“Not Fine In School” – what does that mean, and what can we do about it?

By | 2018-04-13T12:30:51+01:00 December 10th, 2017|Education, Mental Health, Parents, Policies & Procedures, Refusal, Support|

Parents are responsible for ensuring that their children get a full-time education that meets their needs, either through Home Education or by sending them to school. Those who choose the school option are then legally required to ensure they attend regularly, which has recently been interpreted as on-time, every day which many parents do not agree with, as they value their family time and believe as parents they have rights to decide what their children and whole family need, which might include term-time holidays, or other days off for personal and family events.

Currently, the government policy document on attendance explains,

“ Central to raising standards in education and ensuring all pupils can fulfil their potential is an assumption so widely understood that it is insufficiently stated – pupils need to attend school regularly to benefit from their education. Missing out on lessons leaves children vulnerable to falling behind. Children with poor attendance tend to achieve less in both primary and secondary school. The government expects schools and local authorities to:
Promote good attendance and reduce absence, including persistent absence;
Ensure every pupil has access to full-time education to which they are entitled; and,
act early to address patterns of absence.
Parents to perform their legal duty by ensuring their children of compulsory school age who are registered at school attend regularly.
All pupils to be punctual to their lessons”.

Department of Education, 2016.

That sounds reasonable, doesn’t it? It seems fair that parents who have chosen to send their children to school for their education must ensure their children regularly attend, which is the case for the majority of children on roll at schools across Britain. There is some disagreement over the definition of regularly, but most pupils attend school and follow their school curriculums. These children seem to be fine in school. However, an increasing number of children are “Not fine in School”. Some struggle to attend regularly; some struggle to attend at all. These children and young people are often referred to as school refusers or school phobic. They want to attend school, but for a variety of reasons they just can’t. It doesn’t help that many schools regularly describe these children as “fine in school”, as some may hide their difficulties, hold them until they get home, or simply refuse to go unless they feel well enough to cope. It is difficult to count exactly how many as many children and their families are affected by this, as many feel they have no choice but to remove their children from the school rolls, either for their child’s welfare or to overcome legal issues surrounding attendance and are now choosing to home educate them instead. There are 4000+ members of a Facebook group for supporting school refusal families, and home ed groups are bursting at the seams with parents who have fought for their children to get the support they need, and realised it just wasn’t going to work out.

So, with the government seeing the importance of educating children, and parents and children wanting to attend school what help is there for these children? Surprisingly there is not much. Help ranges from denial of problems to mental health referrals, LEA medical needs tuition, to a whole variety of interventions, the most serious of which can result in attendance prosecution or child protection plans. In short, there is no national approach to supporting these children and their families, and so the support and the successful return to education varies from school to school, and across counties, and countries.

One thing is certain though; there is a growing number of children who are not able to access education and therefore at risk of not achieving their potential. Added to that many children are very distressed, to the point of being very unwell, with the rest of their families also being affected in one way or another.

What causes children to be “not fine in school”?

There are many reasons for not being able to attend school. These children are not refusing school as a result of poor parenting, or bad behaviour. It is not that they don’t want to attend, instead of for a variety of reasons they can’t attend. A common theme does seem to be emerging through parents who use social media groups to discuss their experiences and support one another, that the majority of these children have underlying health or emotional conditions and special educational needs which are not being acknowledged or adequately supported by schools. For example, It is estimated that at least half of all high functioning autistic children and adolescents worldwide experience school refusal. Unfortunately, the children who are not fine in school, and their parents receive conflicting advice, which can often do more harm than good, and add to their difficulties at the time when they are in need of support.

As “Not fine in school” we are dedicated to working to ensure that all children are supported by the variety of difficulties they face, to allow them to access a suitable education. School refusal is linked to the following factors, either on their own or in combination:

  • Health conditions – physical and mental health symptoms.
  • Social phobia, separation anxiety, or fear of leaving security to family and home.
  • Long NHS waiting times for mental and physical health appointments for diagnoses and treatment
  • Unmet SEN, such as Dyslexia, Staff not aware of diagnoses, inadequate support
  • Autistic Spectrum difficulties and ADHD, not being supported
  • Sensory processing difficulties or sensory overload.
  • Difficulty with transitions, new school, primary to secondary
  • Trauma, illness or death of family member, parents relationship break down
  • Difficult Family relationships or living conditions
  • Bullying by other pupils or even teachers
  • Bad experiences at previous schools.
  • The organisation of the school – noise levels, light, size of the school, interaction with older pupils.
  • Insufficient pastoral care support.
  • Not feeling safe at school.
  • Stress and resulting reduced immunity to childhood illnesses

School refusal is a complex issue, with links to health, educational, social and family factors. Unfortunately, there are diminishing health and educational resources available. Add to that a climate where schools are measured by performance targets as they struggle to deliver a narrowing exam-based curriculum. Most of these children don’t immediately fit the criteria for ECHPs, and many schools are at a loss to provide the support they need.

So what is offered to support these children, and their families who are often unprepared for the disruption to family life, work and other family commitments, and the sheer exhaustion of supporting children unable to attend school? Remember these are not children who are choosing their responses. These are desperate children who are often in a very distressed state, and many demonstrate their distress in ways that would have to be experienced to be believed,

Obviously, the majority of these children and families need help. Most ask for help, but unfortunately, help is a long time coming, if it ever comes, and by then our children have been out of school so long that their education has been severely disrupted and their health and well being has deteriorated even further. And quite when you finally get to meet the professionals they are sometimes as puzzled as we are about how to offer support and treatment, and eventually discharge them.

Some are offered short-term support at school with reduced timetables, others are referred to Cahms and for counselling, but unfortunately many have up to 24 months waiting time for any form of intervention of treatment, and that is if they meet the criteria for support. There is currently no national standard to acknowledge and support our children. Some are recognised as being too ill to attend school and have access to core subjects at home through the LEA medical needs team, and the very lucky few are offered places at therapeutic schools. For many the help comes too late, but thankfully with support, time for healing and not giving up, some manage to pick up a more suitable education later, and overcome their difficulties.

What if we focused on what our children need rather than the sticking plaster approach of patching them up then sending them back to the front line? What if schools could forget their attendance targets and were supported to provide for, and even measured, by children’s wellbeing. Many schools are not healthy places for anyone. Attendance rewards add to this culture of going to school ill, of not being allowed to take time to recover and be well.

Schools need preventative measures in place, and early intervention, peer support for families and help from the professionals we turn to rather than criticism and unreasonable targets -and not threats of prosecution, and child protection orders. Would the majority of these parents be reaching out for help and willing to try anything, if they didn’t love and care for their children and want the best for them? Kindness and common sense have gone from most organisations. Yes, resources have dwindled, but surely if we all work together – health, education and parents and their children, we can use the resources we have and help all children to not only be fine in school, but to thrive in school, and be prepared for happier, healthier adulthood.

Some refusal/not fine in school responses:

  • Feeling ill
  • Panic attacks
  • Selective mutism, silence.
  • Extreme distress with extreme crying, or wailing.
  • Uncontrollable shouting, swearing
  • Extreme Violence and destroying property
  • Behaviour problems at school
  • Self-harming
  • Suicide attempts
  • Disturbed sleep patterns
  • Chronic fatigue, burnt out
  • Making themselves sick, or involuntary sickness.
  • Fainting
  • Holding it all in at school, meltdowns at home
  • Depression
  • Jumping out of moving vehicles on the way to school
  • Hiding or running away
  • Climbing onto roofs at home or school
  • Refusal to leave room, or house
  • Drug or alcohol abuse
  • Refusal or inability to engage with professionals

Bearing in mind all of the above, here is a list of some professional advice given to school refusal families:

  • S/he is fine in school. Just get her/him in.
  • Have you tried a sticker/reward chart?
  • Tell them to pull themselves together or get on with it
  • Tell them to go to school
  • “If it were my child I wouldn’t give them a choice.”
  • “S/he’ll outgrow it. It’s a phase
  • Restrain them and force them into school
  • This is bad behaviour
  • There is nothing wrong with your child.
  • Don’t take him to specialists that can cause childhood trauma.
  • Take them in their pyjamas if they refuse to get dressed
  • Take away everything they enjoy
  • Remove their computer and devices
  • It’s your parenting; you need to set firmer boundaries.
  • It’s teenage behaviour. Don’t let them be in charge.
  • Punish them
  • Be firmer.
  • My Children don’t like getting up in the mornings either.
  • If you don’t sort this out now, s/he will still be living with you when s/he is 40!
  • Earn points for a big reward
  • Make things at home as miserable as you can so they want to go to school
  • Trust school that they are fine when they get there
  • Shall I come and collect him and show you how to get him in?
  • They have learned this from you. You are projecting your worries.
  • Wait for Cahms
  • Why Haven’t you medicated him/her?
  • Everyone else attends school all day every day, so s/he should be able to
  • They need to face their phobias and fears, not run away from them.
  • Don’t believe them; they are just pushing your buttons to get what they want.
  • They won’t be able to pick and choose their hours and tasks when they have a job
  • All subjects are important, so they cant drop any
  • Call the police
  • Threaten them with social workers taking them away!
  • Tell them their parents will be fined, prosecuted or even go to prison
  • We cant authorise this absence as illness.
  • Lectures on the effects of missing education on results.
  • They can do a part time timetable for a limited time.
  • They can go to hospital school, or have home tuition
  • How about moving schools or home educating?

Most of those suggestions are ridiculous when considering the gravity of their problems. Who would tell the person who was ill and desperate that a sticker chart or pulling themselves together would heal them, or that their parents would go to prison if they didn’t get well? . It’s unlikely that anything on the list would help with such a complex problem. Many parents have tried to follow much of the advice. Sadly most of these opinions and suggestions have made their problems worse. Who would want to risk causing further harm? Ultimately who would risk adding to their children’s problems? And ultimately who would risk being that parent who finds their child really couldn’t cope and decided that suicide was the only way to make it all stop?

But what has worked, or is working in school refusal families?

Some parents report having a good relationship with the school, and their child’s schools are understanding the need to be flexible and supportive. Some have strategies and safe places and people trained and willing to overcome the barriers that many children face at school. Try to maintain good relationships with school, ask for help, and assure them that you want to work with them to support your child. Keep a record of all meetings, conversations, maybe even a diary to show what you have tried to do, and what did and didn’t work. Its very common for schools to refuse to acknowledge their part in a child’s decline into school refusal, to do so would be to admit failings. It is so much easier to blame the parents, of course, more often the mother, the people asking for help, the people living day to day with the distress and disruption to their lives. Schools have less and fewer resources to support the neediest children, but instead of blaming each other, the greatest success comes with everyone working together.

With the right support, many of our children will manage to attend school again. Once the major triggers and causal factors of the refusal are addressed, and the necessary support plan is in place the following have been found to help:

  • A key person they trust such as an experienced pastoral manager to coordinate their return and gradual reintroduction plan agreed by parents, child,
  • school and other professionals involved and inform all members of staff, not just those who teach them.
  • Someone they can go to if they need support, and someone else if that person is unavailable.
  • Somewhere safe and comfortable to go when school feels too difficult
  • A card to show to staff to leave a class with the least fuss.
  • Adjustments of the timings of the day, depending on the needs of the child, eg. Arriving and leaving before the rush, a place to eat lunch, and break times
  • with some friends if possible.
  • Acceptance of some lateness, due to morning struggles, but being allowed to begin the day on a positive note.
  • A reduced timetable with very gradual increases of timetable, perhaps with reduced subjects or a flexible timetable, and allowing reductions again when necessary.
  • An alternative curriculum,
  • Support to catch up with subjects missed through absences.
  • Patience, kindness empathy and mutual trust.
  • They need to know they can trust the school to keep them safe, as many school refusers are vulnerable to bullying.
  • The willingness of school to allow them to go home if they need to, Encourage them but not force them to remain.
  • Recognition of their strengths and building on them.
  • Encouraging them to participate in the parts of school they enjoy.

Schools that are willing to offer these are less likely to have school refusal in the first place. The culture of a school can make a huge difference, but sometimes because of the nature of these struggles, and despite schools best efforts, they can only operate within the existing system, with existing budgets, with existing skills. Further training and awareness, and changes to the system, or more access to alternative more suitable educational provision must be a priority if children are to manage to be fine in school.

Sadly not enough children get the support they need when they need it, and specialist help, therapy or provision is not be available in every location. The longer it takes to receive help and treatment the harder it will be to return. Some children can access alternative provision at school or therapeutic schools. Some will be reintegrated into mainstream school. However, it is estimated that 1/3 to 1/2 of all school refusers will not be able to return to mainstream school.

It’s important to remember that these school years are only a fragment of children’s whole life. It is not worth seriously damaging their mental health for. There are other opportunities for learning, different times and in different ways that might work out better. Stay enrolled if you can, as that should help you to access support but be prepared to consider other options if your child needs them, but consider other options too. Part-time timetables can work, with only very slow, child-led increases. There are supportive online learning opportunities. These can be expensive, but there could be financial help available to those unable to attend school. Many have decided to educate home, and it has worked well. Others find that the problems don’t instantly resolve by doing that, but with the removal of the pressure to conform to full-time school education, children do access other education, later on, many going on to further and higher education. Ironically there seems to be more relevant support for our children to access education in these settings. Many can follow a chosen career, a career that fits their needs and that they can have success with. Interestingly most successful entrepreneurs didn’t follow a typical educational route to success, and many of our children have dreams of careers not requiring so many formal qualifications in so many subjects. Sometimes we have to do whatever it takes to get them through these years so that they can come out on the other side ready for whatever the rest of their lives hold for them.

What can parents do?

School refusal parents supporting one another report the importance of understanding our children and helping them, and unanimously agree that physically forcing or blackmailing children into school is a completely inappropriate approach. Of those who have tried it, most regret it, and have not found it helpful, but that it caused more harm.

Instead of forcing them into school, parents emphasise the need to build trust between yourself and your child. Our children need to feel safe, to feel secure.They need to know someone is on their side. This builds resilience and healing.
Trust your instincts and those of your child. What is it that feels wrong? Has it been a gradual build-up of some issues, or something specific?

Explore the possibility that there are undiagnosed conditions. Autism, high functioning autism, Aspergers, ADHD, Dyslexia. Criteria for diagnoses are often updated, and maybe a spectrum but still affect life, and especially school life. There are medical conditions that may have previously been missed.
If they are already diagnosed are they getting the support they need, are all staff aware of their needs. Do they need an ECHP? Will school apply, or do you need to request an ECHP assessment? Can you wait for school to assess? Could you arrange some private assessments, support from specialist charities? Waiting for NHS appointments especially CAHMs can take years and then not necessarily offer the relevant treatment and support. The absence of diagnoses, however, doesn’t mean that our children are well enough to attend school.

Don’t take away things that comfort and lift children. Limiting computer time works for some, but for many, this is their safe place, where they can succeed and communicate with others. Categorically argue for children to continue with the parts of school they enjoy and feel they can succeed with, even if that is lunch time, PE, or other extracurricular activities. Taking these away from our children is taking away a lifeline.

Actively encourage them to develop interests that will give them feelings of hope and happiness. Any moments spent out in the fresh air, moments of enjoyment, any opportunity to forget about their difficulties are part of healing.

Remember that you know your child better than any professional and your agenda for their recovery is not a target, policy, or budget led. Trust yourself and don’t allow professionals to ignore you. You are often your child’s voice. Write what they say, record what they say and share with their permission share it. Children need to learn skills to overcome their difficulties, but until there is adequate support in place, they often can’t cope with school.
It isn’t their fault; it isn’t your fault. Sometimes when you have tried and tried, you need a break, and you have to keep as well as you can and keep life going. Never underestimate the effects on the rest of the family, and try to find ways to support everyone. Sometimes we have to do some surviving in the short term while waiting for the long-term improvement. Often parents and other family members become very distressed, and also report a decline in their mental health, so it’s important to seek help for yourself too, as you need to be as well as you can be not to get sucked into a cycle of stressed responses that perpetuate the difficulties.

Research the relevant law, read the government policies on SEN, attendance, children too ill to attend school and to support pupils with medical conditions and take copies to meetings to remind schools of their statutory duties, to remind them that they are allowed, even expected to make reasonable adjustments. Keep records of all appointments, meetings, medical and professional advice, of each request for help to build a chronology of the difficulties and the attempts to resolve them, to demonstrate what works and what doesn’t work. Take notes in meetings and email school with agreed points if they do not provide you with minutes. Ask for someone to attend with you for support. Ask for support and advice from Sendiaas, and if necessary legal advice from Ipsea or SOSSEN.
Don’t be afraid of threats, and maybe even preempt consequences by contacting LEA attendance departments etc. and ask for help.
Join support groups, reach out to others.

It’s important to share helpful information you have found with professionals involved in our children’s care, such Beths guides, bloggers who share experiences, anecdotal evidence and advice. Ultimately we need to bring this to the attention of decision-makers – the politicians, the heads of departments, those with responsibility for education and children’s services, nationally and locally, and join with others who also share these difficulties so that we can campaign for, and actively promote the kind of changes that our children need.

Meanwhile, recovery is a process – often with two steps forward, three steps back. Sometimes they will be relapses, or blips, maybe as a response to something, perhaps illness, specific stress. Some strategies that have been known to help might not continue to work. Whatever the stage, whatever the outcome, we have to do all we can to survive, to not let this define our children and hurt them more than they already hurt. Perhaps all we can do at times is hang on in there, with patience and a hope that things will be better, that somewhere there is a workable solution, one that can offer the support and skills to enable our children to engage in a suitable education. In the meantime be grateful to have a child who was strong enough to express that something was wrong, and who felt strong enough and safe enough to say no to whatever it is they just couldn’t cope with, and be proud of every success, no matter how small. Quite often the seemingly small achievements are in fact huge successes and pave the way for others and better times ahead.