"He's shouting so loud but nobody's hearing him": A multi-informant study of autistic pupils' experiences of school non-attendance and exclusion

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.

[Inpatient Schema Therapy for School Avoidance - A Case Study]

Inpatient Schema Therapy for School Avoidance - A Case Study Abstract. After a short overview of the basic concepts and methods of schema therapy, we report a case study on the inpatient treatment of a 16-year-old youth with depression and chronic school avoidance. The scores on the Schema inventories and Depression questionnaires are compared before vs. after the treatment, and we then discuss the opportunities and limitations of schema therapy with school-avoiding youths.

[Course of School Absenteeism 1.5-3 Years After Initial Evaluation: Symptoms, Psychosocial Functioning, and Help-Seeking Behavior]

Course of School Absenteeism 1.5-3 Years After Initial Evaluation: Symptoms, Psychosocial Functioning, and Help-Seeking Behavior Abstract. Objective: To explore the course of patients with school absenteeism 1.5-3 years after their initial evaluation, including symptoms, school attendance, psychosocial functioning, and help-seeking behavior. Method: Of the 237 patients from specialized psychiatric units for youths displaying school absenteeism, we successfully contacted 108 of them 1.5-3 years after initial admission. We conducted a telephone interview with their parents (SDQ, school situation, help-seeking behavior). Among others, we analyzed the extent of school absenteeism, the scales of the Inventory of School Attendance Problems (ISAP; Knollmann et al., 2019), and the quality of school absenteeism (school refusal vs. truancy vs. mixed group) at admission as possible predictors. Results: The patients had received an extensive amount of youth-welfare measures and inpatient, daycare, and outpatient therapy. 46.3 % had elevated values in the SDQ total score at follow-up, mostly because of emotional problems or problems with peers. Psychosocial functioning, including school attendance, was described as poor for only about 30 %. School attendance problems were significantly predicted by having a conduct disorder and elevated scores on the ISAP-scales Aggression, Teacher Problems, and Peer Problems, though the effect sizes were weak. Conclusions: Externalizing symptoms and associated psychosocial problems seem to be predictive of a negative course of school absenteeism. Implications for prospective longitudinal studies are discussed.

Risk Factors for Peer Victimization among Middle and High School Students

Peer victimization at school is a pressing public health issue. Peer victimization has a deleterious impact on the victim and can lead to lifelong negative outcomes such as depression. The purpose of the present study is to examine peer victimization and potential individual, school, and peer correlates in a national sample of middle and high school students. A secondary data analysis of the School Crime and Safety survey was conducted to investigate study aims. Greater than one in 20 (7.2%) of students reported peer victimization at school. Multiple individual factors were found to increase the odds of victimization including grade level, grades received, and school avoidance among other variables. School and peer factors were also found to be significant. Study findings may be useful to school personnel for reducing peer victimization at school. Specific recommendations for school personnel are offered.

Student's Perceptions of School Safety: It Is Not Just About Being Bullied

This study examined the relationship of students' perceptions of school safety and school avoidance related to feeling unsafe with predictor variables: bullying victimization, student/teacher/parent/administration relations, rule clarity and consistency, school physical environment (negative and positive), and student's belongingness. In a public high school sample ( n = 585), 24.7% of students felt unsafe and 14.4% avoided school due to feeling unsafe during the past month. Being female and experiencing bullying was associated with feeling unsafe. However, after accounting for demographics and bullying victimization, perceptions of safety increased when students reported positive student and teacher relations, consistent rules, a clean school that is also crowded/noisy, and a sense of school belonging. Avoiding school because of safety concerns was related to decreased school belonging and teacher/student relationships, but not bullying. Focusing on enhancing the school climate/environment, facilitating student belongingness, and reducing bullying are ways school nurses can help promote safer schools.

[Factors relating to the feeling of school avoidance among elementary school children: Results from the MEXT (Ministry of Education, Culture, Sports, Science and Education) Super Shokuiku School Project]

Purpose　This study aims to evaluate whether lifestyle factors including media use and social and family environments are associated with elementary school children's feeling of school avoidance.Methods　Total study population for this study was 2,057 children in 5 elementary schools in Takaoka city, Toyama prefecture, which participated in the MEXT Super Shokuiku School Project. A questionnaire survey was conducted in July 2014 and 1,936 students responded (Response rate: 94.1%). Of those who responded, data from 1,698 respondents were relevant for this study. The questionnaire included questions on lifestyle factors (e.g., eating habits, media use, exercise habits, and sleep), health status, and the social and family environments. Children responded to questions on lifestyle factors, health status, and feeling of school avoidance with their parents. Parents were asked to only respond to the questions on social and family environments. Logistic regression analysis was performed to evaluate whether the feeling of avoiding school, as the dependent variable, is associated with the independent variables such as social and family environment factors and lifestyle factors. The odds ratios (OR) and their 95% confidence intervals (95%CI) were calculated.Results　The percentage of children who had the feeling of avoiding school was 32.2% in the study sample. In comparison with the 6^th graders, the 1^st, 3^rd, 4^th, and 5^th graders were more likely to have this feeling. Relevant adjusted ORs [95%CI] for Grades 1-5 were found to be 1.48 [1.02-2.13], 1.63 [1.10-2.42], 1.60 [1.08-2.39], and 1.56 [1.03-2.35], respectively. Other factors positively correlated with this feeling were skipping breakfast (OR 1.76, 95%CI [1.12-2.75]), daily snacking (OR 1.64, 95%CI [1.21-2.22]), watching TV for 3 hours or longer (OR 1.55, 95%CI [1.05-2.28]), video gaming for 0.5-2 hours (OR 1.37, 95%CI [1.08-1.74]), feeling sleepy (OR 1.51, 95%CI [1.14-1.99]), not feeling well upon waking up (OR 1.64, 95%CI [1.30-2.06]), being unsatisfied with their own health (OR 1.43, 95%CI [1.10-1.87]), and dislike for playing outside (OR 1.62, 95%CI [1.05-2.52]).Conclusions　This study showed that feeling of school avoidance was significantly correlated with several lifestyle factors. School health activities aiming at establishing desirable lifestyles for children could reduce the number of children who have the feeling of school avoidance.

[The School Refusal Assessment Scale: Psychometric properties and validation of a modified version]

Objective

Psychometric properties of the original and a modified version of the «Einschätzungsskala der Schulverweigerung» (German version of the School Refusal Assessment Scale, SRAS; Kearney & Silverman, 1993; Overmeyer et al., 1994) were analyzed in order to identify alternative ways to revise the SRAS/ESV compared to the existing revision SRAS-R (Kearney, 2002). The SRAS/ESV consists of a parent and a child version and measures four functions of school refusal (avoidance of negative affect related to school settings, escape from aversive social or evaluative situations, attention-getting behavior, positive tangible reinforcement).

Method

Data from N = 124 (parent version) respectively N = 156 (child version) patients of a specialized psychiatric outpatient unit for children and adolescents with school-avoiding behavior were obtained. Analyzes included characteristics of items and scales, face-, factorial-, and construct-validity (correlations with other questionnaires, e. g., YSR, CBCL were analyzed).

Results

Many items seem to measure overall anxiety instead of the functional aspects of school refusal, one item measures expansive behavior. Four factors were obtained, but they did not reflect the assumed structure of the ESV (e. g., overlap of the two avoidance-related scales). Post-hoc-analyzes with a modified version (elimination of several items with problematic content validity) suggested three factors, convergent and discriminative validity of the modified version was confirmed. Because only some of the afore-mentioned problems have been addressed in the revised version (SRAS-R; Kearney, 2002), a new revision and extension of the German version of the questionnaire covering more aspects of school avoidance behavior (e. g., bullying, depression, somatic complaints, psychosocial factors) is discussed.