School Refusal in a Post Pandemic World

School refusal in a post pandemic world has become a problem world wide since returning to school after the seismic disruption of the pandemic.  In the UK persistent school absence - missing more than 10% of lessons has are than doubled in the academic year 2022-2023 than before the pandemic according to the Department for Education.

The reason for this are complex and mulifactoral, however there are indications that the majority of school refusal (rather than illness) is due to emotional and mental health issues.  Consequently school refusal is a misleading term as it implies that there is an act of will on behalf of the child, rather than serious mental health problems.  Therefore the term Emotionally Based School Avoidance or EBSA is more appropriate.

There were issues prior to Covid, linked to the change in the school curriculum with increasing focus on academic subjects and exams and a reduction in more creative or humanity based subjects, even those vocational subjects became increasingly academic.  This made children feel alienated and that school was neither meaningful or enjoyable.

Current data shows that mental health disorders affects more than 1 in 5 children and that disproportionately affects vulnerable children.  Those at risk of harm, neglect, who are likely to be dealing with poverty, who are living with disabilities or long term health issues, including mental health challenges.

Many children who struggled at school found that being able to stay at home during lockdown a huge relief.  Bullying, feeling left out and school related anxiety stopped.  This was particularly relevant to children with autism, ADHD and other neuro divergent conditions.  Add to that the general fear around contracting the virus from parents, grandparents and the media, the outside world suddenly became an unsafe place.  Play grounds are locked, cinemas and social spaces are closed and peer interaction is impossible.  We have forgotten so much of this, because we’ve all been so keen to put the pandemic behind us.

But what can you do when you are taught for nearly two years that the world is dangerous and the main source of your anxiety is closed so that you can stay safely at home?

This is where an understanding of retained primitive reflexes may be extremely helpful.  Primitive reflexes are movement patterns that all babies make to help development of their central nervous system.  If the baby is not able to express those movements fully, primitive reflex movements will stay active in their central nervous system, which can have a profound effect on them.

You may think - what has that got to do with EBSA?  Let me explain.  All of those movement patterns have mental, emotional and physical symptoms associated with them.  If those movement patterns or reflexes remain active then they can have a significant effect on behaviour.  The reflexes that are mainly associated with anxiety are grouped together as fear reflexes - they don’t necessarily make you frightened but they will stop you from feeling safe.  So this creates an overwhelming sense that the world is an unsafe place and that they are fundamentally unsafe.  If you couple this innate sense of unease and lack of a sense of safety with being told for two years or more that the world is indeed an unsafe place, we can better understand why children don’t want to leave the house and mix with strangers at school.

The two reflexes which cause the most problems in children with EBSA are The Fear Paralysis Reflex, which, as its name implies, causes the child to feel like they are paralysed.  It’s job, when activated, is to shut down the whole system.  So for children who can’t even leave the house, who have selective mutism, who are just not able to function, this reflex will often be the trigger.  Also because this is a reflex, like blinking, the child has no control over these overwhelming feeling.

Additionally the Fear Paralysis Reflex will also cause breath holding or breathing problems, panic attacks, low self esteem and chronic shame. lack of confidence, problems with sleep, problems with friendships and relationships, OCD type behaviour, sudden drops in blood pressure which can cause dizziness and anxiety and general pessimism.  It can also create perfectionism and children who appear very good and compliant because they don’t want to draw attention to themselves.

The second reflex which can also cause problems is the Moro Reflex, this is the opposite to the Fear Paralysis Reflex, in that it activates the system, triggering the fight/flight response.  So this reflex can be applied more to the children who can become aggressive when challenged or being forced to do something that they don’t want to do, or they will run away at the first opportunity.  This reflex can also cause digestive problems, sugar cravings, sensory processing issues - the world is too loud, too bright, too busy.  The children affected often need a routine and become upset by change.  They are full of fears and anxiety and will have the complete meltdowns when under pressure.

Children can swing between these two reflexes, they can have more aspects of the Fear Paralysis Reflex in school but more aspects of the Moro Reflex when at home, which is why parents can really struggle to get their children into school, because they are in fight/flight at home and then go into shut-down when at school.

The positive side of hypothesising that primitive reflexes play a role in this, is that we can encourage reflexes to integrate through specific movement programs.  Primitive reflexes are innate movement patterns, by accessing these movements, we should be able to calm or integrate those over active reflexes.  A movement program is relatively unchallenging, it doesn’t require much time and isn’t as confrontational as talking therapies can be.  A movement program can be conducted at home or in the classroom, no equipment is required and although isn’t a quick fix, its something that the child has some control over.  A movement program can be tailored to any age group, and to any ability level.  A program can be done as a group, as a whole class or in smaller groups or children can be given an individual program.

Understanding primitive reflexes and their impact would be a useful tool moving forward in helping and supporting our children to be able to fulfil their potential and improve their mental health for the rest of their lives. If you would like to come along to my course An Introduction to Primituve Reflexes then please click here. If you would like more information on training in schools please click here or email me Niki@OrganisedMind.co.uk