I work as part of an early intervention team that assesses children’s mental health, and I have noticed that teachers, parents and healthcare professionals seem increasingly terrified of talking to children about their weight. In many ways, this is understandable. Eating disorders in children are on the rise, with over 11,000 children and young people beginning treatment last year on the NHS (a figure that has more than doubled since 2016). And there is a common — if not always accurate — perception that they are triggered by body image issues.

The trouble is, we need to talk about children’s weight. Britain is experiencing an obesity crisis that is putting them at risk of lifelong illness. Last year, almost a quarter of children in Year 6 were considered obese. In the early Eighties, only 1% of children were obese. And in 2020, a third of UK teenagers began their adult lives with excess weight. It’s obvious but worth stating that obesity has all sorts of negative consequences, not only for children’s health but also their social lives. Obese young people are less physically active, for instance, missing out on opportunities to develop skills, relationships and strategies for managing their mental health. They are also more likely to develop type 2 diabetes, high blood pressure and liver disease at an early age.

And yet, the authorities responsible for children often seem far more comfortable discussing restricted eating than over-eating. This is a society-wide phenomenon, affecting adults as well as children. Healthcare professionals are routinely criticised for mentioning excess weight at check-ups. When Cancer Research publicised the well-established links between obesity and cancer, academics and activists attacked them for fat-shaming. And the body positivity movement preaches that you can be healthy at any size.

It’s easy to sympathise with the aims of this movement. Obese people do get treated unfairly, and often harshly, by society. They are more likely to be judged as lazy, weak-willed and unintelligent, and they earn less money. One of the reasons Katie, the 14-year-old I assessed, wanted to lose weight was that she had been bullied about being overweight in primary school. And when I met 12-year-old Leo, to work out why he was missing so much school, he told me he never came in on PE days because he would have to get changed in front of people. He is overweight, and worried about being teased.

Teachers at school, trying to do the right thing, told him not to let other people’s opinions get to him. But Leo was already doing this, to an extent. Even though he felt like people were looking at him, he told me he knew they probably weren’t. He admitted that insensitive comments definitely fed his anxieties, but said that he knew they were made in jest, and that nobody meant to hurt him with them. But still, Leo wanted to lose weight, and when he asked adults for help, all he got were platitudes, or at best a link to a healthy eating website. The odd rude comment may have been a problem, but adults in his life focused on them as the only problem, ignoring Leo’s entirely rational desire to be a healthy weight.

Suggested reading

Western society is built on stigma

By Lionel Shriver

Two things can be true: overweight kids don’t want to be shamed for their weight, but they usually still want to lose it. Our increased awareness of body image issues is on the whole a positive thing — but it has created a tendency to catastrophise. We see restricted eating in children as disordered eating, and therefore believe it ought to be avoided at all costs. Parents can know their child is overweight and want to do something about it, but still be terrified that if they say anything, they might trigger lifelong insecurities, or even anorexia.

This is, partly, down to common misconceptions of what causes the eating disorder. Anorexia, especially in the severe forms that see people hospitalised, is not strictly caused by body image issues — or seeing pictures of very thin models in magazines — though they can sometimes act as a catalyst. A colleague who worked in an inpatient eating disorder unit described the complex webs of troubled family dynamics, trauma and obsessive tendencies that feature on the ward: histories of abuse, or ambivalent parents who didn’t visit, and the sorts of counting and checking behaviours we associate with OCD.

Suggested reading

Fat positivity is a fantasy

By Kat Rosenfield

At the same time, the causes of obesity are likewise poorly understood. It’s widely recognised that there are significant socioeconomic differences: children in the most deprived areas are more than twice as likely to be obese as those in the richest areas. For a while, the idea of the food desert seemed to help explain this — if you’re stuck in an area with small convenience stores that tend to stock junk rather than bigger supermarkets, your options will be limited. But more recent research showed this to be a myth: poorer families mostly shop in big, better value supermarkets, just like everyone else. And obesity figures are still very high for children in wealthy areas, 13% of whom are obese by the end of primary school.

A more reliable predictor of obesity in children is their parents’ choices. Adults shape their children’s bodies as much as their own. Their eating habits will be mirrored in their children’s: adults who eat unhealthy food at home are likely to feed unhealthy food to their children. So the fact that nearly two-thirds of UK adults are overweight, and 28% obese, is implicated in the child obesity crisis.

In theory, programmes exist that support the whole family in managing children’s weight, drawing on everything from behavioural psychology to nutrition and free local sporting activities. But access varies across areas: there is nothing on offer for children in my county, for example, and in better-resourced areas these programmes are only available to families when their child’s BMI is already very high, even though research shows that the higher your BMI is, the harder it is to lose weight. Until that point, all that local authorities and the NHS provide is information about healthy eating. And we all know about our five a day. You can’t move through a primary school without seeing a healthy eating display board. If public health information campaigns worked, we’d be looking leaner.

The structural problems are partly to blame, of course. Doctors, teachers and parents can’t change the fact that we live in a time of superabundance in which we are surrounded by cheap, delicious food. It is extremely difficult to maintain the willpower to give up a pleasurable and compelling habit. But it becomes near-impossible if you’re in two minds about it. And if the prevailing narrative is that dieting is inherently unhealthy, or that the desire to lose weight is a sign of a dangerous mental health problem, of course you’ll prioritise your emotional wellbeing.

More from this author

How ADHD became a luxury label

By Kate Adams

The reality is, most adults have two options: the discomfort of watching what we eat or the discomfort of being overweight. Learning how to feed yourself properly is part of growing up — like learning to navigate conflict or hold down a job. It’s not necessarily fun or particularly fulfilling — it’s just life. If we want child obesity rates to come down, adults will firstly need to acknowledge that fact.

We will also need to provide the structure and support to help with weight loss. An 11-year-old girl I worked with started secondary school worrying about her weight, but felt much better two months later — not because of any magical intervention from our team, but because her mum signed the whole family up to the gym and made them all go at least twice a week. Having done that, the girl explained, the family started thinking more about what to eat, and it felt easier to choose better food, because they were all on the same team.

Without adults’ input, children can’t learn to manage their own bodies as they get older. We have come a long way in teaching them that we are all more than our bodies, and pushing back against an image-obsessed world that once promoted being underweight. But we mustn’t go so far as to ignore the awful consequences of being overweight. Obese people don’t deserve to be stigmatised, but they do deserve to be healthy.

But Jane really wanted Lily to get some qualifications. She was 13, the age at which persistent absence starts to increase in secondary schools. And in a year’s time, her peers would be choosing their GCSE subjects. But Lily didn’t feel able to go to school. She wanted to be home educated. Unfortunately,  while Jane’s job as a web designer allowed her to work from home, and therefore keep an eye on her daughter, it kept her too busy to teach her. They needed the school to make more of an effort to include her.

The problem was, the school imposed expectations that Lily couldn’t meet. They wanted her in class with her peers, but Lily was terrified of being picked on by a teacher. Her fear gave her stomach aches and headaches. At first, she’d take days off to recover, but those days off turned into weeks off, until she wasn’t coming in at all. School said she could come in part-time, but teachers still expected her to keep up with the work and sit in lessons.

The authority that Jane exercised over her daughter was quite different from that of the school. She had always given Lily the space to be autonomous, to act according to her needs. Her parenting style was “child-centred”. Informed by attachment theory, “gentle parenting”, as it is otherwise known, tells parents to be led by their child’s stated needs — and is increasingly popular in the West. The rationale is that a calm and reassured child will be able to make good choices, observe boundaries and thrive in the world. You don’t give orders; you allow them to make choices. Rules are negotiated on an equal basis rather than imposed from above. Problems with behaviour reflect a problem with the connection to the caregiver: a child acting out only does so if needs have not been met, and the way to address the behaviour is to address the relationship first.

This approach seems idyllic when it’s going well. If things go wrong, however, parents end up feeling helpless. Many end up in a double-bind, knowing their child’s behaviour needs to change while believing that their child must not be forced into doing anything against their will. For Jane, it was inconceivable that she would pressurise Lily to go back to school — but that meant that Lily would only return if she wanted to, and she didn’t want to.

More from this author

How ADHD became a luxury label

By Kate Adams

The school absenteeism crisis made the news last week, when Labour announced its plan to tackle a growing crisis. One in five pupils is persistently absent from school, a number that has doubled since before the pandemic, with many blaming lockdown for the spike. And while it was once linked to markers of poverty such as free school meals, to assume that this is simply a class problem would be misguided. Plenty of absent children come from middle-class homes. In fact, middle-class parenting philosophies seem to be contributing to the problem.

Taylor was also 13 when he stopped going to school. He became increasingly withdrawn at home, staying up all night on his phone or Xbox. He wouldn’t feel like coming downstairs for dinner, so his mother Luci took meals and snacks to his room. She knew it would be better for him to take part in family meals, but she worried that insisting would affect their relationship. She knew that he spent too much time on his screens, but she feared that taking his Xbox away would only make his mental health worse.

Taylor was starting to show signs of depression, and Luci was increasingly worried and frustrated — who was supposed to help him? Was it the school, or the local authority, or the NHS? In her view, setting rules at home was near-impossible, because she didn’t want to affect her relationship with her son — therefore, any change had to be facilitated from the outside.

It’s common to hear parents say that their absentee children can’t come to school. The relationship between “can’t” and “won’t” crops up a lot when we talk about school avoidance — and young people’s mental health issues more generally. And it has fundamental implications for the question Taylor’s mum often came back to: whose responsibility is this? If a child won’t do something that they are supposed to do, like go to school, it’s a problem that needs to be addressed with discipline. The responsibility is the child’s, and by extension their caregiver’s. If someone can’t do something they’re supposed to do, it’s not their fault. The system has to accommodate them: school needs to be more flexible, or homeschooling needs to be provided.

Many parents frame their child’s difficulties in terms of mental health: she is avoiding school because she feels anxious — and if I challenge her, her anxiety will only increase, and her behaviour will only get worse. Here, the lines between won’t and can’t blur. Anxiety thrives on avoidance; if a child doesn’t confront the challenges that school poses, they are likely to fear school even more, having been deprived of the opportunity to find out that it isn’t so bad.

Suggested reading

The kids aren't alright

By Hadley Freeman

School pastoral officers are endlessly infuriated with the effect of parenting on attendance. One tells me how pupils text their mums from the loos to say they are having a bad day, and some parents will drop everything to come and pick them up. There are options for struggling children, though: they can use their time-out card, or make an appointment to see the counsellor. But parents who get immediately involved undermine the work her school is doing to help kids settle. It’s understandable for them to find their child’s distress distressing — but sheltering them from the challenges will not serve them well in the long run.

When she tells them this, the parents will agree, and then they’ll do it all over again. Each of them, Kim says, knows on some level that their behaviour is causing problems — not just for their child, but for the school more generally. But they also see their child as vulnerable, as being an exception. This is the influence of attachment theory, which sees all children as fragile, and all discipline as traumatic.

And yet, attachment-based theories are starting to leak into schools. “Connection before correction” is now the most fashionable approach to discipline; it preaches that bad behaviour is an expression of unmet needs and staff need to make pupils feel emotionally safe before introducing any sanctions. Proponents of more traditional approaches, such as government school behaviour adviser Tom Bennett, are sceptical, expressing concern about the increasingly widespread belief that poorly-behaved pupils can’t help themselves — which stops teachers from using sanctions that work.

Suggested reading

What I've learnt about motherhood

By Kathleen Stock

Indeed, replacing no-excuses behaviour policies with a theory that is its own tailor-made excuse for poor behaviour has not led to great outcomes. In Scotland, where this approach has been taken to its logical conclusion — a restorative approach that focuses on helping the offender process their emotions — a rise in violence against staff in schools has led to a near-doubling in payouts due to workplace injuries over the last year. Bad behaviour is not only contributing to Britain’s teaching retention crisis but also having deleterious effects on the nation’s most vulnerable pupils. Firm rules tend to make children with profound special educational needs feel safer, because they minimise the risk of other kids behaving noisily or aggressively. And each child who isn’t in school needs to be chased, checked up on, even visited at home — time-consuming tasks that can draw attention away from pupils who may need it more.

That’s not to say that all schools are pleasant, or that all children can manage mainstream education. Plenty have needs or disabilities that mean they simply can’t cope with environments or demands that others can adapt to. Increasingly, though, this category is expanding to include children who are avoiding school because it is uncomfortable or difficult — rather than impossible. Children depend on boundaries; under-18s aren’t legally responsible for themselves for a reason. Their capacity for decision-making, emotional regulation and self-control is still developing.

The official concern about children missing school is the effect it will have on their life choices, narrowing their options without formal qualifications. But arguably more important is what school teaches them about to get on in the world. And if we believe that making youngsters do things they don’t want to is going to harm them, they aren’t going to learn that. They need rules to be upheld and expectations to be consistent. It’s down to the adults to help the children grow up.

That same little brother, who has just turned seven, is already catching up with Josh in English and Maths. And unlike Josh, he’s able to regulate his emotions and follow instructions. Their mum fears that Josh may never get there. She knows he needs specialist support, and she knows, at least in theory, how to get it.

His school’s Special Educational Needs and Disability Coordinator — or SENDCo — referred Josh to the NHS’s Child and Adolescent Mental Health Services (CAMHS) for an autism spectrum assessment. CAMHS rejected the referral. The SENDCo then put in a referral for an ADHD assessment. Both times, Josh’s mum did the parenting courses that you have to do to indicate that a child’s home environment isn’t the problem. Having two other children who were doing well both socially and at school wasn’t enough evidence that she’s a competent parent. She kept a three-month diary of Josh’s behaviour, and made notes about the ways in which she and her husband tried to support him. But it was all for nothing: CAMHS rejected the second referral as well.

It can sometimes seem as though CAMHS’s primary job is saying no. Josh’s story is far from unusual. Working as part of an NHS early intervention team, I met the family of another boy, of a similar age, who keeps getting excluded at school because he can’t sit still and stay focused in lessons — but who excels on every sports pitch and behaves well at home, where he can move around and go outside whenever he needs to. That boy got rejected from CAMHS five times.

The team I work in can’t diagnose ADHD or autism. Neither can the SENDCos in schools, even though they’re often experienced and knowledgeable. Diagnoses can only come from a clinical psychologist, a psychiatrist or a highly trained specialist nurse. For most families, this means going to either CAMHS or whatever’s left of their local authority’s educational psychology team. In our small county, that team amounts to one employee. The waiting time for an assessment is between one and two years, which colleagues in neighbouring areas say isn’t too bad.

More from this author

Not all children belong in school

By Kate Adams

But to get onto the waiting list, you have to be accepted first. One way for CAMHS to keep waiting times down is to just say no to most referrals. Getting a child the support they need from the NHS is an arduous, exhausting process for schools as well as families — and, of course, for the children, who know that there is something different about them that keeps on causing problems, but can’t be offered any solutions without a diagnosis. SENDCos face rejection after rejection if they request either CAMHS involvement or funding for Education Health Care Plans (EHCPs), which pay for the resources and support some children need to cope with mainstream education.

If, however, parents can afford a private assessment, a booming industry of psychiatrists and educational psychologists is on hand to provide their child with a diagnosis within a week or two. It’s a frictionless, even pleasant experience: you go online, book an appointment and chat to a friendly, highly credentialed specialist. I know this because I’ve done it myself: a few years ago, I had some problems at work, and an ADHD diagnosis helped make sense of them. While Josh’s mum has to justify herself to an institution that holds all the power — an institution that can demand she take courses multiple times and jot down observations for months, all in the hope that her child will be accepted for an initial conversation — paying clients can expect a service that works for them.

This affects far more than the speed of the diagnosis. And here, the thesis of the psychiatrist Thomas Szasz might give us pause. Szasz was critical of the very idea of mental illness, observing that medicalising problems in living puts the patient at the mercy of a controlling healthcare system. We could see learning difficulties similarly, as problems in living that have somehow become the remit of the medical establishment. The primarily social difficulty of being wired in a way that makes getting on in the world harder — which can be alleviated by the primarily social interventions of extra attention and time — has been assigned to ever-stretching mental health services.

Suggested reading

Mental illness doesn't make you special

By Freddie deBoer

Szasz analysed the power play in various models of doctor-patient relationships: in some, the doctor had absolute authority, like a parent over an infant; at best, the relationship was balanced and collaborative, cultivating the patient’s autonomy and avoiding abuses of power. Services such as CAMHS should, in theory, take this latter, patient-centred approach, but in practice they rarely do. In systems such as the NHS, healthcare is rationed, and the implication is that you’re supposed to be grateful for whatever you can get. Some individual clinicians may be excellent, but when the system is creaking and everyone seems to resent you for it, it’s hard not to get sucked into hiding behind the defences of a power imbalance stacked in your favour. The patient needs you more than you need them.

So, money doesn’t just get you access to healthcare — it also changes your relationship with it. If you’re paying, you get to ask questions, rather than obediently tick the boxes required of you. Instead of feeling beholden to a larger and more powerful system, grateful for whatever it is prepared to give you, you can think about what you want from it.

And if you get that SEND diagnosis, it can alter your power relationship with other institutions too, because it means they have a legal duty to accommodate you, to help smooth over those problems in living. Last year, a spike in demand for ADHD referrals in Cambridge resulted in GPs being provided with template letters requesting extra time in exams.

Of course, it’s natural to be hypersensitive to dips in concentration while revising for finals. But with a quarter of UK students now claiming extra time on the basis of additional need, we have to ask whether it’s time to reassess the concept of special educational needs. Originally, it was about people like Josh, who struggle with basic education. Now, the UK’s cleverest students are seeking the same diagnosis as him.

The middle-class, mid-life ADHD revelation has become a bit of a media cliché, but it’s indicative of a broader pattern. The middle-classes account for an ever-larger proportion of SEND diagnoses, partly because we can afford to pay for them. And yet, the need for SEND services is greater in more deprived areas, not least because caring for a high-need child exerts a financial strain. Despite this, a recent LSE study suggests that wealthy areas enjoy far more SEND provision than poorer areas.

Suggested reading

The invisibility of autistic girls

By Clara Törnvall

The differences are dramatic: in the richest decile of areas, 15% of children have a formal diagnosis of Specific Learning Difficulties, or SPLD (an umbrella term for learning difficulties that can only be diagnosed by specialists, such as autism, ADHD, dyslexia and dyspraxia); in the poorest decile, only 6% do. Those diagnoses often lead to extra funding: in wealthy areas, 22% of children with SEND have an Education Health Care Plan, compared with 15% in deprived areas. And funding can change everything for the parents of children with special educational needs. It means a teaching assistant whose sole job is to guide your child through school, the knock-on effect being that they’re then easier to look after when they get home; it means that if caring for your child prevents you from holding down a full-time job, you can supplement your meagre income with a carer’s allowance.

But perhaps more fundamentally, there are plenty of children who, without EHCPs, simply cannot participate in the otherwise mostly inflexible education that takes place in mainstream schools — which tend to be the only option. Blair’s drive for inclusion in mainstream education led to most special schools being shut in the belief that keeping children with their peers was better for them and society, and could be achieved by making allowances for them in the mainstream system. Inclusion became a buzzword, a moral good in itself; sceptics noted that scrapping expensive specialist provision happened to save the state a lot of money — but put children with more significant disabilities in a more vulnerable position.

Contemporary ideas of inclusion tend to gloss over the unappealing bits of disabilities, preferring to describe them as “superpowers”. The focus is on dyslexic inventors and autistic activists. You can buy ADHD self-help books about how we, the special ones, are in-the-moment hunters enjoying heightened sensitivity in a world of boring, plodding farmers — upon whom we rely to create the conditions for us to wield our talents. Your disability doesn’t have to hold you back. The more neurodiversity the better. Or so the story goes.

Suggested reading

Adderall is not an identity

By Oliver Bateman

It is a flattering story, if you’re privileged enough to be able to afford the support you need to prevent your neurodiversity disrupting your life — or if it didn’t disrupt it too badly in the first place. In other words, if your ADHD is more of a personality quirk than a disability. But ADHD, or autism, or whichever box he eventually gets put in, probably isn’t Josh’s superpower. He’s a lovely boy; right now, he’s also a liability. His mum can’t imagine him being capable of living independently without something terrible happening; she envisages caring for him for the rest of her life. There is grief in her vision of his future, and in her day-to-day experience of parenting a child who can scare his own siblings.

What does it mean to include Josh? Time, attention, and lots of structure provided by lots of different people. At the moment, he is getting none of that. As with most other parts of the NHS, mental health services are sleepwalking into an American-style two-tier system. Privately, some of us are able to afford neurodiversity labels, which are becoming a luxury. Meanwhile, the system is failing children like Josh.

But so is the prevailing narrative about disability, which is dominated by the voices of those who have managed to integrate into mainstream society. Platitudes about uniqueness aren’t enough: disabilities are called disabilities because they impair functioning, causing us problems. Overcoming those problems is hard, and often expensive, but more urgently it requires the problem to be recognised with an official diagnosis. If Josh is to get one, CAMHS will have to see him first.

Names have been changed.

After an altercation with a member of staff in the summer term, he didn’t return for the rest of the year. Instead, he spent much of the time with his dad, a labourer who picks up jobs on farms and building sites, doing what sounded like back-breaking work from the time he would normally get up for school until long after he would normally get home. He loved it — he likes getting on and doing things, and being useful rather than being treated, however sensitively, as a problem.

Kieran is one of many such problems. And as more than 100 schools threaten not to reopen this term, their plight looks set to be ignored once again. One in four English children are persistently absent from school; one in 50 are missing more than half. Among pupils in years 10 and 11, a third  are missing the equivalent of at least one GCSE’s worth of school.

Often, these cases are referred to mental health teams like the one I work in, which were set up to address common problems around behaviour, anxiety and low mood with brief self-help treatments. What happens in practice, however, is more complicated: schools, faced with scant resources, often end up referring children out of a need to be seen to be doing something, and low attendance often features.

Kieran, for example, had an Education, Health and Care plan (EHCP) — the highest level of support for special educational needs — for dyslexia and ADHD. His mum begged his teachers to let him sit certain classes out, so he could focus on a handful of core subjects rather than skip school entirely, but there wasn’t much they could do — in the name of inclusivity, the school is expected to provide a full curriculum for all children, including those with special educational needs and disabilities (SEND).

Kieran was, in effect, a victim of a doggedly one-size-fits-all approach which maintains that everything can be fixed with education. It started with Blair, who believed in sending half the population to university: his argument was that academically clever people went to university, so if everyone went to university, everyone would be academically clever. Britain’s next wave of reformers, Dominic Cummings and Michael Gove, held that a traditional knowledge-rich curriculum would impart more information and better life chances to English children. Pisa results indicate that it probably has, but that average contains multitudes, and some of them aren’t coming into school. And it isn’t just the children with diagnosed special needs that suffer — it can be a pretty bleak experience for those who simply aren’t academic, too.

Suggested reading

Why are teachers striking over slavery?

By Matt Feeney

Ella is 13 and softly spoken. She is in Year 8 and missed a lot of school last year. She gets headaches which were probably caused by anxiety — it is very common, especially in children and adolescents, for anxiety to manifest somatically in the form of physical aches and pains or nausea. If you ask Ella how things are going, she will reliably say that she is ok, home is great and school is tricky. She isn’t being bullied, and she’s too well-behaved to get into trouble — she just gets stressed out by school. Ella is in the bottom set for everything, and while the groups are smaller and the teachers do their best to make the work make sense, she knows she isn’t doing well at it.

Ella loved being at home in lockdown. She liked being able to do schoolwork in her own time, because it takes her longer to work things out than others. She liked being able to hang out with her cousins, and help out on her family’s farm. Like Kieran, Ella has a strong sense of her values and what she wants to do with her life. School is barely relevant to it.

A team like mine could work on some of Ella’s worries; helping to build up her confidence. But what you can’t cure therapeutically is the empirically observable knowledge that you’re stuck doing something you are bad at. If the core of your anxiety is a belief that you’re not good enough, there’s nothing more effective at feeding that belief than not being good enough at the only thing you have the opportunity to do for most of your waking existence.

In an under-resourced system optimised for academic exam performance, pastoral teams can do their best to find out about the interests and motivations of non-academic children, but they can’t rewire the curriculum. In response, activist groups, such as Not Fine In School which represents families of mostly neurodiverse children who are out of school, argue that the current model, far from being inclusive, is failing many children. They advocate for a less punitive approach to pupil absence — at present, local authorities can fine parents over children’s low attendance — and more rights for parents in determining the best educational provision for their children.

Suggested reading

The Oxford kids are alright

By Kathleen Stock

The preference of many children is to be able to self-direct with one-to-one attention when they need it. The obvious place to do this would be at home; but unlike the US, where a strong culture of home-schooling is has resulted in better outcomes than those of state-educated children, the Department for Education collects no outcome data for home-schooling families and the education establishment is, at best, sceptical. Moreover, there is very little support for families where both parents are working. Some US states, by contrast, help fund home-schooling with tax credits or deductions.

Instead, the axiomatic assumption in Britain is that school is best, and any misalignment with the school system is an individual pathology. We defer to the language of “anxiety”, which has become a catch-all term for all distress caused by an aversive experience. But this can be unhelpful for a number of reasons, especially where school avoidance is a feature: it can pathologise ordinary difficulties, undermining children’s self-confidence and self-efficacy; it can mistake the distress that many autistic children experience in the school environment for something that can be straightforwardly treated with exposure; it also assumes that the individual, rather than the environment, is the problem. 

We could, for instance, describe the frustration of being stuck in a lesson you are unable to participate in as anxiety, and we could do the same with the sensory discomfort of the classroom, but those aren’t irrational fears and they can’t be fixed in the same way irrational fears can. And even when those children are coping with the demands of being in the school environment, they tend to emerge with little to show for it. Pupils with an ECHP are working on average three years behind their peers by the time they leave school; only 13% of children with special educational needs leave with GCSE passes in English and Maths.

One way of looking at this is to see children who are statistically less likely to do well at school as voting with their feet and staying away. The education establishment would argue that this is precisely why it’s so important for them to be in school — to “close the gap” in their attainment compared to other children. But I am not convinced. In The Cult of Smart, the Left-wing writer and ex-teacher Freddie DeBoer argues that academic ability is largely heritable and that the increasing amount of pressure and money spent on trying to close achievement gaps have little impact. We justify wildly disparate outcomes in wealth and well-being as being merit-based — if you work hard in school, you deserve better in life — when the outcomes are determined more by luck than hard work.

Suggested reading

Children don't need woke stories

By Dominic Sandbrook

DeBoer’s solutions include ditching the assumption, beloved of cognitively blessed elites, that academic attainment signifies moral goodness, and allowing children to opt out of the academic curriculum at age 12. David Goodhart makes similar arguments for the UK in Head Hand Heart, arguing that a cognitively minded ruling class has failed to take skilled manual labour and caring professions seriously. What do we signal about the work we value as a society when we tell children that the only things worth learning in their formative years involve memorising and decoding information?

In the current system, we pretend that everyone can jump through hoops of academic cleverness, which are the only hoops worth jumping through. When that doesn’t work, we pathologise the individual and blame the teachers, who should be able to skilfully engage all children in the class, no matter how large their spread of aptitude and interest for the subject.

Kieran and Ella have been having a miserable time in an environment ill-suited to their needs — it was that, rather than any irrational error of thought, that dented their attendance. The only thing they were taught was that they had failed.