Emotionally Based School Non-Attendance (EBSNA) is a broad term that refers to children and young people who experience persistent difficulties attending school due to emotional distress or overwhelming feelings associated with the school environment.
About EBSNA
There is no single cause for EBSNA and there are usually several contributing factors, which can present differently in each child. It can lead to prolonged absences from school and can involve physical and emotional symptoms.
It differs from truancy, as the absence is due to emotional distress rather than a lack of interest in school.
EBSNA can also be known as:
School anxiety
School Refusal
Emotional Based School Avoidance (EBSA)
Signs of EBSNA
Common early signs of EBSNA include:
Worry, panic or low mood before school, and/or after weekends and holidays
Physical symptoms (such as tummy aches or headaches), or difficulty sleeping the night before school
Meltdowns or distress before school
Withdrawal after school
Masking at school, followed by distress at home
Masking is when a child puts a lot of effort into managing their feelings or difficulties at school so they appear to cope. This can take a lot of energy, and may mean they struggle more once they are at home.
What parents can do
Parents of children experiencing EBSNA should:
Talk and listen
Ask about your child’s feelings and experiences with school in a way that feels comfortable for them.
Keep a diary
Record dates of absence or late arrival, any triggers, and what helped.
Contact your child's school
Request a meeting with the class teacher or form tutor and the SENCO or pastoral lead. Use this to share your concerns and agree a support plan.
National guidance expects schools to support pupils whose mental health affects their attendance. This includes early help and reasonable adjustments.
Speak to a GP or medical professional
Some parents choose to speak to their GP or another professional already involved with their child (for example, a paediatrician) about their child’s emotional wellbeing.
This can be helpful, especially if the difficulties have been ongoing, to explore whether there may be any underlying physical or mental health needs. They may offer advice on managing symptoms and, where appropriate, refer to other services.
EBSNA is not a medical diagnosis, and a GP cannot diagnose or 'confirm' it. If a GP or medical professional agrees that your child is currently unable to attend school, ask if they can provide a letter for the school or local authority explaining the reason for their absence.
What schools should be doing
Schools should take action when you raise concerns about EBSNA, including:
Listen and take concerns seriously
The school should listen to both you and your child and take your concerns seriously.
Schools must follow Department for Education guidance when mental health is affecting attendance.
Communicate clearly
Keep you informed about what support is being offered and any progress made.
Create and review support plans
Put support in place for your child and review it regularly. This should involve you, your child, and any relevant staff or professionals.
Involve external professionals where needed
Work with educational psychologists, counsellors or other specialists where appropriate and available.
Follow legal duties
Follow the law and national guidance on attendance, wellbeing and support in school.
Working with the school
You can work with the school in stages:
Prepare – gather information
Meet – discuss concerns
Agree – set a plan
Review – check and adjust
Before a meeting with the school
Write down your child’s views and your own observations. Use your diary to help with this, and include any questions you have.
Observations could include lessons, staff changes, crowds, noise, lunch or break times, transitions, being tearful, not sleeping, or saying they feel unwell. Only include what feels relevant.
Note any significant life events that may have had an impact, such as bereavement, family separation, moving home, or a new sibling.
In the meeting
Share what you know about your child’s worries and feelings, both at home and at school.
Ask what the school has noticed about your child’s wellbeing and how they are managing in school.
Talk about which parts of the day are most difficult and what the possible triggers might be.
Discuss whether your child may be masking. Are they hiding or suppressing their feelings in school and then showing distress at home.
Support and training
Ask how staff are supported and trained to help children with EBSNA, and what approaches the school usually uses.
Adjustments and targets
Agree practical adjustments to the school day, such as flexible start times, changes to lessons, or access to a quiet space.
Agree a written plan with small realistic outcomes and set review dates. Examples of outcomes could include 'reduced anxiety at drop-off' or 'attends period 1 three days a week'.
Ask which adjustments can start straight away (for example, changes to space, timings, transitions, a key adult, or sensory needs).
Recording absence
Ask how your child’s absence is being recorded, in line with Department for Education attendance guidance.
After the meeting
The agreed support or reintegration plan should be put in place and monitored.
There should be regular reviews (for example, weekly, fortnightly or monthly) with you and your child to check if it is working.
If not, the plan should be adjusted and other options considered.
What to include in a support plan
A support plan should include:
Your child’s views and early warning signs
Named adults who will be supporting your child, specific adjustments and when they will happen
Small achievable goals and how progress will be measured
Home–school communication (what, when, who)
What is the review date and who will attend
Ordinarily Available Provision (OAP)
In Wandsworth, schools should first use their own expertise and resources (budget) to support children. This is called Ordinarily Available Provision (OAP).
Find out more about Ordinarily Available Provision in Wandsworth.
The Schools and Community Psychology Service also shares EBSNA resources for autistic pupils. Find out more about supporting children with EBSNA and autism.
Examples of OAP
Ordinarily Available Provision can include:
Daily check-ins - A member of staff checks in with your child during the day. Your child could also have access to a key adult they can go to for support
Safe or quiet spaces - Access to a quiet space, a toilet pass, or a time-out/exit card
Reduced sensory load - For example quieter entrances or corridors, headphones, seating changes, or a workstation in a quieter part of the classroom
Peer support - Buddying or peer mentoring within their class or tutor group
Changes to class or tutor group - Where appropriate, moving to a different class or group
Flexible routines - Adjusted start and finish times, and support with transitions (for example from home to school or between lessons)
Emotional support - Opportunities to talk about feelings and build understanding (for example small groups, ELSA, or Zones of Regulation).
Autonomy and predictability - Visual timetables, advance notice of changes, and some choice in their day
If your child is not attending school, a member of staff could check in by phone or video call to help them feel part of the class. School could also provide work without pressure until a plan is agreed.
In exceptional circumstances and only on a short-term basis the school could introduce a part time (reduced) timetable with regular reviews. A part time timetable must be done with parental agreement, otherwise it could be considered unlawful exclusion.
If OAP is not helping
If these approaches are not improving your child’s wellbeing and attendance, you can ask the school to consider additional support, such as assessments or input from specialist services.
For example, you could ask if:
Education Wellbeing Service (NHS) support is available (if your child is not already supported by CAMHS or Children’s Services)
Wandsworth EBSNA Hub can provide outreach or reintegration support
Educational Psychology (Schools and Community Psychology Service) can offer advice or assessment
Primary PRU (Victoria Drive) can offer short-term support for primary pupils
Secondary PRU (Francis Barber) can provide targeted programmes and psychological support
Your child does not need an Education, Health and Care (EHC) plan to access these services, although referral routes vary by need and availability. Schools can advise on referral criteria and discuss which may be the most appropriate.
If your child may need longer-term support
If your child’s emotional needs are affecting their ability to learn over time, they may have special educational needs or a disability (SEND).
In this case, the school should provide support through their own resources. This is called SEN Support. Find out more about SEN Support.
If your child’s needs cannot be met through SEN Support, you (or the school) can request an Education, Health and Care (EHC) needs assessment. Find out more about EHC needs assessments and EHC plans.
If your child already has SEND
If your child is on SEN support without an EHC plan, speak to the SENCO and class teacher about whether the support in place is meeting your child's needs.
If your child is on SEN support with an EHC plan, speak to the SENCO and your child’s EHC coordinator. An early annual review may be needed to update support and outcomes.
Find out more about annual reviews of EHC plans.
The law and national guidance
Schools and local authorities must follow government guidance on school attendance. This sets out what is expected of children, families, and schools.
The main guidance is Working together to improve school attendance (August 2024), which explains:
The expectations for school attendance
What schools and local authorities must do to support attendance
What parents need to know about their rights and responsibilities on school attendance
There is also additional guidance called Summary of responsibilities where a mental health issue is affecting attendance. This explains what schools and local authorities should do when a child’s mental health is affecting their ability to attend school.
Your child's right to education
Every child of compulsory school age (5 to 16) has a legal right to a full-time education that is suitable for their age, ability, and any special educational needs or disabilities (SEND).
Parents are legally responsible for making sure their child receives this education, either by attending school or through another suitable arrangement.
Attendance and enforcement
Although attending school is a legal requirement, any decisions about enforcement should take your child’s emotional wellbeing into account.
Local authorities have legal powers to act on attendance, but they must consider the reasons behind a child’s anxiety, distress, or refusal to attend before acting.
Recording absences
National guidance explains how schools and local authorities should record and manage absences. This includes using the correct attendance codes and keeping accurate records of why a child is not in school.
Getting temporary education
Local authorities have a legal duty to arrange suitable education for children of compulsory school age (5 to 16) who cannot attend school because of:
Illness
Exclusion
or other reasons
Other reasons can include school anxiety, EBSNA, placement breakdown, unmet special educational needs (SEN), or trauma.
This duty applies to all children aged 5 to 16, whether or not they have an Education, Health and Care (EHC) plan.
When support should start
Government guidance says suitable provision should begin once it becomes clear a child will miss 15 or more school days. These days do not have to be in a row.
Support should be put in place as soon as possible, without unnecessary delay.
Providing medical evidence
If medical evidence is not immediately available, schools and local authorities should still look at all relevant information, including:
Observations from school staff
Information from other professionals
Your child’s emotional wellbeing
This helps them decide what education should be offered as soon as possible.
What the education should look like
The education provided should be:
Suitable for a child’s age, ability and needs
Similar in quality to what they would normally receive in school
Delivered in a way that supports their health and wellbeing
Asking the council for support
If you need to request temporary or alternative education from the local authority, you can download and adapt the IPSEA template letters.
Support services
We do not recommend specific services, but the organisations below can help you understand your options and find support: