The Cost of Waiting: Early Intervention, Anxiety, and the Alternative Provision Dilemma
- Victoria Allen
- Nov 17
- 6 min read
Emily* has anxiety and ADHD. For her, school is a daily endurance test of noise, social demands, and concentration. “Josh is tapping his pen. Sasha keeps sniffing. Someone in this room smells.” Each day, she masks her discomfort, trying to fit in while her mind races. By lunchtime she’s exhausted, and by the afternoon she’s in trouble for not paying attention. Over time, the reprimands grow, her frustration builds, she snaps at teachers and other students and school becomes a place she cannot bear to be. Emily’s attendance drops to around 10-30%.
Two years later, Emily is in Year 10. Her attendance has been inconsistent for so long that school has recommended an Alternative Provision (AP) placement. Meetings are now focused on her post-16 plans and what can be done to salvage her GCSE outcomes. But the question remains: what could have been done earlier?
"The longer a student disengages, the harder it becomes to re-engage"
The rise of emotionally based school avoidance
Emotionally Based School Avoidance (EBSA) has become increasingly visible in UK education, more so since the COVID-19 pandemic. Schools report growing numbers of students experiencing anxiety-related absence, many linked with neurodiversity such as ADHD or autism. Recent research describes EBSA as a “growing crisis” (Halligan and Cryer, 2022). In a systematic review, McDonald and Pervez (2025) found that early intervention is critical, noting that “early support is required to prevent this pattern from becoming entrenched.”
These findings align with what practitioners see daily: the longer a student disengages, the harder it becomes to re-engage. EBSA rarely appears overnight. It begins with sporadic absences, social withdrawal, growing emotional exhaustion, and often, persistent somatic complaints (such as headaches or abdominal pain) that lack a clear medical explanation. These internalised signs are often the first observable evidence that the emotional load of attending school has become overwhelming, marking the critical point at the top of the slope towards full avoidance (Local Authority Guidance, e.g. KELSI). As I often say to colleagues, once a student is on the slope, climbing back up takes much more than goodwill.
When intervention comes too late
In many schools, intervention begins at the point of crisis, when attendance is below 50%, or when the student has already disengaged from learning. By then, even supportive measures such as reduced timetables or small group work can feel punitive, as they arrive after trust has eroded.
The “academic panic” often begins in Year 10, the recognised start of GCSE preparation. Schools, understandably, focus on exam results and accountability measures. Yet, as Bond et al. (2024) note, persistent absence is directly linked to poor attainment: only 36% of persistently absent pupils achieved expected grades in English and maths, compared with 78% of rarely absent peers. This is not just a matter of lost learning time; it is about declining confidence, self-concept, and connection to education.
Emily’s situation is far from unique. For students like her, AP is often presented as a last resort rather than an early, targeted intervention. By the time AP is considered, the student may have already lost faith in mainstream schooling. As Hamadi and Havik (2025) found in their study of young people with attendance problems, many felt that professional help arrived “too little, too late.”
"By the time AP is considered, the student may have already lost faith in mainstream schooling"
The slope and the cost of waiting
School avoidance is best understood as a continuum rather than a binary state. A student may begin by missing occasional lessons, then days, then weeks. Each missed moment compounds anxiety and erodes academic confidence. Intervention must occur at the top of this slope, when the signs are emerging, not after the student has already fallen down.
The old business adage, “you have to spend money to make money,” has a parallel in education: you have to spend money to save money. The cost of persistent absence is stark: the Department for Education (DfE) estimates that just one additional day of absence for a student is associated with a decrease of £750 in future lifetime earnings (DfE analysis, 2025). Investing early in tailored support, mentoring, and flexible learning pathways can prevent the far greater costs associated with long-term non-attendance, exclusion, or mental health crisis, which amount to a significant burden on the public purse and individual potential. Yet, as many educators know, budgets are stretched, and AP placements are often viewed as a financial burden rather than an investment in prevention.
Alternative Provision: A place to rebuild
Despite these challenges, Alternative Provision can be transformative when used proactively. I have seen students thrive in our AP setting. The smaller class sizes, consistent relationships, and flexible structures create an environment where students can be themselves without masking their anxiety or differences. The focus shifts from compliance to connection, from punishment to purpose.
Research supports this. Halligan and Cryer (2022) emphasise that students in specialist AP environments value “interconnectivity” and “psychological safety” as the conditions that allow learning to resume. These are not luxuries; they are prerequisites for re-engagement. This aligns with broader UK research by Professor Kathryn Riley (2022), which concludes that when young people feel safe, rooted, and that they belong in school, they become open to learning and succeed at every level. When students feel safe, respected, and understood, they begin to rediscover curiosity and confidence.
However, this model should not be reserved for those who have already fallen through the cracks. Early, short-term AP interventions or hybrid models could allow students to maintain academic continuity in core subjects while receiving emotional and behavioural support. Currently, access to such provision is inconsistent and often dependent on whether a student has an Education, Health and Care Plan (EHCP). As the Department for Education (2022) acknowledges, Alternative Provision is too often reactive, not preventive.
A call for early investment
The evidence is clear: waiting until students are in crisis is both educationally and economically short-sighted. Early intervention, particularly for students showing signs of anxiety, ADHD, or other learning difficulties, must be prioritised within mainstream settings. This includes funding for school-based counsellors, key workers, sensory regulation spaces, and flexible curriculum design that accommodates neurodiversity.
Alternative Provision should form part of a continuum of support, not an endpoint. When used early, it can act as a bridge back to mainstream education rather than a detour away from it.
In our AP, I have seen students rediscover joy in learning, build trusting relationships, and begin to imagine futures beyond school. These outcomes should not depend on a student’s postcode, diagnosis, or the timing of a crisis.
"Alternative Provision can be transformative when used proactively"
Early intervention leaves no one behind
The cost of waiting is not only measured in missed grades or attendance figures but in the erosion of potential and self-worth. We cannot continue to respond only when the slope has become too steep.
The question is no longer whether Alternative Provision works, it does, when applied well. The real question is when we allow it to work. For students like Emily, timing is everything.
*Emily is a fictional student made up of a combination of very real experiences
References
Bond, L., et al. (2024) An evidence-based plan for improving school attendance. N8 Research Partnership. Available at: https://www.n8research.org.uk/media/CotN_Attendance_Report_10.pdf [Accessed 14 November 2025].
Department for Education (DfE) (2022) Alternative provision for primary-age pupils in England: a long-term destination or a temporary solution? London: DfE. Available at: https://www.gov.uk/government/publications/alternative-provision-for-primary-age-pupils-in-england-a-long-term-destination-or-a-temporary-solution [Accessed 14 November 2025].
Department for Education (DfE) (2025) The cost of absence on future earnings. (Based on DfE/IFS analysis). https://assets.publishing.service.gov.uk/media/67d2cf8f4702aacd2251cbae/The_impact_of_school_absence_on_lifetime_earnings.pdf
Halligan, S. and Cryer, L. (2022) ‘Emotionally Based School Avoidance: Students’ Views of What Works in a Specialist Setting’, Continuity in Education, 3(1), pp. 1–12.
Hamadi, A. and Havik, T. (2025) ‘“Too little, too late”: Youth retrospectives on school attendance problems and professional support received’, Frontiers in Child and Adolescent Psychiatry, 2, 1595289.
Local Authority Guidance (e.g. KELSI, Barnet, Milton Keynes) (n.d.) Identifying and Supporting Emotionally Based School Avoidance (EBSA). https://www.barnetlocaloffer.org.uk/senco_zone/documents/2272-barnet-ebsa-guidance-for-schools-families-and-professionals
McDonald, S. and Pervez, M. (2025) ‘School partnered approaches to emotionally based school avoidance in UK primary and secondary school-age learners: A systematic review’, Educational Review, [Online]. Available at: https://www.researchgate.net/publication/392964560 [Accessed 14 November 2025].
Riley, K. (2022) Compassionate Leadership for School Belonging. London: UCL Press. Available at: https://www.uclpress.co.uk/products/171324 [Accessed 14 November 2025]
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