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Emotionally Based School Avoidance (EBSA) and ADHD

School avoidance can affect many students for various reasons but with our children with ADHD, it is extremely commonplace. Previously termed School Refusal the correct term is now Emotionally Based School Avoidance (EBSA). I prefer this term as it highlights the fact that the child is experiencing emotional distress about attending school, rather than simply refusing. (EBSA excludes physical illnesses preventing a child from attending school, truancy or parent-condoned absences). I work with a few children who experience EBSA, and watching their struggle can be heartbreaking. Another set of initials that affect our children with ADHD.

Signs of Emotionally Based School Avoidance, EBSA

EBSA can be so gradual in onset that it is hard to notice at first. It can begin at any point in a child’s academic journey, but there do seem to be higher rates between periods of transition between school phases, primary to secondary school, changing schools etc.

Common signs include:

  • Stomach aches, headaches and other physical symptoms that have no apparent medical cause.
  • Asking to stay home for trivial reasons
  • Withdrawing from social activities
  • Increased anxiety, panic attacks and/or depression, lower self-esteem and lack of confidence
  • Becoming extremely agitated, tearful and/or angry when asked about school
  • Younger children may refuse to leave their parents or get out of the car
  • Patterns in absences, for example, particular days and/or subjects, after weekends and holidays
  • Reluctance to attend school trips
  • Expressing a desire to attend classes but is unable to do so
  • Social isolation and avoidance of classmates or peer group
  • Confusion or extreme absent-mindedness shown in school due to lack of concentration resulting in, lower attainments

Causes of EBSA

There is no single cause for EBSA (Emotionally Based School Avoidance) and it is likely that there are various contributing factors that make it difficult for young people to attend school. These factors include bullying, family problems, academic struggles or mental health issues. Or it could be as simple as preferring to be home and playing on their computer. Home is their safe space with fewer demands than the school environment.

Identifying why a child doesn’t want to attend school can be particularly challenging. It could be due to separation anxiety in the younger years or fear of increasing academic demands later. Many children with and without ADHD found it difficult to return after the Covid-19 pandemic. Schools are still seeing the repercussions of the lockdown with its extended periods of home time.

It is important to note that all these reasons are not mutually exclusive and may overlap. Additionally, it is crucial to understand that EBSA is a complex issue that requires a comprehensive approach to address. It is never a simple issue and needs to be taken seriously. It really isn’t just that a child is being awkward or defiant. They really can’t help how they are feeling.

Risk Factors for EBSA

As always, events that lead to EBSA will differ depending on each child’s unique characteristics, circumstances, and experiences. However, certain factors can be associated with vulnerability and potential triggers for EBSA and can be grouped as shown below:


  • Bullying
  • Transitions to a new school, secondary school or into a new Key Stage
  • Academic demands and pressures
  • Journey to school
  • Exams and tests
  • Social pressures between peers and staff
  • Difficulty with a certain subject


  • Separation or divorce
  • Being a young carer
  • Loss or Bereavement
  • Being the youngest child in your family
  • Overprotective parenting style
  • Parents with physical or mental health issues
  • Dysfunctions family or high-stress levels

The child

  • Learning difficulties, ADHD and ADD
  • Separation anxiety from parent
  • Low self-esteem/ low confidence
  • Traumatic events
  • Personality traits including reluctance to interact or withdrawal from others and/or settings
  • Physical Illness
  • Key ages relating to the school transition phases

Frequently, the absence of a child from school is the result of a combination of various factors. Attempting to pinpoint a single cause can lead to the unfair blaming of individuals, causing them to feel anxious and defensive. Us parents in particular, may feel targeted and criticised for our parenting skills. As an ADHD mum this is a common feeling. We must be doing something wrong! There is also the fear of legal repercussions for our child’s non-attendance. Children may also experience feelings of guilt and fear, worrying that they will be forced to attend school against their will, that they are letting people down and that they are ‘useless’ for not being able to attend school or classes.

Push Pull Factors of EBSA

Risk and resilience are sometimes termed as ‘push’ and ‘pull’ factors when dealing with Emotionally Based School Avoidance. These are the factors that push or pull a child away from, or to school or home.

For example, a push towards school would be when a child finds school ‘easy’, can access lessons, learns well and is academically bright. They have no reason not to like school. A pull away from school could be that schools are too noisy, the fear of the unknown and pressure to succeed academically. All factors which are common with our children with ADHD.

Anxiety and Emotionally Based School Avoidance

ADHD and Anxiety

Anxiety is a prevalent feature of EBSA, which can significantly impact a young person’s functioning and school experiences. While some level of anxiety is considered normal, heightened levels of anxiety can lead to school avoidance and fearful thoughts about attending school and coping with academic demands. These feelings can manifest as physical symptoms such as nausea, vomiting, shaking, and sweating, and may begin days before school.

Emotionally Based School Avoidance and ADHD

I’m sure as you read this you are seeing the parallels as to why our children with ADHD may wish to avoid school and the reasons often behind EBSA:

  • Noise
  • Fear of unknown
  • Difficulty accessing curriculum
  • Peers
  • Bullying due to being regarded as different
  • Preferring predictability of home and adults/parents

Our children with ADHD are particularly vulnerable to the risk factors and are already affected by low self-esteem, anxiety and depression. School is often not regarded as fun! As we know children with ADHD need the element of fun to be able to engage so they would definitely rather be elsewhere! Unless a school is supportive and implements the necessary strategies to support a child with ADHD, a school can feel like the last place your child would want to be.

Many children with ADHD suffer from Learning Disabilities such as Dyslexia or Dyscalculia too which places even more demand on their executive function. This can cause them to struggle academically and fall behind if not supported by the school.

Ensuring that bullying is not at the root of school avoidance is vital, for all children. It is unacceptable and can be avoided, again if the school is supportive.

Interventions and Strategies for EBSA

Research suggests that early intervention is six times more likely to produce successful outcomes for CYP (Children and Young People), (Reid, 2002). The longer a child stays off school or out of classes the harder the re-entry will be.

The importance of listening to your child and acknowledging their fears is essential. Even if you are pulling your hair out! Try to remain calm. How they are feeling is so real to them so try to stay patient. Making them feel heard and understood cannot be under-stressed! Do remind them of the importance of school, without applying so much pressure.

I’m not sure if this is the right thing to do, but I would tell mine to put their effort into English and Maths if they were struggling to complete a full day. At least it made them feel like they had achieved something by attending two lessons rather than feeling like a failure because it was only two. EBSA is not just about avoiding school but also about avoiding lessons once in school. Getting your child into school is one thing, but getting them to attend and participate in lessons is another. As the saying goes, ‘You can take a horse to water, but you can’t make it drink’…. Therefore, attending one or two lessons a day and building up is better than nothing at all! Focus on what they did achieve, rather than on what they couldn’t. Each day is a new day.

Another obvious strategy, make home boring! No computers, games, phones etc if they aren’t at school unless, of course, it is for study. If your child is saying they feel sick, bed rest is a must đŸ˜‰ And obviously no after-school activities or friends over. It sounds so harsh but this will be a push factor from home to encourage them to go back to school.

Try to focus on asking positive questions too like, what are the best things about school as well as what are you most worried about? If they can’t tell you ask them to message you or write it down, maybe even draw it depending on their age. Sometimes it can be difficult to articulate how we feel so any method is fine.

As always, consistency is the key so ensuring that home and school work together on their approach is essential. Anticipating where failures may occur and maintaining an optimistic approach are also vital. If your child can’t make it in one day, tomorrow is another day. It doesn’t mean the plan has failed. Be prepared for bumpy times after a school holiday, a period of illness or even the weekend. And unless you have real concerns with your child’s school try not to move them as difficulties will often re-emerge at the new school.

Each council in the UK has great advice on EBSA and there are some fantastic downloads for strategies that can be implemented at home and at school, here is one example from the West Sussex County Council. This will involve working with the your child, your family, and the school to identify and address the underlying factors contributing to their school avoidance.

Finally, as a parent, it can be challenging to see your child unhappy. Make sure that you have someone to talk to as well. This could be a friend, family member, or an organisation. Remember, by working together and staying positive, you can help your child overcome their fears and succeed in school.

I have started a private support group on Facebook for parents and carers who need support with their child with ADHD. It’s a friendly place to chat with others. Please do click this link ADHDinchildren to join. And for anyone on Instagram, I’m there too ADHD Mum.

Vicki x

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