The school year is drawing to a close amid reports of rising pupil absences and warnings of a ‘national crisis in education’. But what is being done to understand and address the psychological aspects of persistent absenteeism, including unmet additional needs? Suzy Rowland, CBT practitioner, autism / ADHD specialist trainer and founder of the happyinschool project, reflects on the difficult emotional dynamics around what is still unhelpfully termed ‘school refusal’ – and shares some suggestions for improving communication between school, families and children.