How positive behaviour support can help reduce school refusal in children and teenagers with Autism and PDA

Activ8 Insights

Whether you’re struggling to get your child into the car for drop-off, or you’re overwhelmed with pre-bedtime meltdowns, behaviours associated with school refusal can strike at any time - day or night.  

School refusal in children with autism and Pathological Demand Avoidance (PDA) can have a dramatic impact on attendance levels, and on family life and wellbeing in general.   

In this guide, we cover:

• What can cause school refusal in children with autism and PDA

• What is considered a behaviour of concern (BOC)?

• How can positive behaviour support help children struggling with school refusal?

• School refusal intervention: An example of positive behaviour support for school refusal

• School refusal intervention outcomes: can positive behaviour support help reduce school refusal in children with autism and PDA?

• How to get the right help when your child is struggling with school refusal

What causes school refusal in children with autism and PDA? 

Each child’s reasons will vary. Some, for example, may feel overwhelmed by the various academic, social and sensory demands in day-to-day school life; others might simply prefer the familiarity and comfort of being at home.  

What is considered a behaviour of concern? 

A behaviour of concern is behaviour that could – 

• Cause your child distress or harm.  

• Be harmful to others around your child.  

• Prevent your child from doing things that are important to them.  

  
  

Behaviours of concern that are associated with school refusal can look different in each child. For example, some might try to avoid demands through persistent negotiation and bargaining, others might experience emotional outbursts and an increased need for emotional and sensory regulation when arriving at school.  

How can Positive Behaviour Support help children struggling to attend school? 

Positive Behaviour Support is people-centred, evidence-based and outcome-focused therapy. In school refusal interventions, it can help to reduce behaviours of concern by:  

• Uncovering the reasons behind the behaviours of concern.   

• Providing personalised strategies to help your child learn how to get their needs met through safe alternative methods, rather than behaviours of concern.  

• Ensuring that the recommended strategies are understood, accepted and used consistently by parents and other supports (i.e. family members, caregivers, school staff).  

School refusal intervention: An example

Our Lead Behaviour Support Practitioner, Imogen, helped a 10-year-old with autism and PDA reduce behaviours of concern associated with school refusal.  

The child was experiencing emotional outbursts and aggressive behaviours, with school attendance averaging around one day per week.  

In this scenario, Imogen supported the child and family by - 

Understanding the reasons behind the behaviours of concern  

Through 1:1 time and a functional behavioural assessment, Imogen discovered that unmet sensory needs were causing increased dysregulation. She carefully uncovered the reasons behind these unmet needs and found ways to have them met at school and in the home.  

Providing psychoeducation for the child and their parents

Psychoeducation sessions were offered to the child and their parents. These sessions helped them understand what was happening and why. Increased understanding allowed for acceptance of the child’s unique needs and improved recognition of triggers and early warning signs of dysregulation. This was beneficial because it allowed for strategies to be implemented early which reduced escalation and behaviours of concern.

Teaching the child strategies to help reduce behaviours of concern

To help the child manage school refusal anxiety in a healthier way, Imogen taught personalised strategies that helped the child –  

• Build awareness of their school refusal anxiety, and  

• Learn when and how to use the strategies to self-regulate and calm down.  

Coaching parents to help them understand the strategies their child needed to be using  

Parental support and alignment are crucial in a school refusal intervention. Coaching parents in the same anxiety-reduction techniques as the child helped ensure that support and encouragement was readily available to the child, even when our practitioner wasn’t nearby.   

Collaborating with school staff to ensures that strategies are understood, accepted and used consistently  

Imogen met and worked closely with relevant school staff, providing training and coaching to facilitate the smooth roll out of the positive behaviour plan.  

This collaboration helped to ensure that –  

• Imogen could identify and introduce suitable accommodations at the school to help reduce demand anxiety and increase predictability for the child.  

• School staff understood and supported the implementation of the positive behaviour support plan.  

• School staff could consistently use the recommended strategies to support the child effectively and enable them to overcome school refusal behaviours.   

Intervention outcomes

As with all therapies, results will vary, but overall, effective behaviour support strategies can help to reduce behaviours of concern in children with autism and PDA.  

In the scenario that we noted earlier – the 10-year-old child refusing to attend school – the results were very positive.  

By identifying unmet sensory needs and addressing environmental factors, Imogen helped the child reduce their baseline anxiety levels. This, combined with the consistent roll out of positive behaviour strategies and Imogen’s continued support, made the following outcomes achievable -  

The child adopted healthier ways to deal with their anxiety and the behaviours of concern associated with school refusal reduced  

Through psychoeducation, the child developed an understanding of their own needs and triggers. This understanding made it easier to use the recommended anxiety reducing strategies and to benefit from the accommodations made by school staff.  

School attendance increased from 1 day a week to an average of 4.5 days a week

Accommodations made by school staff and a strong alignment with the recommended strategies helped the child progressively increase the number of days that they attended school, moving from 1 day per week pre-intervention to an average of 4.5 days per week post-intervention.  

The child built positive relationships with classmates and teachers  

Successfully increasing the number of days that the child attended school had a direct impact on their ability to build positive relationships with classmates and school staff. These relationships helped improve quality of life, and made coming to school feel a little less daunting.  

Caregiver burnout was reduced  

Caring for a child with behaviours of concern can have a significant impact on a caregiver’s mental and physical health. Through reducing behaviours of concern and increasing average weekly school attendance, the caregiver was able to lighten their mental and physical load; they found emotional relief in the fact that their child was happier and more settled, progressing with classroom learning, and building positive relationships.

Through psychoeducation and positive behaviour training, caregivers felt well equipped to support their child when school refusal behaviours surfaced. With increased understanding and personalised tools, they were better able to recognise triggers and respond more effectively in difficult moments.  

Are you and your child struggling with school refusal? 

If your child is living with a disability and struggling with behaviours of concern, our positive behaviour support team can help.  

We support NDIS participants with Improved Relationships funding. If you have a NDIS plan without Improved Relationships funding, and you believe that positive behaviour support is needed, our practitioners can complete a Pre-PBS funding assessment of your child’s support needs including behaviours of concern and restrictive practices (if present).  

If your child has Improved Daily Living funding and needs proactive support while waiting on Improved Relationships funding or other therapies, our positive behaviour support practitioners can also provide short-term skills-building therapy.  

Our services are available face-to-face in Adelaide, North West Melbourne, North East Melbourne, North Melbourne, and West Melbourne.  

To request support from our team, fill in the NDIS referral form, email us at info@activ8group.com.au or call us at 1300-575-329.

Please note -

The detail provided in the school refusal intervention example is minimal; to successfully support your child, a personalised positive behaviour support plan with bespoke strategies and progress measures is required - please seek professional support.