Many of our parents have reported that their trans-identified child has experienced a period of time when they were out of full-time education, whether for a few weeks or several years. Whilst dealing with a child or young person experiencing gender confusion can already be a stressful time for parents, it is particularly so when coupled with school reluctance or refusal.
Whether your child’s difficulties with attending full-time school are related in part to their trans identity or because of broader issues, we cannot stress enough how good communication is key – between schools, parents, professionals and most importantly with your child. When attending meetings to discuss how to resolve the difficulties, think about what you want to say in advance, keep clear notes of who has agreed to do what, and work closely with the educational and mental health professionals to help your child overcome their barriers to education.
How common is school refusal?
School refusal is not uncommon. It is estimated that it occurs in 1% of all school children and most likely to occur in those with mental health diagnoses. Around a quarter of school children will refuse to attend school at some point in their educational careers and most likely to occur at transitions between school settings; first between the ages of 5-6, then a second peak at 11/12 years, and the third peak at 14. It affects boys and girls equally and often occurs in children who were otherwise academically above average.
What does school refusal look like?
Refusal to attend school is often accompanied by extreme anxiety symptoms and sometimes depression or oppositional behaviour. Physical symptoms are commonly reported to parents, such as stomach aches, headaches and nausea, and these may well disappear if your child is allowed to stay at home. This doesn’t mean that they are making the symptoms up, but simply that being permitted to not attend school reduces their anxiety and hence the symptoms recede.
How to approach school refusal
Maintaining good communication between you, your child and the school is essential to achieving a resolution. It has been shown that addressing the problem as early as possible can help prevent school reluctance from becoming a long term problem of prolonged school refusal.
Of course, when the source of the refusal is a direct consequence of gender issues, things can become a little tricky. Use of names and pronouns, bathrooms and changing facilities along with school sports and residential trips can all cause our gender distressed children elevated anxiety. As we have stated elsewhere in our advice, you need to decide what is the best course of action for you, your child and your circumstances. Decide where your boundaries are and stick to them. Discuss pronouns and names with the school, and encourage them to take your lead, especially with younger children. Bathrooms, changing facilities, sports and residential trips are all matters where child safeguarding must take precedence. We advise looking at this guide to supporting gender non-conforming and trans-identified students in school. In an article for TES, it was judged to be the only transgender guidance for schools with safeguarding at its heart and fully complies with all government legislation.
As long as there are no physical problems or ongoing school-based issues, reassurance and encouragement to return may be enough. If not, a more comprehensive look at how to facilitate a return to school will be needed, and this is where good relations between all parties is essential. A graduated return to school, with regular reviews of progress to ensure that the strategies are working requires the cooperation of parents, school and of course the child themselves.
What is the long term outlook?
Most children who refuse school carry on with no continuing mental health difficulties. However, a significant number, nearly a third, will go on to have long term problems such as anxiety or depression. This may well be because the difficulties with attending school were a symptom of an underlying difficulty, rather than a refusal to attend school being the cause of later problems.
School refusal tips and advice
There is no one-size-fits-all solution to school refusal. You need to decide what might work for your child and stick with it for some time. Solutions may not appear to work at first but, with perseverance, you can make a difference. If you are consistently using a strategy and it is not having an impact, look again and perhaps try something else.
What you shouldn’t do
Don’t use physical force. School refusal should be seen as an anxiety state and the forced facing of fears is called ‘flooding’. It should only be done by trained individuals and, if done badly, can make things a whole lot worse. By heightening your child’s anxiety you may make matters worse in the long run.
Don’t use bribes. You will feel disappointed if they do not succeed and often as parents we aren’t as good at hiding our true feelings and emotions as we think. Your child may also feel they have let themselves down as well as you, increasing their sense of failure. They may also experience this as additional pressure and give up before they even try. Rewards can always be used for attendance after the target has been achieved but without preconditions.
Don’t remove your child’s devices as punishment for non-attendance. As parents, we may limit access to gadgets when a child is off school for other reasons, such as illness, but try not to do this for school-related anxiety. Our kids often use electronic devices as a form of respite from the pressures of school, especially neuro-atypical kids. If they are at home and at a loss as to what to do with no distraction from their thoughts, their anxieties may well worsen. Keep them occupied as much as you can – with gadgets if necessary. But always keep in mind our advice that unfettered access to the internet and social media sites can be detrimental.
Don’t be too rigid about bedtimes. Good sleep routines are essential, but don’t force the issue more than necessary – the more pressure they feel at bedtime, the later they are likely to be up. Parents will often report that their child’s sleep paradoxically worsens when they are not attending school. This can be due to the lack of structure of being at home all day but also sleep can give the illusion of time speeding up, bringing the next day’s school run ever closer. By delaying going to sleep your child may be attempting to delay the start of the next day and the anticipated onset of the cause of their anxiety. Remember, it is also normal for teenagers to enter a period of altered sleep patterns where they tend to leave behind their early rising in favour of becoming night owls.
What you should do
Remain positive and praise your child for each step they take towards returning to school, no matter how small or insignificant the effort may seem
Be consistent. Some strategies may take a while to work, but showing that you can persevere sets a good example to your child.
Ask directly about what is bothering your child about school – when your child identifies as trans, they might be anxious about name and pronoun changes or bathroom use. If you and your child are experiencing differing opinions on these subjects, you may find thinking with them about what accommodations could be made difficult, but it is not an impossible conversation. Take their concerns and worries seriously, and let them know that you understand these things make it hard for them to attend school. As always, remain calm and actively listen. Some of our parents have felt that getting their children back into school forced them to compromise on names and pronouns. Remember to do what’s right for your family.
Contact school as soon as you have concerns. Ask the school about your child’s behaviour, grades and social interactions. There may be situations at school which you are unaware of. Being pro-active can work in your favour, especially when no changes have yet been implemented at school. You can work with the school to think of ways that the situation could be improved, bearing in mind safeguarding issues at all times.
Keep a note of when your child is reluctant to attend school. Is it related to certain days or lessons, or certain teachers? Show the school any patterns you find, as they may help identify what it is that is causing your child such anxiety.
Try and maintain routines. Even if your child is not attending school, regular routines are important. Finding something to look forward to each day can help. If you can get your child to school on some days but not others, keep their daily schedule going – getting up, getting dressed and having breakfast should still happen at the same time, even on the days they do not attend.
Look at incremental targets your child can achieve. Sometimes the thought of going back to school full time is so overwhelming, that a graduated approach taken step by step, can help to alleviate some of the fears your child has developed.
Address Special Educational Needs. Whether your child already has SEN input from school, or you believe they may benefit from assessment, addressing the SEN requirements of your child is important. Children whose needs are not identified, or are poorly met, can suffer from increased distress and anxiety, which in turn can trigger school reluctance or refusal. Many children with conditions such as ASD or ADHD benefit hugely from interventions that make accessing the school environment and curriculum easier, whether or not they demonstrate difficulties academically. Talk to school about what accommodations your child may need to ensure they do not struggle unnecessarily.
Address anxiety issues. Helping your child to express and manage their anxiety around school and other situations will facilitate an overall improvement in their wellbeing and likelihood of resolving their school refusal. This could be through general activities such as hobbies or more targeted approaches such as direct anxiety management strategies. Where anxiety is not reducing or is in fact escalating it may appropriate to discuss referrals to CAMHS with your GP.
There are many online resources that can help parents address anxiety issues in children and young people. Below we have listed a few websites you may find useful:
- Anxiety Canada – My Anxiety Plan is a free, online CBT course to help you to support your child to work through their anxieties.
- Young Minds advice to parents on supporting a child with school-related anxiety and refusal
- Royal College of Psychiatrists’ information for parents on helping children to cope with worries and anxieties
- Action for Children has a webpage with good suggestions for dealing with school anxiety
School-based strategies that may help
It is really important to work with schools to identify ways in which they can help to relieve your child’s anxiety over going to school. Simple changes such as altered start and finish times, the ability to use different entrances to school buildings, changes to homework or lesson timetables, or alternative arrangements for lunch and breaktimes can all help to reduce the stress of the school day. These arrangements will of course depend on the reasons for your child’s resistence to attending school, and shouold be tailored to individual circumstances.
The following are a few suggestions of interventions that may be appropriate for more significant difficulties.
Reduced timetables. These are especially useful if a child is returning to school after a prolonged period of absence.
Changing form or tutor group. Particularly when this has been identified as an area of anxiety.
Mentor/buddy schemes. Some local authorities have targeted teams who can help with getting your child back into school by providing one-to-one support. Alternatively, having a named mentor within the school setting can reassure your child that there will always be someone available to offer understanding and guidance.
Attendance at a high staff:pupil ratio unit within your child’s school, perhaps one designated for SEN children, if appropriate.
Attendance at alternative provision settings. Those children for whom mainstream education is not working, or who cannot attend for reasons of mental health, may be entitled to an education in an alternative setting. This could be in a unit within a mainstream school, an external provider of educational facilities or at home tuition. Check out your local authority’s ‘Local Offer’ for an outline of the alternative provision options in your area.
Sometimes these last three options can only be accessed once an Education Welfare Officer has been alerted to your child’s school refusal. Although having an official local authority figure involved with your child can be daunting, many of these officers are very experienced and have access to various avenues of support that may help resolve your child’s reluctance to attend school. Be honest and upfront with them about your child’s difficulties and keep lines of communication open.
Professionals who may be involved
Education Welfare Officer. Every local authority has a named EWO, whose role is to ensure that every child in that area receives a suitable full-time education. The School Run has a good summary of the role of an EWO.
School Counsellor. Many schools now employ their own therapists. You can ask to speak with the counsellor before any therapeutic work with your child, to explain the difficulties they are having and the co-ordinated approach you would like to take.
CAMHS. Your child may already be seeing a mental health professional through CAMHS or privately. If not, the school or your GP can make a referral for more specialist mental health support
SENCO. Your child may already have additional needs identified, or school refusal may be the first indication that this form of support is needed. Liaise with the school Special Educational Needs Co-ordinator to explore additional in-school support that may be needed.
For further information
IPSEA is an organisation centring on SEN support and advice for SEND children. They have some good school refusal advice
The British Psychological Society produced a briefing paper entitled Behaviour Change – School attendance, exclusion and persistent absence. In it, they discuss ways policymakers can improve school attendance. Useful for contextualising absence from school.
Mental health charity Mind has a good section on anxiety, from symptoms of anxiety disorders and panic attacks to self-help and how to help friends or family members with anxiety.