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Totsika V, Kouroupa A, Timmerman A, Allard A, Gray KM, Hastings RP, Heyne D, Melvin GA, Tonge B. School Attendance Problems Among Children with Neurodevelopmental Conditions One year Following the Start of the COVID-19 Pandemic. J Autism Dev Disord 2024; 54:2998-3007. [PMID: 37480438 DOI: 10.1007/s10803-023-06025-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE The present study investigated school absence among 1,076 5-15 year-old children with neurodevelopmental conditions (intellectual disability and/or autism) approximately one year following the start of COVID-19 in the UK. METHODS Parents completed an online survey indicating whether their child was absent from school during May 2021 and the reason for each absence. Multi-variable regression models investigated child, family and school variables associated with absenteeism and types of absenteeism. Qualitative data were collected on barriers and facilitators of school attendance. RESULTS During May 2021, 32% of children presented with persistent absence (missing ≥ 10% of school). School refusal and absence due to ill-health were the most frequent types of absence, accounting for 37% and 22% of days missed, respectively. COVID-19 related absence accounted for just 11% of days missed. Child anxiety was associated with overall absenteeism and with days missed because of school refusal. Parent pandemic anxiety and child conduct problems were not associated with school absenteeism. Hyperactivity was associated with lower levels of absenteeism and school refusal but higher levels of school exclusion. A positive parent-teacher relationship was associated with lower levels of absenteeism, school refusal and exclusion. Child unmet need in school was the most frequently reported barrier to attendance while COVID-19 was one of the least frequently reported barriers. CONCLUSION COVID-19 had a limited impact on school attendance problems during this period. Findings highlighted the role of child mental health in different types of absence and the likely protective role of a positive parent-teacher relationship.
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Affiliation(s)
- Vasiliki Totsika
- Division of Psychiatry, University College London, 149 Tottenham Court Road, Maple House 6th Floor, London, W1T 7NF, UK.
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.
- Tavistock & Portman NHS Foundation Trust, London, UK.
| | - Athanasia Kouroupa
- Division of Psychiatry, University College London, 149 Tottenham Court Road, Maple House 6th Floor, London, W1T 7NF, UK
| | - Amanda Timmerman
- Division of Psychiatry, University College London, 149 Tottenham Court Road, Maple House 6th Floor, London, W1T 7NF, UK
| | - Amanda Allard
- Council for Disabled Children, National Children's Bureau, London, UK
| | - Kylie M Gray
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, Australia
| | - Richard P Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
| | - David Heyne
- Developmental and Educational Psychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
| | - Glenn A Melvin
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Bruce Tonge
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Melbourne, Australia
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Nordin V, Palmgren M, Lindbladh A, Bölte S, Jonsson U. School absenteeism in autistic children and adolescents: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1622-1637. [PMID: 38159071 PMCID: PMC11191666 DOI: 10.1177/13623613231217409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
LAY ABSTRACT Autistic children and teenagers are, on average, absent from school more than their peers. The aim of this review was to provide an overview of the research on absence from school in autistic learners in primary and secondary school, to help guide future research. We sifted through 4632 reports and found 42 studies with a focus on school absence and autism. We looked at how, when, and where the studies were conducted. We also summarized the results and outlined how absence was measured in the studies. Absence from school may lead to problems later in life, like incomplete education and unemployment. It is therefore important to know how common this problem is among autistic learners, what the reasons may be, and what type of support they need. The studies were from high-income countries and were mainly published in the last 10 years. Studies based on school registers from the United States and the United Kingdom clearly showed that children and teenagers with autism had higher risk of school absence than those without autism. Absence was often linked to problems with mental health or additional neurodevelopmental conditions. Several studies also showed that absence in autistic children and adolescents was related to problems in school, like bullying or lack of knowledge about autism. Support programs were only evaluated in a few studies with a small number of study participants. We conclude that more research is needed to better understand why autistic learners are absent and what they need to thrive in school.
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Affiliation(s)
- Viviann Nordin
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Maud Palmgren
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anna Lindbladh
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Ulf Jonsson
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
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Di Vincenzo C, Pontillo M, Bellantoni D, Di Luzio M, Lala MR, Villa M, Demaria F, Vicari S. School refusal behavior in children and adolescents: a five-year narrative review of clinical significance and psychopathological profiles. Ital J Pediatr 2024; 50:107. [PMID: 38816858 PMCID: PMC11141005 DOI: 10.1186/s13052-024-01667-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 04/28/2024] [Indexed: 06/01/2024] Open
Abstract
The aim of the study was to explore the clinical significance of school refusal behavior, its negative impact on psychological well-being of children and adolescents and its relationship with the most common psychopathological conditions during childhood and adolescence (e.g. neurodevelopmental disorders, psychiatric disorders). School refusal behavior refers to a distressing condition experienced by children and adolescents that compromise regular school attendance and determine negative consequences on mental health and adaptive functioning. A narrative review of the literature published between January 2019 and March 2023 was conducted. Ten studies (n = 10) were included from a literature search of the electronic databases PubMed, CINAHL, PsycInfo, MedLine, and Cochrane Library. The results indicate that school refusal is highly present in neurodevelopmental disorders such as autism and attention-deficit/hyperactivity disorder due to the presence of behavioral problems and deficits in communication skills. As for psychiatric disorders, school refusal appears to be highly common in anxiety disorders, depressive disorders, and somatic symptoms. We also found that school refusal behavior may be associated with various emotional and behavioral conditions that act as risk factors. Especially, but are not limited to, it may be associated with a diminished self-concept, exposure to cyberbullying, specific affective profiles and excessive technology usage. Our results indicate that school refusal is a condition with many clinical facets. It can be attributed to both vulnerability factors, both temperamental and relational, and to various psychopathological conditions that differ significantly from each other, such as neurodevelopmental disorders and psychiatric disorders. Recognizing these aspects can improve the implementation of patient-tailored therapeutic interventions that are consequently more likely to produce effective outcomes. The therapeutic intervention should facilitate the recognition of cognitive biases regarding school as a threatening environment, while regulating negative emotions associated with school attendance. Additionally, therapeutic intervention programs linked to social skill training and problem-solving training, conducted directly within the school setting, can enhance children's abilities to cope with academic performance and social relationships, ultimately preventing school refusal.
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Affiliation(s)
- Cristina Di Vincenzo
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, 00165, Italy.
| | - Maria Pontillo
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, 00165, Italy
| | - Domenica Bellantoni
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, 00165, Italy
| | - Michelangelo Di Luzio
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, 00165, Italy
| | - Maria Rosaria Lala
- Department of Life Sciences and Public Health, University Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Marianna Villa
- Department of Life Sciences and Public Health, University Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Francesco Demaria
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, 00165, Italy
| | - Stefano Vicari
- Child & Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, 00165, Italy
- Department of Life Sciences and Public Health, University Cattolica del Sacro Cuore, Rome, 00168, Italy
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Cleary M, West S, McLean L, Johnston-Devin C, Kornhaber R, Hungerford C. When the Education System and Autism Collide: An Australian Qualitative Study Exploring School Exclusion and the Impact on Parent Mental Health. Issues Ment Health Nurs 2024; 45:468-476. [PMID: 38593464 DOI: 10.1080/01612840.2024.2328251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Autistic students experience elevated rates of school exclusion, whether this be through expulsion, suspension, informal suspension, refusal of enrolment, or school refusal. This exclusion can come about from a range of factors, including sensory or cognitive overload, a lack of training in neurodiversity for teachers, an absent sense of safety by the student at school, or poor attitudes towards the inclusion of autistic students in schools. The impacts of this exclusion on parents can be logistical, financial, and psychological, with a range of mental health outcomes. This Australian qualitative study presents case studies of seven parents of autistic students, as well as four themes that capture the recommendations of parents to address school exclusion. The findings demonstrate that parents experience stress in finding a suitable school for their child, working with staff to meet the needs of the child, and attempting to maintain employment and other commitments when the child experiences exclusion. Parents recommend greater acceptance of autism by education systems, better communication and use of neuro-affirming language, the option for flexible learning, and individualised support by the school for the student.
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Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Sydney, New South Wales, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Sydney, New South Wales, Australia
| | - Loyola McLean
- Dip Psychodynamic Psychotherapy, Cert ATP, Accredited AAI Coder and Trainer. Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Psychotherapy Program for Complex Traumatic Disorders, Western Sydney Local Health District, Parramatta, New South Wales, Australia
- Western Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Consultation-Liaison Psychiatry, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Colleen Johnston-Devin
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Brisbane, Queensland, Australia
| | - Rachel Kornhaber
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Sydney, New South Wales, Australia
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Thorell LB, Klint Carlander AK, Demetry Y, Marainen L, Nilsson S, Skoglund C. Parental Experiences of Distance Learning in Families with and without an Adolescent with ADHD/ASD: A Large Qualitative Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:388. [PMID: 38673301 PMCID: PMC11049798 DOI: 10.3390/ijerph21040388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024]
Abstract
One of the greatest COVID-19-related challenges for children and their families was managing distance learning due to school closures. We also know from previous research that families with a child with a neurodevelopmental disorder such as ADHD or ASD were struggling more than others but also experienced some positive effects. However, few qualitative studies have been conducted. The present study therefore aimed to investigate parental experiences of the negative and positive effects of distance learning during the COVID-19 pandemic in a large sample of families with an adolescent with ADHD and/or ASD and a matched comparison group (n = 682). Data were collected through open-ended questions as part of a larger survey study. Five main themes with different sub-themes were identified for both negative and positive effects: (1) Teaching, (2) Social, (3) Support, (4) Child factors, and (5) Home environment. In addition, the main theme "Technical problems" was identified for negative effects. Families with a child with ADHD/ASD reported negative effects related to "Child factors" and "Support" more frequently than the controls, as well as negative effects related to some aspects of "Teaching" and "Technical problems". Regarding positive effects, significant group differences were primarily found for the theme "Child factors". These findings are discussed both in terms of how to best prepare for possible future pandemics, but also of how to best provide educational support for children with ADHD and/or ASD when schools are open.
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Affiliation(s)
- Lisa B. Thorell
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
| | | | - Youstina Demetry
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Lisa Marainen
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Sarah Nilsson
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Charlotte Skoglund
- Department of Women and Child Health, Uppsala University, 75124 Uppsala, Sweden
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Ambrose K, Simpson K, Adams D. Using Q-sort method to explore autistic students' views of the impacts of their anxiety at school. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241231607. [PMID: 38390716 DOI: 10.1177/13623613241231607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
LAY ABSTRACT Many autistic students experience anxiety, but there is little research that explores how anxiety might affect autistic students in the school environment. In this study, 45 autistic students, aged 7 to 17 years, completed an online sorting activity to tell us how anxiety impacts them at school. The students were given 21 statements about possible social and academic effects of anxiety (for example, 'When I'm worried it's hard to start my schoolwork' or 'When I'm worried I talk less to my friends or other students'), and sorted them based on how much they agreed each statement was true for them. The three statements most highly rated as being impacted by anxiety were difficulties related to schoolwork. By comparing the information provided by students, six smaller groups of students were identified who sorted the statements in a similar order. These groups show that anxiety affects different autistic students in different ways, including missing school or activities, communicating less with friends and teachers and finding it harder to complete schoolwork. This online sorting activity enabled autistic students themselves to report how anxiety affects them at school. The results suggest that it is important to provide individualised support for autistic students who experience anxiety at school, to reduce the impact of their anxiety on their participation, communication and interactions, and schoolwork. Further research about the effects of anxiety on the academic outcomes of autistic students is also needed.
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Affiliation(s)
- Kathryn Ambrose
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Kate Simpson
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Dawn Adams
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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Li B, Heyne D, Scheeren A, Blijd-Hoogewys E, Rieffe C. School participation of autistic youths: The influence of youth, family and school factors. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613231225490. [PMID: 38311864 DOI: 10.1177/13623613231225490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
LAY ABSTRACT School-aged youths have a basic human right to participate in educational and recreational activities at school. Yet, autistic youths are at high risk of being excluded from school and from school-based activities. It is important to understand how this occurs, to ensure that all autistic youths have opportunities to participate in school activities that are equal to the opportunities of their non-autistic peers. The present study investigated multiple influences on the school participation of autistic youths, including youth factors (age and autistic traits), family factors (parent education level and parental self-efficacy for supporting their child's schoolwork) and school factors (the impact of problems autistic youths experienced with the physical and social environments of school). Using an online survey, we gathered the views and experiences of the parents of 200 autistic youths aged between 4 and 16 years, in the Netherlands. We found that among the factors, only the impact of problems that autistic youths experienced with the physical environment of school was associated with their school participation. In particular, autistic youths who experienced greater difficulties with the physical environment of school had lower levels of school participation. Our findings highlight the pressing need to modify school environments to better accommodate the needs of autistic youths so that they can participate easily and comfortably.
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Affiliation(s)
- Boya Li
- Leiden University, The Netherlands
- Delft University of Technology, The Netherlands
| | | | | | | | - Carolien Rieffe
- Leiden University, The Netherlands
- University of Twente, The Netherlands
- University College London, UK
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Haque UM, Kabir E, Khanam R. Investigating school absenteeism and refusal among Australian children and adolescents using Apriori association rule mining. Sci Rep 2024; 14:1907. [PMID: 38253599 PMCID: PMC10803378 DOI: 10.1038/s41598-024-51230-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
Identifying and determining the multitude of reasons behind school absences of students is often challenging. This study aims to uncover the hidden reasons for school absence in children and adolescents. The analysis is conducted on a national survey that includes 2967 Australian children and adolescents aged 11-17. The Apriori association rule generator of machine learning techniques and binary logistic regression are used to identify the significant predictors of school absences. Out of 2484, 83.7% (n = 2079) aged (11-17) years children and adolescents have missed school for various reasons, 42.28% (n = 879) are (11-15) years old, 24.52% (n = 609) and 16.9% (n = 420) are 16- and 17-years old adolescents respectively. A considerable proportion of adolescents, specifically 16.4% (n = 407) and 23.4% (n = 486) of 16 and 17 years old, respectively, have selected 'refused to say' as their reason for not attending school. It also highlights the negative outcomes associated with undisclosed reasons for school absence, such as bullying, excessive internet/gaming, reduced family involvement, suicide attempts, and existential hopelessness. The findings of the national survey underscore the importance of addressing these undisclosed reasons for school absence to improve the overall well-being and educational outcomes of children and adolescents.
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Affiliation(s)
- Umme Marzia Haque
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Australia.
| | - Enamul Kabir
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Australia
| | - Rasheda Khanam
- School of Business, University of Southern Queensland, Toowoomba, Australia
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Azizi M, Imannezhad S, Moradpoor M, Alaghbandian E, Saeidi P, Sobhani M, Maleki MM, Jahangiri S, Shojaei B, Mohammadi Y. Increasing the tolerance of mothers with children with autism: the effectiveness of cognitive therapy based on mindfulness - experimental research. Ann Med Surg (Lond) 2024; 86:207-211. [PMID: 38222757 PMCID: PMC10783297 DOI: 10.1097/ms9.0000000000001525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/09/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction and importance Autism spectrum disorder significantly impacts the life and psychosocial health of the family, resulting in high levels of anxiety, stress, isolation, and indecisiveness among parents. This study aimed to determine the effectiveness of cognitive therapy based on mindfulness in increasing the tolerance of mothers of children with autism. Case presentation The study used a semi-experimental pre-test-post-test design with a control group. The study population comprised mothers referred to autism centers in Tehran. Eighty mothers were randomly divided into two groups, with 40 in each group. The Connor and Davidson Resilience Scale was used to measure the level of tolerance in both groups in the pre-test and post-test stages. The experimental group underwent cognitive therapy group therapy based on mindfulness, comprising eight sessions of 120 min. On the other hand, the control group did not receive any intervention. Clinical discussion The results of the study showed that the tolerance scores of the experimental group significantly increased after the intervention, in both the post-test and follow-up stages. Conclusion Therefore, the results of this research emphasize the importance of using this intervention in increasing the tolerance of mothers of children with autism spectrum disorder and creating new horizons in the clinical interventions of these people.
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Affiliation(s)
- Mojgan Azizi
- Department of Counseling, Tonekabon Branch, Islamic Azad University, Tonekabon
| | - Shima Imannezhad
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad
| | | | | | - Parisa Saeidi
- Department of Psychology, Urmia Branch, Islamic Azad University, Urmia
| | | | - Mohammad Mehdi Maleki
- Department of Nursing, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz
| | - Shima Jahangiri
- Department of Psychology, Kermanshah Branch, Islamic Azad University, Kermanshah
| | - Behnaz Shojaei
- Midwifery Department, Faculty of Nursing and Midwifery, Kerman Branch, Islamic Azad University, Kerman
| | - Yasaman Mohammadi
- School of Dentistry, Shiraz Branch, Islamic Azad University, Shiraz, Iran
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Cleary M, West S, Johnston-Devin C, Kornhaber R, McLean L, Hungerford C. Collateral Damage: The Impacts of School Exclusion on the Mental Health of Parents Caring for Autistic Children. Issues Ment Health Nurs 2024; 45:3-8. [PMID: 38190434 DOI: 10.1080/01612840.2023.2280718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Despite legislative and policy mechanisms that promote inclusion in education for children with disabilities, many students still experience exclusion from the education setting. For example, autistic children are more likely than their neurotypical counterparts to be expelled or suspended from school or to refuse to attend school on an ongoing basis. This situation gives rise to various challenges for their parents. This discursive paper synthesizes current knowledge on school exclusion involving autistic children, including the causes and consequences of exclusionary practices. The paper also considers the negative impacts of these exclusionary practices on the emotional and psychological well-being of parents and caregivers. Mental health nurses who understand the issues related to school exclusion can better support the educational, social, and developmental needs of autistic children and the mental health needs of parents or caregivers.
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Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Sydney, NSW, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Sydney, NSW, Australia
| | | | - Rachel Kornhaber
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, NSW, Australia
| | - Loyola McLean
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Westmead Psychotherapy Program for Complex Traumatic Disorders, Western Sydney Local Health District, Parramatta, NSW, Australia
- Western Clinical School, The University of Sydney, Sydney, NSW, Australia
- Consultation-Liaison Psychiatry, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia
| | - Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Sydney, NSW, Australia
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Melvin GA, Freeman M, Ashford LJ, Hastings RP, Heyne D, Tonge BJ, Bailey T, Totsika V, Gray KM. Types and correlates of school absenteeism among students with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:375-386. [PMID: 36744441 DOI: 10.1111/jir.13011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/24/2022] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND It appears that students with intellectual disability (ID) are more frequently absent from school compared with students without ID. The objective of the current study was to estimate the frequency of absence among students with ID and the reasons for absence. Potential reasons included the attendance problems referred to as school refusal, where absence is related to emotional distress; truancy, where absence is concealed from parents; school exclusion, where absence is instigated by the school; and school withdrawal, where absence is initiated by parents. METHODS Study participants were 629 parents (84.6% mothers) of Australian school students (Mage = 11.18 years; 1.8% Aboriginal and/or Torres Strait Islander) with an ID. Participants completed a questionnaire battery that included the School Non-Attendance ChecKlist via which parents indicated the reason their child was absent for each day or half-day absence their child had over the past 20 school days. The absence data presented to parents had been retrieved from school records. RESULTS Across all students, absence occurred on 7.9% of the past 20 school days. In terms of school attendance problems as defined in existing literature, school withdrawal accounted for 11.1% of absences and school refusal for 5.3% of absences. Students were also absent for other reasons, most commonly illness (32.0%) and appointments (24.2%). Of students with more than one absence (n = 217; 34.5%), about half were absent for more than one reason. Students attending mainstream schools had lower attendance than those attending special schools. CONCLUSIONS Students with ID were absent for a range of reasons and often for multiple reasons. There were elevated rates of school withdrawal and school refusal. Understanding the reasons for absenteeism can inform targeted prevention and intervention supports.
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Affiliation(s)
- G A Melvin
- School of Psychology, Deakin University, Burwood, Australia
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - M Freeman
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
| | - L J Ashford
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Hawthorn, Australia
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
| | - D Heyne
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - B J Tonge
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
| | - T Bailey
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - V Totsika
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
- Division of Psychiatry, University College London, London, UK
| | - K M Gray
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry & Psychology, Monash University, Clayton, Australia
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Kouroupa A, Allard A, Gray K, Hastings RP, Heyne D, Melvin GA, Tonge B, Totsika V. The association between home learning during COVID-19 lockdowns and subsequent school attendance among children with neurodevelopmental conditions. Child Care Health Dev 2023. [PMID: 36898964 DOI: 10.1111/cch.13113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/23/2023] [Accepted: 03/03/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND Children with neurodevelopmental conditions have high levels of school absence. During the COVID-19 pandemic, schools closed for many students. The relationship between home learning during school closures and subsequent school attendance requires attention to better understand the impact of pandemic education policy decisions on this population. This study aims to investigate the association between home learning, hybrid learning and school learning during school closures (in January-March 2021) with subsequent school attendance (in May 2021) in children with neurodevelopmental conditions. METHODS An online survey was completed by 809 parents/carers of 5- to 15-year-old autistic children and/or children with intellectual disability. Regression models examined the association of learning location during school closures with subsequent school absence (i.e., total days missed, persistent absence and school refusal). RESULTS Children who were learning from home during school closures later missed 4.6 days of a possible 19. Children in hybrid and school learning missed 2.4 and 1.6 school days, respectively. The rates of school absence and persistent absence were significantly higher in the home learning group even after adjusting for confounders. Learning location was not associated with subsequent school refusal. CONCLUSIONS Policies for school closures and learning from home during public health emergencies may exacerbate school attendance problems in this group of vulnerable children.
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Affiliation(s)
| | - Amanda Allard
- Council for Disabled Children, National Children's Bureau, London, UK
| | - Kylie Gray
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Richard P Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - David Heyne
- Developmental and Educational Psychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
| | - Glenn A Melvin
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,School of Psychology, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Bruce Tonge
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Department of Psychiatry, Monash University, Clayton, Victoria, Australia
| | - Vasiliki Totsika
- Division of Psychiatry, University College London, London, UK.,Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK.,Tavistock and Portman NHS Foundation Trust, London, UK
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Gray L, Hill V, Pellicano E. "He's shouting so loud but nobody's hearing him": A multi-informant study of autistic pupils' experiences of school non-attendance and exclusion. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2023; 8:23969415231207816. [PMID: 37860824 PMCID: PMC10583514 DOI: 10.1177/23969415231207816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Background and aims Children and young people on the autism spectrum frequently report a range of negative educational experiences and face disproportionally high rates of school non-attendance, including school avoidance and permanent exclusion, which can have a significant impact on their well-being as well as educational and broader life outcomes. To date, few studies have examined the full range of proximal (child, parent/family, school levels) and distal (community and society levels) barriers to ensuring the school attendance and the inclusion of autistic pupils. The current study sought to do just that by examining autistic young peoples' school non-attendance and exclusion experiences from the perspectives of multiple informants. Methods We recruited 12 autistic pupils, who had previously experienced school avoidance and/or exclusion, from one local authority in England, United Kingdom. We conducted semi-structured interviews with the young people themselves, ten of their parents, eight of their current teachers and nine local authority professionals, including six educational psychologists and three specialist autism teachers. We analyzed interviewees' responses using reflexive thematic analysis. Results Interviewees gave overwhelmingly negative accounts of autistic pupils' school non-attendance and exclusion experiences. Our analysis identified a range of school-related factors they felt led to, or exacerbated, negative experiences in their former mainstream schools, and which ultimately led to their or their children's school non-attendance. It also went further to identify distal factors, including fragmented educational experiences, parents "fighting" against a complex bureaucratic system to secure appropriate education for their children, and limited professional involvement. Conclusions Our findings emphasize the importance of examining the broader context in which autistic pupils are embedded and demonstrate that such pupils are able to successfully attend-and even enjoy-school when they receive the appropriate care and support. Implications Schools and local authority professionals should seek to work in partnership with parents and autistic pupils to secure the necessary support for their inclusion in mainstream education. Government policy should support the provision of sufficient local authority professionals to adopt a more proactive approach to mitigate autistic pupils' avoidance of and exclusion from school.
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Affiliation(s)
- Laura Gray
- Educational Psychology Service, Barnet, UK;
UCL Institute of Education, University College London, London, UK
| | - Vivian Hill
- UCL Institute of Education, University College London, London, UK
| | - Elizabeth Pellicano
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Heyne D. Developmental Issues Associated with Adolescent School Refusal and Cognitive-Behavioral Therapy Manuals. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2022; 50:471-494. [PMID: 35762908 DOI: 10.1024/1422-4917/a000881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
It is important to consider developmental issues when addressing school refusal (SR) in adolescence. Referral rates appear to be higher among adolescents relative to children, and treatment appears to be less effective among adolescents. This paper provides an in-depth review of developmental issues associated with adolescent SR and treatment via cognitive-behavioral therapy (CBT). It begins by considering the reasons for the higher referral and poorer treatment outcomes, including the higher level of absenteeism in adolescence, higher rates of concurrent social anxiety disorder and depressive disorder, and the developmental challenges inherent to adolescence. Such challenges include increased academic and social demands in the secondary-school environment, and increasing autonomy which may contribute to family conflict. These developmental issues may potentiate and exacerbate an adolescent's difficulty attending school, make it difficult for families to cope, and complicate practitioners' efforts to provide effective treatment for SR. Further, the review describes CBT manuals for SR and the extent to which they are developmentally sensitive. There are five CBT manuals, which vary in their sensitivity to developmental issues. Various multimodal treatments employ interventions in addition to CBT, such as medication or inpatient treatment, to address the complexity of SR in adolescence. Nevertheless, nonresponse to treatment for adolescent SR ranges from one-third to two-thirds of youths. Attention thus needs to be given to ways of improving treatment outcomes.
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Affiliation(s)
- David Heyne
- Institute of Psychology, Leiden University, The Netherlands
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