New research has concluded that anxiety can be a factor in poor school attendance among children and young people.

A team at the University of Exeter Medical School conducted a systematic review, which analyses all available evidence in the field. The study, published in Child and Adolescent Mental Health, increases our understanding of the link between anxiety and poor school attendance, particularly when unexcused.

The research, supported by the Wellcome Trust and the National Institute for Health Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula (PenCLAHRC), also identifies the lack of high-quality research in the area. In particular, we need more studies that follow children over time to clearly disentangle whether the anxiety leads to poor school attendance or the other way round.

Of 4,930 studies in the area, only 11 met the criteria which meant they could be included in the robust analysis. They were conducted in countries across North America, Europe and Asia.

The team categorised school attendance into the following categories: absenteeism (i.e. total absences); excused/medical absences; unexcused absences/truancy; and school refusal, where the child struggles to attend school due to emotional distress, despite awareness from parents and teachers.

Findings from eight studies suggested a surprising association between truancy and anxiety, as well as the expected link between anxiety and school refusal.

Lead author Katie Finning said: "Anxiety is a major issue that not only affects young people's schooling, but can also lead to worse academic, social and economic outcomes throughout life. It's important that we pick up the warning signs and support our young people as early as possible. Our research has identified a gap of high-quality studies in this area, and we urgently need to address this gap so that we best understand how to give our young people the best start in life."

Professor Tamsin Ford, who was involved in the research, said: "School staff and health professionals should be alert to the possibility that anxiety might underlie poor school attendance and can also cause lots of different physical symptoms, such as tummy and headaches". Lots of things about school can trigger anxiety in children and it is important to realise that while we all get anxious about somethings, anxiety that is severe can have a major impact on children's development.

"Anxiety is highly treatable and we have effective treatments. It is also important to understand that anxiety can lead to impulses to avoid the thing that makes you anxious. Although this avoidance reduces anxiety in the short term, it makes it even harder to cope with the trigger next time and so makes the problem worse. Most anxiety treatments work by teaching the child ways to calm themselves and slowly, with support, helping the child to prove to themselves that they can cope with things that make them anxious.

The full paper is entitled 'The association between anxiety and poor attendance at school: A systematic review'.