Can’t Not Won’t: Supporting Children Who Can’t Attend School
Understanding the “can’t” vs. “won’t” Distinction
The fundamental insight from this work is the critical distinction between children who won’t go to school (behavioral choice) versus those who can’t go to school (neurological/physiological limit). This difference is not semantic—it’s rooted in brain science and has profound implications for how we respond to school refusal.
When a child’s brain perceives school as a threat, their nervous system engages survival responses. The amygdala signals danger, the prefrontal cortex (responsible for reasoning and learning) disengages, and the body moves into fight-flight-freeze responses. As neuroscientist Bessel van der Kolk explains, “Despite the well documented effects of anger, fear and anxiety on the ability to reason many programs continue to ignore the need to engage the safety system of the brain before training to promote new ways of thinking.”
This means that when school anxiety or sensory overload triggers a child’s threat-detection system, no amount of behavior charts, rewards, or consequences can override their neurological state. Learning simply cannot happen when the brain’s safety system is activated.
Early Warning Signs and Systemic Misinterpretation
Patterns Frequently Dismissed as “Normal”
From infancy, children who later struggle with school attendance often display clear patterns that professionals systematically misinterpret:
- Distress during separations from familiar adults
- Preference for staying with known people rather than exploring independently
- Difficulty with transitions (walking home from nursery, moving between activities)
- Anxiety around changes in routine or environment
- Extended recovery time after stressful events (immediate need for sleep, withdrawal)
These behaviors are often attributed to shyness, typical childhood behavior, or parenting issues rather than recognized as potential neurodevelopmental signals. The pervasive professional response becomes “she’s fine once you’ve gone” and parents are advised not to “make a fuss.”
The Long-Term Impact of Missed Signals
When genuine distress is normalized and parental concern is dismissed, children learn that their internal signals—their accurate perception that something is wrong—should be ignored or hidden. This creates dangerous patterns:
- Self-doubt: Children learn not to trust their own bodily signals
- Masking: Children learn to hide distress to appear compliant
- Compounding trauma: Each forced exposure adds layers of trauma
- Delayed intervention: Early opportunities for accommodation are lost
The patterns visible from infancy often continue throughout childhood: anxiety with unfamiliar people, difficulty with transitions, need for time alone to recover. What might have prompted early intervention and accommodation instead accumulates into years of compounded distress and eventually school refusal.
The Autism Diagnosis: Label Without Transformation
The Administrative Event of Diagnosis
After years of school difficulties, many children receive an autism diagnosis that should catalyze support but instead becomes merely an administrative event. The diagnosis itself changes nothing about how schools approach the child’s needs. Instead, families are funneled into systems designed around compliance and behavior management rather than understanding neurodivergent differences.
EHCPs (Education Health and Care Plans) often arrive in incomprehensible language. Parent workshops focus on “behavior management” techniques rather than understanding autism itself. Professional support feels fragmented—different specialists appearing once then disappearing, no consistent relationships, no one person understanding the child’s full picture.
The Tools vs. Relationship Problem
Support tools like laminated “color cards” for emotions (“Just Right,” “blue,” “red”) often feel alienating and disconnected from how actual children communicate. Parent training might feature relaxation exercises about “letting go” when families need concrete, practical guidance on supporting their child.
As Sue Moon, a speech and language therapist, emphasizes, autistic children need unconditional positive regard and genuine relationship—not just autism awareness, training certificates, or laminated strategies. The most impactful support comes from personal relationships and consistency rather than procedural tools.
School as a Source of Escalating Distress
Patterns That Compound Anxiety
Shame and Humiliation: Children often experience public humiliation that creates lasting avoidance. Swimming lessons might end when a teacher places a child with younger students for not swimming proficiently—a public shame that compounds anxiety around that activity.
Unpredictability and Chaos: Unannounced timetable changes trigger severe morning distress. Lack of coordination means children arrive at school with no designated adult to meet them. Sports Day, assemblies, and other unstructured events cause days of meltdowns—cascading anxiety that reveals how unstable the school environment feels.
The Hidden Cost of Masking
The masking trap is perhaps the most dangerous pattern. Children learn to appear “fine” despite internal panic—managing to attend school while their nervous system screams danger. This creates a false sense that they’re coping when actually they’re expending enormous energy on performance and compliance.
At home, the cost becomes visible:
- Shutdowns and inability to engage
- Sleep problems and insomnia
- Changes in eating patterns
- Signs of severe anxiety
- Emotional dysregulation
The school sees a child who “manages”; the family experiences crisis. This disconnect means the child’s distress is systematically underestimated until it reaches crisis proportions.
Fragmented Systems and Accountability Gaps
The Silo Problem
Support systems are often artificially divided in ways that leave families unsupported and blamed:
- The “ASC teacher” advises on school matters but can’t help with home issues
- The “food prep coordinator” can’t address drink requests
- Services require prior coordination to handle basic support
- When something falls between categories—like a child unable to attend school but also not in acute mental health crisis—no one takes responsibility
This fragmentation means no one understands the child’s full experience or can implement consistent, holistic strategies. Parents coordinate frantically between disconnected systems, attending endless meetings in sterile offices with professionals more interested in discussing their own roles than the child’s actual needs.
The Accountability Vacuum
When the child couldn’t attend secondary school, weeks passed with no one making decisions or checking on the family. As the parent describes: “I have no idea who is meant to help with this… No one has even checked on us. I don’t know who is meant to take responsibility and make sure we get an education?”
This accountability vacuum forces parents to either continue forcing their children into harmful situations or take unilateral action to protect them.
Parental Mental Health and Systemic Pressure
The Hidden Burden on Parents
The parent’s mental health often deteriorates significantly during years of navigating these systems. Many experience:
- Anxiety and panic symptoms
- Physical symptoms like vertigo attacks triggered by worry
- Descriptions of “putting on a brave face at the school gates” while feeling unwell
- Worry about being labeled “a bad parent” because attendance falls below 90%
- Profound guilt and shame questioning their parenting
- Spiraling worry about the future
Parents feel vulnerable, exposed, mistrustful of systems, and exhausted by the unpaid emotional labor of navigating bureaucracy.
The Impossible Double Bind
Parents are caught in conflicting directives:
- Some professionals suggest more firmness and structure
- The child’s distress intensifies with every demand
- Schools pressure for attendance while providing inadequate support
- Mental health professionals may recognize the harm but have limited power to change educational systems
As Tom Vodden, educator and SEN parent, points out: “All it needs to say is just being in school is enough.” When children exhaust themselves achieving attendance, learning becomes impossible. Attendance markers should not outweigh engagement in learning.
The Neurobiology of School-Based Anxiety
Understanding the Threat-Detection System
When a child’s brain perceives school as dangerous, several neurological processes occur:
- Amygdala activation: The brain’s threat-detection center signals danger
- Prefrontal cortex disengagement: Areas responsible for reasoning, impulse control, and learning go offline
- Stress hormone release: Cortisol and adrenaline flood the system
- Survival mode: The child moves into fight, flight, or freeze responses
This is not something willpower, motivation, or behavior charts can override. The child is not choosing to avoid school—their nervous system is preventing attendance for safety reasons.
The Accumulating Trauma
Each forced exposure to a perceived threat adds to the child’s trauma load. The nervous system becomes increasingly sensitized, requiring less provocation to trigger threat responses. What might have started as mild anxiety escalates into full panic attacks, school phobia, or complete school refusal.
Understanding this neurobiology reframes the entire response: from punitive/compliance-focused (“make her go”) to therapeutic/accommodation-focused (“what needs to change so she can attend safely?”).
Relationship-based Support Strategies
Building Genuine Connections
Rather than focusing on behavior management tools or strategies, prioritize consistent, caring relationships. Assign a key person to work with the child—someone who stays consistent, listens without judgment, learns the child’s communication style, and demonstrates genuine care.
How to apply:
- Identify one adult who can be the consistent presence
- Meet regularly with the child in low-pressure contexts
- Learn their communication style (verbal, behavioral, written, nonverbal)
- Show up consistently, even in small ways
- Avoid changing this relationship when institutions change
Creating Unconditional Escape Routes
Establish truly accessible calm spaces available on demand—not as punishment removal but as genuine access to dysregulation recovery. This prevents escalation and teaches the child that when their nervous system signals overwhelm, they have agency to respond.
How to apply:
- Identify a genuinely calm space (sensory-reduced, quiet, available without conditions)
- Make it immediately accessible without bureaucratic permission
- Ensure the child knows it’s theirs to use without judgment
- Stock it with things that help the individual child (noise-cancelling headphones, fidgets, soft items, or just emptiness—ask the child)
- Protect it from being used as punishment or isolation
Environmental Accommodations and Adaptations
Predictability as Foundation
Predictability reduces cognitive load spent on anxiety about “what’s happening?” and frees capacity for actual learning. Make transitions and schedule changes explicit in advance. Use clear, direct explicit communication.
How to apply:
- Communicate schedule changes at least a day in advance
- Use written/visual information when possible (doesn’t require interpretation)
- Give direct instructions rather than implied requests
- Explain the “why” behind transitions and changes
- Ask the child how they need information communicated
Eliminating Shame-Based Spotlight Moments
Avoid putting autistic children on display—reading aloud in class, being called on unexpectedly, receiving public awards, performing in assemblies—without genuine consent and preparation. These situations compound anxiety and trigger masking responses.
How to apply:
- Ask if the child wants to participate before putting them in spotlight
- Offer alternatives (written answers, private discussion, etc.)
- Prepare thoroughly if they do participate
- Never force participation as “building resilience”
Recognizing and Addressing Masking
Identifying Masking Patterns
Learn to identify quiet compliance and good behavior as potential masking rather than evidence of coping. When a child appears compliant at school but dysregulates at home (can’t sleep, won’t eat, shutdown), recognize this as a crisis signal.
Key patterns:
- “Fine” at school, dysregulation at home = likely masking
- Perfect compliance that seems effortful rather than natural
- Physical symptoms (headaches, stomachaches) that disappear away from school
- Exhaustion after school that seems disproportionate to the day’s demands
How to respond:
- Ask directly: “Are you okay, or are you masking?”
- Communicate with families about home behavior patterns
- Respond to masking by reducing demands, not by increasing pressure
- Understand that the child maintaining compliance is already expending maximum effort
Systemic Change and Policy Implications
The False Binary of Current Systems
As Tom Vodden critiques, schools face pressure to hit 95% attendance targets and good Ofsted ratings, but families face a different pressure—how do you educate your child if school attendance is traumatizing? The system pits school institutional interests against child wellbeing.
Flexibility Already Exists—it’s Just Rationed
During the COVID-19 pandemic, schools rapidly implemented virtual learning, accommodations, and flexible schedules—proving these are possible at scale. Yet these solutions are typically reserved for systemic emergencies rather than persistent needs of neurodivergent children.
Policy should embrace flexibility as standard rather than exceptional. This includes:
- Flexible schedules and part-time options
- Virtual learning alternatives
- Individualized pacing and approaches
- Alternative assessment methods
Reframing Prevention Questions
Rather than “How do we get them in?” ask “What needs to change to prevent this in the first place?” This requires examining:
- Rigid classroom structures
- Standards agendas and their impact
- Assumptions about what learning environments must look like
- The cost of forcing children into misaligned environments
Alternative Educational Approaches
When to Consider Alternatives
Sometimes protecting a child means recognizing that mainstream education is fundamentally misaligned with their needs. Consider alternatives when:
- The child’s mental health is deteriorating despite accommodations
- The family’s wellbeing is suffering from system pressure
- The child is consistently in crisis rather than learning
- All attempts at accommodation have been insufficient
Home Education as Response to System Failure
This book does not present home education as ideal—it’s presented as necessary when systems fail. Families considering this path should recognize:
- They’re taking on both curriculum responsibility and therapeutic support needs
- There’s typically no institutional or financial support available
- This represents not failure but reclamation of agency and protection
The Impact of Professional Fragmentation
Coordinated Support Needs
Children struggling with school attendance need coordinated support that addresses:
- Educational needs and accommodations
- Mental health and therapeutic support
- Family wellbeing and parent support
- Social connection and peer relationships
When these are siloed across different professionals and systems, no one has the full picture or authority to implement comprehensive support.
Professional Accountability
Systems need clear accountability structures where someone takes responsibility for ensuring:
- The child’s education continues appropriately
- The family receives coordinated support
- Decisions are made in timely ways
- Support adapts based on what’s working rather than rigid protocols
Communication and Collaboration Strategies
Genuine Listening vs. Compliance-Seeking
Schools should practice genuine listening—using all forms of communication (words, emotions, behavioral signals, choices), staying curious and willing to be wrong. This differs fundamentally from listening to extract compliance or diagnostic confirmation.
Genuine listening includes:
- Accepting non-verbal communication as valid
- Recognizing behavior as communication
- Staying curious about meaning rather than assuming intent
- Being willing to change approaches based on what’s learned
Family-Professional Partnerships
Effective support requires genuine partnership between families and professionals, characterized by:
- Mutual respect and trust
- Shared decision-making
- Open communication about what’s working and what isn’t
- Recognition of families as experts on their children
Cultural and Systemic Barriers
Language That Obscures Reality
Terms like “playing truant,” “school refusal,” and “elective home education” (implying choice when families have no options) oversimplify complex issues. Non-attendance driven by anxiety or demand avoidance is self-preservation, not defiance.
The Standards Agenda vs. Individual Needs
Contemporary education policy often prioritizes standardized testing, attendance metrics, and institutional benchmarks over individual child wellbeing. This creates systemic pressure to force attendance even when it’s harmful to the child.
Supporting Parents and Families
Recognizing Parental Expertise
Parents are the true experts on their children. Systems that dismiss parental concern or blame parents for children’s struggles miss crucial information and damage the collaborative relationships needed for effective support.
Supporting Parental Mental Health
Parental and child wellbeing are inseparable. Systems that drain parental capacity harm children. Support should include:
- Mental health support for parents
- Practical support navigating systems
- Community connection with other families
- Respite and recovery resources
Addressing Systemic Pressures
Recognize that parental distress in these contexts is often a rational response to systemic failure, not individual problems to be solved through better coping skills.
Moving Toward Neurodiversity-Affirming Systems
Core Principles
Neurodiversity-affirming practice requires:
- Viewing differences as variations rather than deficits
- Focusing on accommodation and relationship rather than behavior management and compliance
- Recognizing that environment changes are often more effective than trying to change the child
- Valuing autistic culture and community
Implementation in Practice
This means:
- Changing environments rather than forcing children to fit
- Providing accommodations without bureaucratic barriers
- Prioritizing relationship over procedure
- Measuring engagement and wellbeing rather than just attendance
Key Questions for Systems and Professionals
For Schools and Educational Systems
- What patterns in our environment might be creating barriers for neurodivergent children?
- How can we make our spaces more predictable and sensory-friendly?
- What escape routes and calm spaces are genuinely available without permission?
- How do we distinguish between coping and masking?
- What flexibility can we offer as standard rather than exceptional?
For Professionals Working With Families
- Am I listening to understand or listening to extract compliance?
- Do I recognize the family’s expertise on their child?
- How is my work contributing to or alleviating systemic pressures on the family?
- What coordination is needed between different professionals and systems?
- How do I ensure someone takes holistic responsibility for the child’s wellbeing?
For Parents and Caregivers
- What patterns do I see in my child’s distress signals?
- Where does my child appear to cope but shows signs of stress at home?
- What accommodations would genuinely help, regardless of whether they’re “allowed”?
- How is my own wellbeing affecting my capacity to support my child?
- What alternatives should I consider when current approaches aren’t working?
The Cost of System Failure
Individual Impact
When systems fail to provide appropriate support, costs include:
- Child mental health deterioration
- Trauma from forced exposure
- Educational disruption
- Family relationship strain
- Parental mental health challenges
- Financial costs of seeking private alternatives
Systemic Costs
Systemic failures also create broader costs:
- Increased need for mental health services
- Higher special education costs when early intervention fails
- Workforce impact when parents must reduce employment
- Healthcare costs from stress-related conditions
- Lost human potential when children cannot access appropriate education
The Path Forward: Systems That Work
What Would Help?
Based on the experiences and guidance in this work, effective systems would include:
Early Recognition and Intervention:
- Training for early years professionals to recognize neurodevelopmental patterns
- Support before crises develop
- Parental concern taken seriously and acted upon
Coordinated Support:
- Single point of contact for families
- Professionals who communicate across disciplines
- Holistic understanding of the child’s full experience
Flexible Approaches:
- Multiple educational pathways and options
- Ability to adapt environments rather than forcing children to adapt
- Recognition that different children need different structures
Relationship-Based Support:
- Consistent caring adults who build genuine connections
- Support based on understanding the individual child
- Focus on wellbeing rather than compliance
The Role of Advocacy
Change requires advocacy at multiple levels:
- Individual advocacy for specific children and families
- System advocacy for policy and practice changes
- Cultural advocacy for understanding neurodiversity
- Professional advocacy for training and accountability
Conclusion: From “Can’t” to “Can and Will”
The journey from recognizing that a child can’t attend school to creating environments where they can and will engage with education requires fundamental shifts in how we understand:
- Neurodiversity as difference rather than deficit
- Anxiety as neurological reality rather than behavioral choice
- Accommodation as necessity rather than luxury
- Relationship as foundation rather than add-on
- Flexibility as standard rather than exception
When we center these understandings, we move from forcing children into systems that harm them to creating systems that welcome and support all children in ways that work for their unique nervous systems, communication styles, and learning needs.