When participation breaks down: Parent and child accounts of the development of emotionally based school avoidance in autistic pupils

Emotionally based school avoidance (EBSA) refers to persistent difficulties attending school associated with significant emotional distress. Autistic pupils appear to experience EBSA at elevated rates, yet little research has examined how these difficulties develop over time. This study explored the developmental trajectory of EBSA through qualitative analysis of specialist educational consultation transcripts relating to 30 autistic pupils aged 10–14 attending mainstream schools in the United Kingdom, all of whom had sustained attendance difficulties. Thematic analysis identified a recurring developmental pattern. Early stages were characterised by masked distress and sustained efforts to cope with demanding school environments. Over time, cumulative pressures including sensory overload, social challenges and anxiety contributed to escalating distress. Attendance difficulties were often initially interpreted behaviourally, delaying supportive responses. Findings highlight the importance of recognising masked distress and addressing environmental stressors early to prevent escalating school participation difficulties.