Supporting Autistic Children with Emotionally Based School Avoidance (EBSA) Through Positive Behaviour Support

Emotionally Based School Avoidance (EBSA) is an escalating concern in the UK, particularly among autistic children. The COVID-19 pandemic has exacerbated this issue, with school absences rising significantly. In the 2022/2023 academic year, the overall absence rate in English schools was 7.5%, compared with approximately 5% pre-pandemic, while the rate of persistent absenteeism (missing over 10% of academic sessions) was 22.3%, nearly double the pre-pandemic rate (Department for Education [DfE], 2023).

This surge in absenteeism has profound implications for children's educational attainment, social development, and mental health. The economic impact is also substantial, with increased demand for specialised educational services and long-term societal costs associated with reduced educational outcomes.

Understanding Emotionally Based School Avoidance

EBSA occurs when children experience significant emotional distress related to attending school, leading to prolonged absences. For autistic children, this distress often stems from:

• Sensory sensitivities: Overwhelming stimuli such as loud noises, strong smells, or bright lights (Green et al., 2023).
• Social challenges: Difficulties navigating social interactions, leading to anxiety and isolation (O’Hare et al., 2022).
• Fear of bullying or discrimination: Heightened vulnerability to negative peer interactions (Smith et al., 2021).
• Inconsistent routines: Unpredictable schedules that increase anxiety (Cage et al., 2023).

Addressing EBSA requires a comprehensive approach that identifies and mitigates these underlying factors.

Positive Behaviour Support: A Framework for Intervention

Positive Behaviour Support (PBS) is a person-centred framework aimed at improving quality of life and reducing challenging behaviours by understanding their underlying causes (Gore et al., 2022). It involves assessing the environmental, social, and psychological factors contributing to a child's behaviour and implementing strategies to address these factors positively.

Step 1: Identifying Anxiety Triggers

The foundation of PBS is a Functional Behaviour Assessment (FBA), which helps identify the specific triggers and contributing factors for EBSA. For autistic children, these may include:

• Environmental factors such as noise levels, classroom layouts, or sensory overstimulation.
• Social pressures, such as difficulties with group work, transitions, or unstructured times like lunch breaks.
• Cognitive demands, including tasks that require extended concentration or navigating unclear instructions (Cooper et al., 2022).

Using tools like ABC (Antecedent-Behaviour-Consequence) charts, interviews with parents and teachers, and sensory profiling, an FBA provides a clear understanding of the “why” behind a child’s behaviours.

Step 2: Reducing Setting Events that Lower Tolerance for Triggers

PBS focuses on reducing setting events—broader factors that increase vulnerability to anxiety. Strategies include:

• Creating sensory-friendly environments: Introducing quiet spaces, allowing noise-cancelling headphones, or modifying lighting and classroom layouts.
• Providing routine and predictability: Using visual schedules, task breakdowns, and consistent routines to reduce uncertainty.
• Adjusting demands: Gradually building tolerance for academic and social expectations rather than overwhelming the child with abrupt demands (Hastings et al., 2023).Step 3: Building Coping Skills

PBS equips children with tools to manage anxiety, including:

• Calming techniques: Teaching deep breathing, mindfulness, or sensory regulation strategies.
• Problem-solving skills: Empowering children to request breaks, self-advocate, or seek help in anxiety-provoking situations.
• Gradual exposure: Supporting children to re-engage with school incrementally, starting with small, manageable steps that build confidence (Robinson et al., 2023).

Step 4: Monitoring and Evaluating Progress

PBS incorporates a range of strategies to monitor and evaluate progress:

• Behavioural indicators: Tracking observable signs of anxiety, such as avoidance behaviours or withdrawal.
• Self-reports: Using child-friendly tools, such as visual emotion scales or journals, to help children express how they feel.
• Feedback from stakeholders: Regular input from parents, teachers, and therapists ensures interventions are working (Davies & Smith, 2023).

Progress is measured not only by a reduction in school refusal behaviours but also by improvements in the child’s quality of life, such as positive engagement in learning and social interactions.

The Importance of an MDT Approach

PBS is most effective when integrated within a Multi-Disciplinary Team (MDT) approach. Supporting children with EBSA requires collaboration between professionals, including psychologists, occupational therapists, speech and language therapists, and educators. Each team member provides unique insights:

• Occupational therapists assess and address sensory needs.
• Speech and language therapists support social communication and peer interactions.
• Educators implement classroom-based strategies and ensure consistent adjustments.
• Families share insights about the child’s experiences and provide reinforcement at home (McGill et al., 2023).

Creating a Supportive Environment for All

EBSA is not just a challenge for individual children and families; it’s a systemic issue. Positive Behaviour Support, combined with an MDT approach, provides a clear, evidence-based framework to support children with EBSA. By identifying anxiety triggers, reducing setting events, and teaching coping skills, PBS empowers children to re-engage with education in a way that respects their needs and individuality.

The goal is not simply to "get children back to school" but to create environments where they feel safe, understood, and valued. For autistic children, this can make the difference between dreading school and thriving within it.

Call to Action

Emotionally Based School Avoidance (EBSA) affects countless children and their families, presenting unique challenges that require compassionate and evidence-based solutions. Positive Behaviour Support, integrated with a Multi-Disciplinary Team approach, offers a pathway towards sustainable and meaningful change.

If your school, organisation, or local authority is seeking support to address EBSA, particularly for autistic children, we are here to help. Whether through tailored training, consultancy, or individualised assessments, we can work with you to design solutions that transform lives and create inclusive educational environments.

Let’s take the next step together. Contact us today to discuss how we can support your team and ensure every child has the opportunity to thrive in education and beyond. Together, we can build a brighter future for children facing these challenges.

References

Cage, E., et al. (2023). Understanding autistic children’s school experiences: The role of sensory and social factors. Journal of Autism and Developmental Disorders, 53(4), 212-227.

Cooper, V., et al. (2022). Functional Behaviour Assessments: Understanding the why behind behaviour. British Journal of Special Education, 49(2), 98-110.

Davies, M., & Smith, P. (2023). Monitoring progress in children with school refusal behaviours: Tools and techniques. Educational Psychology in Practice, 39(3), 167-181.

Department for Education (DfE). (2023). Pupil absence in schools in England: 2022 to 2023. Retrieved from https://www.gov.uk

Gore, N. J., et al. (2022). Positive Behaviour Support: A framework for autism support in schools. International Journal of Positive Behaviour Support, 12(1), 23-37.

Green, J., et al. (2023). Sensory processing in autistic children and its impact on anxiety and attendance. Child and Adolescent Mental Health, 28(2), 101-114.

Hastings, R. P., et al. (2023). Reducing anxiety in autistic students: Environmental and psychological interventions. Autism Research, 16(5), 345-360.

McGill, P., et al. (2023). The role of multi-disciplinary teams in addressing school avoidance. Advances in Autism, 9(1), 54-68.

O’Hare, M., et al. (2022). Social communication challenges in autistic children: Impact on school engagement. Social Development, 31(2), 201-215.

Robinson, H., et al. (2023). Evaluating gradual exposure strategies for Emotionally Based School Avoidance. Journal of Child Psychology and Psychiatry, 64(4), 409-420.

Smith, L., et al. (2021). Bullying experiences and their impact on autistic children. Journal of Autism and Developmental Disorders, 51(6), 1234-1245.