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Obsuth I, Madia JE, Murray AL, Thompson I, Daniels H. The impact of school exclusion in childhood on health and well-being outcomes in adulthood: Estimating causal effects using inverse probability of treatment weighting. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2024; 94:460-473. [PMID: 38155360 DOI: 10.1111/bjep.12656] [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] [Received: 02/02/2023] [Accepted: 12/08/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Previous evidence has suggested a strong association between school exclusion and health outcomes. However, as health risks are themselves related to the risk of experiencing a school exclusion, it has been challenging to determine the extent to which school exclusion impacts later health outcomes, as opposed to reflecting a marker for pre-existing risks. AIM The aim of the current study was to address this challenge in estimating the medium-to-long-term impact of school exclusion of health and well-being outcomes. METHODS To this end, we used an inverse propensity weighting approach in the Next Steps data set (N = 6534, from wave 1, 2014, to wave 8, 2015). RESULTS We found that after weighting for propensity of treatment scores estimated based on a wide range of factors, including previous health indicators, there was a significant effect of school exclusion on a wide range of health and well-being outcomes. DISCUSSION These results provide some of the most robust evidence to date that school exclusion harms long-term health outcomes. CONCLUSION The findings suggest that policies should aim to reduce exclusion and ensure access to preventative health support for those who experience a school exclusion.
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Affiliation(s)
- Ingrid Obsuth
- Clinical and Health Psychology, University of Edinburgh, Edinburgh, UK
| | - Joan E Madia
- Department of Sociology, Nuffield College, University of Oxford, Oxford, UK
| | - Aja L Murray
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ian Thompson
- Department of Education, University of Oxford, Oxford, UK
| | - Harry Daniels
- Department of Education, University of Oxford, Oxford, UK
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2
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Russell AE, Benham-Clarke S, Ford T, Eke H, Price A, Mitchell S, Newlove-Delgado T, Moore D, Janssens A. Educational experiences of young people with ADHD in the UK: Secondary analysis of qualitative data from the CATCh-uS mixed-methods study. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2023; 93:941-959. [PMID: 37227452 DOI: 10.1111/bjep.12613] [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] [Received: 07/13/2022] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity and/or impulsivity. Young people with ADHD have poorer educational and social outcomes than their peers. We aimed to better understand educational experiences of young people with ADHD in the UK, and make actionable recommendations for schools. METHODS In this secondary analysis of qualitative data, we used Thematic Analysis to analyse information relating to experiences of education from 64 young people with ADHD and 28 parents who participated in the Children and adolescents with ADHD in Transition between Children's services and adult Services (CATCh-uS) study. Emerging patterns within and across codes led to organization of the data into themes and subthemes through an iterative process. RESULTS Two main themes were generated. The first described young people's early experiences of education, often within a mainstream setting; we labelled this the problematic provision loop, as this was a negative cycle that was repeated several times for some participants. The second theme described young people's more positive progression through education once they progressed out of the problematic loop. CONCLUSIONS Educational experiences for young people with ADHD are often negative and fraught with complication. Young people with ADHD often found themselves on a more positive trajectory after they were placed in an alternative form of education provision (mainstream or otherwise), or where they were able to study topics that interest them and play to their strengths. We make recommendations that commissioners, local authorities and schools could consider in order to better support those with ADHD.
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Affiliation(s)
| | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Helen Eke
- University of Exeter Faculty of Health and Life Sciences, Exeter, UK
| | - Anna Price
- University of Exeter Faculty of Health and Life Sciences, Exeter, UK
| | - Siobhan Mitchell
- University of Exeter Faculty of Health and Life Sciences, Exeter, UK
| | | | - Darren Moore
- University of Exeter Graduate School of Education, Exeter, UK
| | - Astrid Janssens
- Center for Innovativ Medicinsk Teknologi, University of Southern Denmark, Odense, Denmark
- Center for Research in Partnership with Patients and Relatives, Odense University Hospital, Odense, Denmark
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3
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Pajer K, Pastrana C, Gardner W, Sivakumar A, York A. A scoping review of the Choice and Partnership Approach in child and adolescent mental health services. J Child Health Care 2023; 27:707-720. [PMID: 35422129 DOI: 10.1177/13674935221076215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Child and adolescent mental health (CAMH) problems are prevalent and inefficient mental health (MH) care systems can contribute to poor outcomes. The Choice and Partnership Approach (CAPA) is a MH care delivery model aiming to provide efficient, high-quality care. Although widely used, no CAPA research review exists. We conducted a scoping review to fill this gap. Medline, Embase, and PsycINFO databases were searched from inception to June 2021. Grey Matters and Google were used to search the grey literature. We identified 5322 records. Removal of duplicates left 4720 documents, which were successively screened and data extracted by pairs of co-authors. The final dataset comprised six published and three non-published studies, conducted primarily at CAMH sites in England, Scotland, Australia, or Canada. Each study had multiple research objectives, which we summarized into seven categories. Positive outcomes were reported for most objectives, but attributing causality to CAPA was hampered by research methodology. Observational designs were used in all studies and approaches to analyzing data varied considerably. Research gaps included the lack of healthcare economics studies of CAPA and no assessment of facilitators and barriers. Current research on CAPA provides intriguing findings meriting further investigation. We suggest strategies to improve future studies.
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Affiliation(s)
- Kathleen Pajer
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Carlos Pastrana
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - William Gardner
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- School of Public Health and Epidemiology, University of Ottawa, Ottawa, ON, Canada
| | - Aditi Sivakumar
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Ann York
- Children and Young People's Mental Health Young People's Mental Health (Clinical Advisor), Healthy London Partnership, London, UK
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4
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Panayiotou M, Finning K, Hennessey A, Ford T, Humphrey N. Longitudinal pathways between emotional difficulties and school absenteeism in middle childhood: Evidence from developmental cascades. Dev Psychopathol 2023; 35:1323-1334. [PMID: 34955109 DOI: 10.1017/s095457942100122x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Emotional difficulties are associated with both authorized and unauthorized school absence, but there has been little longitudinal research and the temporal nature of these associations remains unclear. This study presents three-wave random-intercepts panel models of longitudinal reciprocal relationships between teacher-reported emotional difficulties and authorized and unauthorized school absence in 2,542 English children aged 6 to 9 years old at baseline, who were followed-up annually. Minor differences in the stability effects were observed between genders but only for the authorized absence model. Across all time points, children with greater emotional difficulties had more absences, and vice versa (authorized: ρ = .23-.29, p < .01; unauthorized: ρ = .28, p < .01). At the within-person level, concurrent associations showed that emotional difficulties were associated with greater authorized (β = .15-.17, p < .01) absence at Time 3 only, but with less unauthorized (β = -.08-.13, p < .05) absence at Times 1 and 2. In cross-lagged pathways, neither authorized nor unauthorized absence predicted later emotional difficulties, and emotional difficulties did not predict later authorized absence at any time point. However, greater emotional difficulties were associated with fewer unauthorized absences across time (β = -13-.22, p < .001). The implications of these findings are discussed.
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Affiliation(s)
| | | | | | | | - Neil Humphrey
- University of Manchester, Manchester Institute of Education, Manchester, UK
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5
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Lawson C, Prentice K, Jennings J, Johnston K. First steps towards a mental health and neurodevelopmental screening of secondary school children following two fixed-term school exclusions in the UK. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2022. [DOI: 10.1080/13632752.2022.2141871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Caron Lawson
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
| | - Kate Prentice
- Adolescent At-Risk & Forensic Service, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Janine Jennings
- Adolescent At-Risk & Forensic Service, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kate Johnston
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
- Adolescent At-Risk & Forensic Service, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, UK
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6
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Finning K, White J, Toth K, Golden S, Melendez-Torres GJ, Ford T. Longer-term effects of school-based counselling in UK primary schools. Eur Child Adolesc Psychiatry 2022; 31:1591-1599. [PMID: 33990854 PMCID: PMC8121011 DOI: 10.1007/s00787-021-01802-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/09/2021] [Indexed: 11/01/2022]
Abstract
Children's mental health is deteriorating while access to child and adolescent mental health services is decreasing. Recent UK policy has focused on schools as a setting for the provision of mental health services, and counselling is the most common type of school-based mental health provision. This study examined the longer-term effectiveness of one-to-one school-based counselling delivered to children in UK primary schools. Data were drawn from a sample of children who received school-based counselling in the UK in the 2015/16 academic year, delivered by a national charitable organisation. Mental health was assessed at baseline, immediately post-intervention, and approximately 1 year post-intervention, using the Strengths and Difficulties Questionnaire (SDQ) completed by teachers and parents. Paired t tests compared post-intervention and follow-up SDQ total difficulties scores with baseline values. Propensity score matching was then used to identify a comparator group of children from a national population survey, and linear mixed effects models compared trajectories of SDQ scores in the two groups. In the intervention group, teacher and parent SDQ total difficulties scores were lower at post-intervention and longer-term follow-up compared to baseline (teacher: baseline 14.42 (SD 7.18); post-intervention 11.09 (6.93), t(739) = 13.78, p < 0.001; follow-up 11.27 (7.27), t(739) = 11.92, p < 0.001; parent: baseline 15.64 (6.49); post-intervention 11.90 (6.78), t(361 = 11.29, p < 0.001); follow-up 11.32 (7.19), t(361) = 11.29, p < 0.001). The reduction in SDQ scores was greater in the intervention compared to the comparator group (likelihood ratio test comparing models with time only versus time plus group-by-time interaction: χ2 (3) = 24.09, p < 0.001), and model-predicted SDQ scores were lower in the intervention than comparator group for 2 years post-baseline. A one-to-one counselling intervention delivered to children in UK primary schools predicted improvements in mental health that were maintained over a 2 year follow-up period.
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Affiliation(s)
- Katie Finning
- University of Exeter College of Medicine and Health, Exeter, UK.
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7
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Toth K, Cross L, Golden S, Ford T. From a child who IS a problem to a child who HAS a problem: fixed period school exclusions and mental health outcomes from routine outcome monitoring among children and young people attending school counselling. Child Adolesc Ment Health 2022; 28:277-286. [PMID: 35506339 DOI: 10.1111/camh.12564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Exclusion from school is a disciplinary tool with an increasingly recognised relationship to poor mental health among children and young people. We explored the relationship between mental health and school exclusion for a cohort of children and young people receiving one to one counselling. METHOD We analysed routinely collected data from a diverse UK sample of children and young people aged between four and 16 years old and receiving school-based counselling (n = 6712 students from 308 primary and 61 secondary schools). Fixed period school exclusion rates (number of sessions) were compared between the academic year before and the academic year in which the child attended counselling. Mental health (Strengths and Difficulties Questionnaire) was compared at baseline and at the end of the intervention (after between 16-22 counselling sessions depending on the phase of education). RESULTS Despite more complex and severe initial difficulties, and facing greater adversity, children and young people who experienced school exclusion prior to counselling demonstrated a significant reduction in subsequent sessions of school exclusion in the academic year that the counselling took place (from two full school weeks to half a school week). Moreover, over 74% of the students had fewer reported exclusions and more than half (56.14%) did not have any further subsequent exclusions. They also had better mental health measured by the teacher reported SDQ (pre-intervention M = 18.94, SD = 6.83 vs. postintervention M = 15.67, SD = 7.56, t(310) = 8.23, p < .001) or by the parents (pre-intervention M = 18.09, SD = 6.42 vs. postintervention M = 14.0, SD = 6.99, t(171) = 7.71, p < .001). CONCLUSIONS School-based mental health interventions may positively influence educational engagement as well as mental health. Providers should, therefore, monitor both to explore the impact of their interventions. The identification of poor mental health may alter staff perceptions and management of challenging pupils, which future studies should explore.
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Affiliation(s)
| | - Lauren Cross
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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8
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Balvardi S, Rahbari N, Jolicoeur-Martineau A, Rudy L, Arnovitz M, Laplante DP, Brown M, Habib P, Zelkowitz P, Guzder J, Wazana AD. Effectiveness and Predictors of Outcomes in a Psychiatric Day Treatment Program for Elementary-Age. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:268-279. [PMID: 33715475 PMCID: PMC9099084 DOI: 10.1177/07067437211000627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In this study, we aimed to (1) assess the effectiveness of an intensive multimodal day treatment program in improving externalizing problems and function in elementary-age children and (2) examine 3 predictors of the treatment outcome (i.e., family functioning, baseline severity, and comorbid disorders). METHODS The sample included 261 children (80.9% boys) between ages of 5 and 12. A retrospective chart review, from 2013 to 2018, and a prospective chart review, from 2018 to 2019, were conducted to extract all relevant data for the present study. Parents and teachers provided reports on children's externalizing problems (i.e., aggressive behavior, attention problems, and rule-breaking behavior) and their level of function across different domains. The level of family functioning was also reported by parents, while clinicians assessed children's severity of disturbance and their diagnoses at intake. RESULTS Based on both parents' and teachers' reports, children showed significant improvement in their externalizing problems. Moreover, children showed functional improvement at home, at school, with peers, and in hobbies by the end of the program. Based on teacher's reports, children with lower level of severity showed less improvement in their attention problems, and those with comorbid developmental problems showed less improvement in their aggressive and rule-breaking behaviors. Family functioning did not predict any treatment outcome. CONCLUSION An intensive multimodal day treatment program was effective in reducing the symptoms of externalizing problems in elementary-age children. However, children with less severe difficulties and comorbid developmental problems showed less improvement in their externalizing problems.
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Affiliation(s)
- Sahar Balvardi
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Noriyeh Rahbari
- Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Alexia Jolicoeur-Martineau
- Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Computer Science, Université de Montréal, Montreal, Quebec, Canada
| | - Lauren Rudy
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | | | - David P Laplante
- Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Maria Brown
- Department of Education, McGill University, Montreal, Quebec, Canada
| | - Paola Habib
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Phyllis Zelkowitz
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Jaswant Guzder
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ashley D Wazana
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
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9
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Allen K, Hansford L, Hayes R, Longdon B, Allwood M, Price A, Byford S, Norwich B, Ford T. Teachers' views on the acceptability and implementation of the Incredible Years ® Teacher Classroom Management programme in English (UK) primary schools from the STARS trial. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2022; 92:1160-1177. [PMID: 35274747 PMCID: PMC9544510 DOI: 10.1111/bjep.12493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/12/2022] [Indexed: 11/29/2022]
Abstract
Background The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may reduce disruptive behaviour in the classroom and improve child and teacher mental health; however, few studies have considered how acceptable TCM is to teachers or what facilitators and barriers there are to its implementation. Aims In this paper we examine the acceptability of the full 6‐day TCM programme and teachers’ perceived barriers and facilitators to implementation in the English (UK) primary school context. Sample Forty‐four English (UK) primary school teachers who attended the TCM programme as part of the STARS trial. Methods We completed focus groups and telephone interviews with participating teachers 2 months after they completed the TCM programme. Thematic analysis was used to examine the data, and a framework approach was applied to organize and summarize themes. Results Teachers liked the structure of the course, the peer group learning environment, delivery methods, and the opportunity to reflect outside the classroom on their practice. They reported that the video clips used lacked cultural relevance and highlighted the importance of group leadership style. Perceived facilitators to implementation included an understanding of the theory underpinning TCM and adaptability of the TCM strategies. Barriers included perceived gaps in the course content in relation to challenging behaviour, applying strategies with older children and the school context within which teachers were working. Conclusion Our findings suggest high levels of acceptability to TCM overall, but also highlight the need for a whole school approach to combat potential barriers to implementation.
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Affiliation(s)
- Kate Allen
- College of Medicine and Health, University of Exeter, UK
| | | | - Rachel Hayes
- College of Medicine and Health, University of Exeter, UK
| | - Bryony Longdon
- College of Medicine and Health, University of Exeter, UK
| | - Matthew Allwood
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Anna Price
- College of Medicine and Health, University of Exeter, UK
| | - Sarah Byford
- King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Brahm Norwich
- Graduate School of Education, University of Exeter, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, UK
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Marraccini ME, Lindsay CA, Griffin D, Greene MJ, Simmons KT, Ingram KM. A Trauma- and Justice, Equity, Diversity, and Inclusion (JEDI)-Informed Approach to Suicide Prevention in School: Black Boys' Lives Matter. SCHOOL PSYCHOLOGY REVIEW 2022; 52:292-315. [PMID: 37484214 PMCID: PMC10358449 DOI: 10.1080/2372966x.2021.2010502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/23/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
Black boys have been dying by suicide at an increasing rate. Although the reasons for this increase are unknown, suicide in Black boys is likely influenced by multiple, intersecting risk factors, including historical and ongoing trauma. Schools can serve as an important mechanism of support for Black boys; however, without intentional anti-racist frameworks that acknowledge how intersecting identities can exacerbate risk for suicide, schools can overlook opportunities for care and perpetuate a cycle of racism that compromises the mental health of Black youth. By recognizing their own implicit biases, modeling anti-racist practices, listening to and recognizing the strengths and diversity of Black youth, and fostering school-family-community partnerships, school psychologists can help transform the school environment to be a safe and culturally affirming place for Black youth. This paper outlines how school psychologists can apply a trauma- and Justice, Equity, Diversity, and Inclusion (JEDI)-informed approach to suicide prevention in order to more holistically support Black boys, disrupt patterns of aggressive disciplinary procedures, and improve school-based suicide prevention programs. By applying this lens across a multitiered systems of support (MTSS) framework, school psychologists can help to prevent the deaths of Black boys and begin to prioritize the lives of Black boys.
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Affiliation(s)
| | | | - Dana Griffin
- School of Education, University of North Carolina at Chapel Hill
| | - Meghan J Greene
- School of Education, University of North Carolina at Chapel Hill
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11
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Fadus MC, Valadez EA, Bryant BE, Garcia AM, Neelon B, Tomko RL, Squeglia LM. Racial Disparities in Elementary School Disciplinary Actions: Findings From the ABCD Study. J Am Acad Child Adolesc Psychiatry 2021; 60:998-1009. [PMID: 33359407 PMCID: PMC8860403 DOI: 10.1016/j.jaac.2020.11.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/09/2020] [Accepted: 11/20/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Detentions and suspensions are common practices of school discipline, despite evidence that they are largely ineffective and disproportionately affect children from racial and ethnic minority backgrounds, particularly Black children, and children of lower socioeconomic status. However, few studies have examined suspension and detention rates among race, ethnicity, and family structure (single parent versus secondary caregiver) when controlling for typical behaviors associated with detention and suspension such as externalizing symptoms, age, sex, family income, family education, family conflict, and special education needs. METHOD Caregivers of 11,875 children between ages 9 and 10 years from the Adolescent Brain Cognitive Development (ABCD) study completed a questionnaire assessing their child's demographics, family information, emotions and behaviors, and past-year school discipline history. Data were analyzed with logistic regression, implemented with a generalized estimating equations model. RESULTS 5.4% of children received a detention or suspension. Controlling for typical predictors of behaviors, Black and multiracial Black children had up to 3.5 times greater odds of receiving a detention or suspension than White children; there were no disciplinary differences for Hispanic or Asian children compared to White children. Children from single-parent households had 1.4 times the odds of receiving detentions or suspensions than children in homes with a secondary caregiver. CONCLUSION Disciplinary actions that can impair typical childhood development, lead to academic failure and dropout, and cause significant emotional and psychological distress disproportionately affect Black children, multiracial Black children, and children from single-parent homes. Racism in elementary school discipline can perpetuate disparities in today's educational system.
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Affiliation(s)
| | | | | | | | - Brian Neelon
- Medical University of South Carolina, Charleston
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12
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Tejerina‐Arreal M, Parker C, Paget A, Henley W, Logan S, Emond A, Ford T. Child and adolescent mental health trajectories in relation to exclusion from school from the Avon Longitudinal Study of Parents and Children. Child Adolesc Ment Health 2020; 25:217-223. [PMID: 32516500 PMCID: PMC7687195 DOI: 10.1111/camh.12367] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 12/05/2022]
Abstract
BACKGROUND As the prevalence of childhood mental health conditions varies by age and gender, we explored whether there were similar variations in the relationship between psychopathology and exclusion from school in a prospective UK population-based birth cohort. METHOD The Avon Longitudinal Study of Parents and Children collected reports of exclusion at 8 years and 16 years. Mental health was assessed at repeated time points using the Strengths and Difficulties Questionnaire (SDQ). RESULTS Using adjusted linear mixed effects models, we detected a nonlinear interaction between exclusion and age related to poor mental health for boys [adjusted coefficient 1.13 (95% confidence interval 0.55-1.71)] excluded by age 8, but not for girls. The SDQ scores of boys who were excluded in primary school were higher than their peers from age 3, and increasingly diverged over time. As teenagers, these interactions appeared for both genders [boys' adjusted coefficient 0.18 (0.10-0.27); girls 0.29 (0.17-0.40)]. For teenage girls, exclusion by 16 was followed by deteriorating mental health. Family adversity predicted exclusion in all analyses. CONCLUSION Prompt access to effective intervention for children in poor mental health may improve both mental health and access to education. KEY PRACTITIONER MESSAGE Children who were subsequently excluded from school often faced family adversity and had poor mental health, which suggests the need for an interdisciplinary response and a multiagency approach. Poor mental health may contribute to and result from exclusion from school, so both mental health and education practitioners have a key role to play. Boys who enter school with poor mental health are at high risk of exclusion in primary school, which prompt assessment and intervention may prevent. Both boys and girls who are excluded between the ages of 15 and 16 years may have poor, and in the case of girls, deteriorating, mental health.
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Affiliation(s)
| | - Claire Parker
- College of Medicine and HealthUniversity of ExeterExeterUK
| | | | - William Henley
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Stuart Logan
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Alan Emond
- Bristol Medical SchoolUniversity of BristolBristolUK
| | - Tamsin Ford
- Department of PsychiatryUniversity of CambridgeCambridgeUK
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13
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May F, Ford T, Janssens A, Newlove-Delgado T, Emma Russell A, Salim J, Ukoumunne OC, Hayes R. Attainment, attendance, and school difficulties in UK primary schoolchildren with probable ADHD. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2020; 91:442-462. [PMID: 32740914 DOI: 10.1111/bjep.12375] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/08/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Among children aged 6-16, there is a clear association between attention-deficit/hyperactivity disorder (ADHD) symptoms and academic attainment. We wanted to know whether this association was replicated in younger children. AIMS To explore the relationship between children aged 4-8 with probable ADHD and their academic attainment and school attendance. Secondly, the study aimed to explore their behaviour within school and their reported attitudes towards school. SAMPLE A total of 1,152 children who were taking part in the Supporting Teachers and Children in Schools (STARS) cluster randomized controlled trial. METHODS ADHD status was established by using the Strengths and Difficulties Questionnaire predictive algorithm to identify children with probable ADHD. Using baseline data, random-effects regression models on ADHD status were fitted to attainment, attendance, special educational needs (SEN) provision, and attitudes towards school and classroom behaviour; models that were also fitted to attainment were evaluated again at 9, 18, and 30 months after baseline. RESULTS Children with probable ADHD (n = 47) were more likely than controls (n = 1,105) to have below-expected attainment in literacy (odds ratio (OR) 16.7, 95% CI 6.93-to-40.1), numeracy (OR 11.3, 95% CI 5.34-to-24.1) and to be identified as having SEN (OR-55.2, 95%-CI 22.1-to-137). Their attendance was poorer with more unauthorized absences (rate ratio (RR)-1.91, 95%-CI-1.57-to-2.31). They had more teacher-reported behavioural problems (mean difference (MD) 5.0, 95%-CI 4.6-to-5.4) and less positive attitudes towards school (MD -1.1, 95% CI -0.56 to -1.85). Poorer attainment in literacy and numeracy persisted at all follow-ups. CONCLUSIONS Children aged as young as 4 whose behaviour indicates probable ADHD struggle to cope at school in terms of academic attainment, attendance, classroom behaviour, and attitude towards school when compared to other children. Early identification and intervention to help these children manage in school are needed.
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Affiliation(s)
- Felix May
- Exeter Medical School, University of Exeter, UK
| | - Tamsin Ford
- Department of Psychiatry, Child and Adolescent Psychiatry, Cambridge, UK
| | - Astrid Janssens
- Department of Public Health, University of Southern Denmark, Odense C, Denmark.,University of Exeter Medical School, UK
| | - Tamsin Newlove-Delgado
- Child Mental Health Research Group, Institute of Health Research, College of Medicine and Health, Exeter, UK
| | - Abigail Emma Russell
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol Medical School, UK
| | - Javid Salim
- Exeter Medical School, University of Exeter, UK
| | | | - Rachel Hayes
- Child Mental Health Research Group, Institute of Health Research, College of Medicine and Health, Exeter, UK
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Toth K, Samad L, Golden S, Johnston P, Hayes R, Ford T. What issues bring primary school children to counselling? A service evaluation of presenting issues across 291 schools working with Place2Be. COUNSELLING & PSYCHOTHERAPY RESEARCH 2020. [DOI: 10.1002/capr.12333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | | | - Rachel Hayes
- Institute of Health Research University of Exeter Medical School Exeter UK
| | - Tamsin Ford
- Department of Psychiatry University of Cambridge Cambridge UK
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15
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Finning K, Ford T, Moore DA, Ukoumunne OC. Emotional disorder and absence from school: findings from the 2004 British Child and Adolescent Mental Health Survey. Eur Child Adolesc Psychiatry 2020; 29:187-198. [PMID: 31054124 PMCID: PMC7024694 DOI: 10.1007/s00787-019-01342-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/19/2019] [Indexed: 12/22/2022]
Abstract
Emotional disorder may be associated with absence from school, but the existing evidence is methodologically weak. We studied the relationships between anxiety, depression and emotional difficulties, and school absence (total, authorised and unauthorised) using data from the 2004 British Child and Adolescent Mental Health Survey (BCAMHS). The BCAMHS was a cross-sectional, community survey of 7977 5- to 16-year-olds. Emotional disorder was assessed using the Development and Wellbeing Assessment (DAWBA), and emotional difficulties using the Strengths and Difficulties Questionnaire (SDQ) completed by teachers and parents. Teachers reported days absent in the previous school term. Multivariable negative binomial regression was used to examine the impact of emotional disorder and difficulties on absence. Age, gender and general health were explored as moderators. Anxiety, depression and emotional difficulties were associated with higher rates of all types of absence [rate ratios for total absence: anxiety 1.69 (1.39-2.06) p < 0.001; depression 3.40 (2.46-4.69) p < 0.001; parent-reported emotional difficulties 1.07 (1.05-1.10) p < 0.001; teacher-reported emotional difficulties 1.10 (1.08-1.13) p < 0.001]. The strongest association was observed for depression and unauthorised absence. Relationships were stronger for secondary compared to primary school children. Health and educational professionals should be aware that children with poor attendance may be experiencing emotional ill health, regardless of absence type. The absence may provide a useful tool to identify those who require additional mental health support. Findings highlight the widespread burden of emotional disorder and the need to support those with emotional ill health in continuing to access education.
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Affiliation(s)
- Katie Finning
- University of Exeter School of Medicine and Health, College House, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Tamsin Ford
- University of Exeter School of Medicine and Health, College House, St Luke's Campus, Exeter, EX1 2LU, UK
| | - Darren A Moore
- Graduate School of Education, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Obioha C Ukoumunne
- School of Medicine and Health, University of Exeter, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK
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