’s an expert on understanding the social, emotional and mental health needs of children.
Sarah’s insight
“EBSNA affects not just the child but their parents/carers who are often trying their best in difficult circumstances. Without being curious to find out what is going on for the child, we are merely dealing with the presenting difficulties and not the actual cause for the child.
“The barriers to school attendance are often not particularly well understood and children can appear defiant rather than being in distress.
“Difficulties of a child feeling anxious about attending school can be further exacerbated by challenges within the wider system beyond that of education. For example, long waiting lists for mental health services, and lack of specialist support for Special Educational Needs, can all contribute to difficulty with attending school. This can lead to the difficulties relating to school attendance becoming embedded and difficult to address.
“The term EBSNA has had several iterations over the years, it may be that you’ve heard the phrase school refusal or more recently Emotional Based School Avoidance. Even newer is the term ‘emotional based school non-attendance’.
“None of these terms are a diagnosis but certainly the more recent use of EBSNA or EBSA attempt to explain some of the difficulties that a child may face by moving further away from ideas of a child ‘refusing’ to attend but struggles with their emotional well-being being a huge factor in non-attendance.”
Different Approaches to Supporting Children with EBSNA
A number of best practices have emerged to support children with EBSNA, as Sarah adds:
“As we move away from ideas of refusal and become more professionally curious about a child’s challenges and difficulties, we may be in a better position to support children in improving their attendance.
“The first element, as touched upon above, is exploring different reasons why a child may not be attending school. It is unlikely to be one definitive reason but a range of factors driving non attendance. I like to draw upon Dan Hugh’s work on PACE. PACE refers to; Playfulness, Acceptance, Curiosity and Empathy. This approach focuses on ideas on how to support a child feeling safe to be able to explore their feelings.
“Being playful: There are different ways of making this happen and can be incorporated into more formal discussions with a child or even from a parent/carer point of view. One element of being playful is understanding a child’s interests and needs.
“For example, one way I have been playful when exploring why a child may be reluctant to attend school is by placing different ideas on post-it notes and asking them to put them in groups of; yes, no, maybe. On the post-it notes I have more serious reasons for a child to choose from such as ‘I feel unsafe’ or ‘I don’t think I have any friends’ as well as more silly things such as ‘The squirrels might bite my toes’ (or other things that might seem equally ridiculous). In doing this, you are approaching a way of opening up dialogue whilst also recognising that things are difficult. I also use blank post-it notes for the child or others in the session to be able to add ideas.
“Another approach I use for being playful is to use the idea of ‘which cat am I today?’ with a picture of several different cats with different facial expressions. I also include the words above the expressions such as ‘angry’, ‘tired’, ‘peaceful’, ‘happy’. The child then chooses an image and you can explore different elements from this. This mood board could be anything that relates to a child’s interest, it could be from animals, to pokemons, to celebrities. What the pictures are doesn’t matter, what does matter is that you are incorporating an individual’s interests and playfulness.
“Accepting what they have to say: In the context of PACE, acceptance involves creating a safe environment in which children feel that their experiences and their feelings are acknowledged and validated without external judgement. This can be particularly important for children who are finding it difficult to attend school as it allows for validation of their feelings.
“You can approach this by using certain phrases that reinforce that you value what they are saying. Saying things such as ‘I can see that this is really difficult for you.’ or ‘that sounds incredibly tough for you’ as part of this process avoids statements that may be interpreted as dismissive or minimising what they are going through.
“Being curious: The C in PACE stands for curiosity. Curiorisity involves exploring the child's experiences and emotions without preconceived notions or judgments. In this approach it is about asking questions that help you understand the underlying reasons for their school non-attendance. In doing this you can use open ended questions that encourage the child to express their feelings more openly. You may wish to consider posing questions such as ‘can you tell me more about what it is like for you at school?’ or ‘is there anything that is making it hard for you to attend school?’.
“There may be a range of reasons for a child’s difficulty in attending school, and it is important that you create a space where you are open to exploring these barriers.
“Building empathy: The E in PACE stands for empathy. Empathy refers to showing understanding and compassion for the child’s feelings and experiences. It’s about connecting with them on an emotional level beyond that of sympathy. Empathy can be seen as phrases such as ‘it must be so hard to feel that way’ or ‘I can see why that would make you not want to go to school.’
“Through these conversations, using PACE as a cornerstone to your approach, you can be in a better position in which to identify and work to minimise or reduce the barriers to attending school.”
Leveraging telepresence technology
What is telepresence technology?
Telepresence robots, such as AV1, allow students to see and hear everything in their lesson, without being physically present in the classroom. If the child feels up to it, they also have the capability to speak and participate in classroom activities and interact with peers and teachers through the robot.
This approach to learning has many benefits for students with EBSNA:
1. Reduced anxiety
- Allows gradual exposure to the classroom/school environment from a safe space e.g an inclusion room at school.
- Offers an element of control, reducing the ‘fight or flight’ feeling of physically being in the classroom.
- Pupils are still able to access the curriculum, preventing learning gaps that can increase anxiety around returning.
2. Flexible learning environment
- Enables students to participate in classes and activities remotely at a pace that feels right for them.
- Eases the transition to regular attendance by providing a bridge back to the classroom.
- Serves as a social inclusion tool, fostering a sense of belonging to the school community.
3. Personalised support
- Facilitates tailored interventions from professionals involved in the student's care.
- Allows real-time monitoring and adjustment of support strategies.
Best practices for implementing telepresence robots
Reasons behind EBSNA can be complex so it is no surprise that when considering suitable interventions there is no one-size-fits-all approach.
When deciding on how, where and when a pupil will start using a robot it is important to plan around their individual needs.
Picture 12 year old Lauren. She hasn’t been able to attend lessons for months out of fear of being in the classroom. Although she is engaged with learning she feels out of control and anxious when sat in a room with 25 other children. She has a good relationship with the Assistant SENCO but struggles to form other relationships
For a child like Lauren the idea of re-entering the classroom, even virtually, can be daunting. If introduced to a robot improperly there is a high chance she could be put off. It would be important for her to see the device in person, spend time operating it in a low pressure environment and understand its purpose by speaking with a member of staff she trusts.
Encouraging her to contribute ideas on how she could start using her robot could also help her to feel more in control.
Consider discussing the below with the pupil:
- What they like about their robot and what concerns (if any) they have about using it
- The subjects or lessons they are missing most and would first like to attend virtually
- How they hope classmates and teachers will interact with them whilst connected through the robot
- Where they would like the robot placed in the classroom
It’s important that the robot supports a phased return back into the classroom.
However, the child must feel in control of this process and start at a pace that feels right for them. Be prepared to start off slowly; the first time the pupil logs on could be to speak to a trusted member of staff or to join a small group session with a few other pupils.
Ask the student to give feedback on their experience; what they enjoyed, what they found difficult and what they might be ready to try next time.
Once moved to the classroom the pupil could begin by simply observing the lesson. You can reassure the pupil that they can remain on mute or log off if they start to feel overwhelmed.
Be prepared to be flexible; it is ok to go back a step and regroup with the pupil and key staff before trying again. Once the pupil’s confidence grows there is a chance to gradually increase the length and amount of virtual sessions and begin setting goals for physical attendance – and remember to celebrate their milestones.
There are opportunities to use robots to support EBSNA pupils even outside of the everyday curriculum. Facilitating access to extracurricular activities, assemblies and even school trips can encourage a sense of belonging within the wider school community. For some, positive social interactions may hold the key to a physical transition back to school.
For many pupils with EBSNA that still have motivation or a willingness to engage with school, telepresence tech can be an excellent tool to enable them to ‘dip their toe’ back into the school community.
However, it is important that robots are used in tandem with other kinds of support at school and at home. We recommend fostering collaboration and open communication between teachers, parents, mental health professionals, and the pupil.
Case study
The Downs School: a case study in telepresence integration
The Downs School, a secondary school and sixth form set in the heart of West Berkshire, supported two students with ESBA. They employed the AV1 robot, loaned through West Berkshire Council.
Stephanie Jones, KS3 Student Manager & Deputy Designated Safeguarding Lead, shared their experience:
“AV1 has absolutely played a role in successfully transitioning both the students back into those particular subjects.
“The AV1 allowed students to join lessons from the student support centre, gradually building their confidence. One student, initially too anxious to enter the classroom, now attends regularly and reminds teachers to activate the AV1.
“The AV1 provided a bridge back to the classroom, allowing students to experience lessons without the physical presence, which reduced their anxiety and built trust.
“Both students have significantly improved their attendance and engagement, with one now attending all core subjects and the other overcoming the fear of the school bus.”
Conclusion
Telepresence technology offers a promising solution for supporting students with Emotionally-Based School Non-Attendance. By following best practices, schools can create a supportive and flexible learning environment that helps students gradually reintegrate into the school community.
