School Refusal and EBSA: How Tuition Can Fit When a Child Is Out of School

School refusal tutoring in England means one-to-one teaching that runs alongside the child's school, the local authority and any health professionals, whilst the school and those professionals lead any return. The SEND Code of Practice names anxiety and depression among the difficulties within social, emotional and mental health needs, and statutory guidance on GOV.UK sets out how local authorities arrange education for children who cannot attend because of health needs. A tutor keeps learning going in agreed steps, and treatment and attendance decisions stay with others.

What do school refusal and EBSA mean?

School refusal and emotionally based school avoidance (EBSA) are terms that families, schools and local authorities use for a child's difficulty attending school, and sources differ on what each covers. Neither the SEND Code of Practice nor the GOV.UK guidance on health needs defines EBSA, so the label on a letter from school may differ from the one a local authority or health service uses. Asking what a professional means by the term, in your child's case, keeps the conversation precise.

The Code groups needs into broad areas: communication and interaction, cognition and learning, social, emotional and mental health, and sensory and/or physical. Anxiety and depression appear under social, emotional and mental health, and the Code adds that children often have needs that cut across areas and that these change over time. The purpose of identification is to work out what action the school needs to take.

What does the SEND Code of Practice say about anxiety?

The Code says children with social, emotional and mental health difficulties may become withdrawn or isolated, and that behaviour may reflect underlying mental health difficulties such as anxiety or depression. Schools should have clear processes to support these children, and the Department for Education publishes guidance on managing pupils' mental health and behaviour, which a parent can ask the school to point to. Support should rest on a full understanding of the child's strengths and needs and use well-evidenced interventions targeted at areas of difficulty.

SEN support in school follows a cycle of assess, plan, do and review, and the class or subject teacher remains responsible for the pupil even where interventions involve group or one-to-one teaching away from the class. Parents should be fully aware of the planned support, schools talk to parents regularly and should include the pupil's views, and a school may involve specialists at any point. Plans should, where appropriate, seek parental involvement to reinforce progress at home.

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What must a local authority do for a child who cannot attend school because of health needs?

A local authority arranges education for a child of compulsory school age who cannot attend school because of health needs, following the GOV.UK statutory guidance on arranging education for these children. The guidance is written mainly for local authorities and is relevant to schools, alternative providers, health service providers and parents, so it is the document to name when writing to the local authority.

The SEND Code of Practice adds that education for children out of school must be full time unless the local authority determines that, for reasons relating to the physical or mental health of the child, a reduced level of education is in the child's best interests. Alternative provision arranged for health reasons should be on a par with mainstream schools. A parent offered a reduced level can ask the local authority to explain its reasons.

What does the school attendance guidance say about support?

The GOV.UK guidance Working together to improve school attendance covers how schools support families and pupils who are persistently or severely absent or at risk of becoming so. It places support first, with legal interventions used when support does not work, is not engaged with or is not appropriate. A family that stays in contact with the school about what support is offered, and why, is working within the process the guidance describes.

How can one-to-one tuition sit alongside school, the local authority and health professionals?

One-to-one tuition is paced and structured around how the child learns, and it runs alongside the support the school already provides and any specialist or health input. It gives a child more time with one adult on the skills school support has identified, taught in shorter steps with more practice and review on whatever a child's needs make harder in a busy classroom.

In practice, school refusal tutoring tends to mean sessions at regular agreed times, which keep learning going and give the week a predictable routine. Steps stay gradual and are agreed with the family and, where relevant, the school and professionals, so session length and subjects can be adjusted as those agreements change. Sessions can run online from home, which removes travel from the arrangement.

Coordination with the school tends to be simple: the family shares what the school has set or recommended, and the tutor teaches towards the skills named in it, so the two strands support each other.

What can a tutor not do for a child who is out of school?

A tutor cannot treat anxiety or decide an attendance plan, because support for anxiety sits with the health professionals involved and attendance plans sit with the school, the local authority and the professionals around the family. A tutor's part is regular, well-paced teaching. If a child voices a worry during a session, the sensible route is for the parent to raise it with the school or a health professional.

Who leads a return to school?

The school and the professionals involved lead any reintegration, and the GOV.UK health-needs guidance lists reintegration into school among the topics it covers. A tutor can keep teaching at the pace already agreed, and a family can tell the tutor which steps the school and professionals have set, so that session times and content sit comfortably beside them. Decisions about timing and pace of a return stay with those leading it.

What should parents ask the school and the local authority?

Questions put in writing give the school and the local authority something specific to answer, and the replies can be shared with a tutor so that teaching follows the same plan. The following are drawn from the Code and the GOV.UK guidance:

• School: what does the current SEN support plan say, and what is planned under assess, plan, do and review?
• School: which specialists have been involved, and who is the named contact for work set at home?
• Local authority: does the guidance on children who cannot attend because of health needs apply to my child?
• Local authority: what medical evidence is needed, and is the education offered full time or reduced, and why?
• For the local authority: how does alternative provision compare with mainstream schools, and how can a concern be raised?

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