Sociodemographic and clinical characteristics of youths and parents seeking psychological treatment for school attendance problems
Daniel B Johnsen, Johanne J Lomholt, David Heyne, Pia Jeppesen, Morten B Jensen, Wendy K Silverman, Mikael Thastum, Daniel B Johnsen, Johanne J Lomholt, David Heyne, Pia Jeppesen, Morten B Jensen, Wendy K Silverman, Mikael Thastum
Abstract
Background: Knowledge of school attendance problems (SAPs) is needed to inform treatments targeting SAPs and protecting youths from negative outcomes associated with SAPs.
Objectives: This study examined the school absence, absence categories (i.e., absence due to illness, excused, non-excused), sociodemographic characteristics, and mental health problems among youths seeking psychological treatment for SAPs.
Methods: The study used a cross-sectional design. Sociodemographic and clinical characteristics of 152 help-seeking youths with SAPs (i.e., >10% absenteeism) and their parents were examined. The data were derived from the baseline assessment conducted before treatment start.
Results: Older youths, youths with mental health problems, and youths whose parents had mental health problems exhibited higher levels of absence. Lower levels of non-excused absence were found among youths with highly educated fathers, and youths living with both parents. Many youths had clinical levels of anxiety, depression, or 'emotional and behavioral difficulties'.
Conclusion: The study highlights the need for early intervention, addressing a broad range of mental health problems.
Clinical trial registration: ClinicalTrials.gov: NCT03459677.
Conflict of interest statement
The authors have declared that no competing interests exist.
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References
- Catterall JS. The Societal Benefits and Costs of School Dropout Recovery. Educ Res Int. 2011;2011:1–8.
- Hancock KJ, Shepherd CCJ, Lawrence D, Zubrick SR. Student attendance and educational outcomes: Every day counts. Rep Dep Educ Employ Work Relations, Canberra. 2013;(May).
- Neuzil KM, Hohlbein C, Zhu Y. Illness Among Schoolchildren During Influenza Season. Arch Pediatr Adolesc Med. 2002;156(10):986. doi: 10.1001/archpedi.156.10.986
- Heyne D, Gren-Landell M, Melvin G, Gentle-Genitty C. Differentiation Between School Attendance Problems: Why and How? Cogn Behav Pract [Internet]. 2019;26(1):8–34. Available from: 10.1016/j.cbpra.2018.03.006.
- Kearney CA. Bridging the Gap Among Professionals Who Address Youths With School Absenteeism: Overview and Suggestions for Consensus. 2003;34(1):57–65.
- Kearney CA. An Interdisciplinary Model of School Absenteeism in Youth to Inform Professional Practice and Public Policy. Educ Psychol Rev [Internet]. 2008. Sep 12;20(3):257–82. Available from: .
- Kearney CA, Graczyk PA. A Multidimensional, Multi-tiered System of Supports Model to Promote School Attendance and Address School Absenteeism. Clin Child Fam Psychol Rev [Internet]. 2020;(2). Available from: doi: 10.1007/s10567-020-00317-1
- Gottfried MA, Hutt EL. Addressing Absenteeism: Lessons for Policy and Practice. Policy Anal Calif Educ [Internet]. 2019;(February). Available from: =.
- Department for Education. Pupil absence in schools in England: 2017 to 2018 [Internet]. 2019. Available from: .
- Danish Ministry of Children and Education. Bekendtgørelse om elevers fravær fra undervisningen i folkeskolen [Internet]. Børne- og Undervisningsministeriet; 2019. p. 1–2. Available from: .
- Australian Institute for Teaching and School Leadership (AITSL). Attendance Matters. ASD-S Aware Campaign Broch [Internet]. 2020;20. Available from: .
- U.S. Department of Education. Chronic absenteeism in the nation’s schools: A hidden educational crisis. 2019.
- Kristensen N, Jensen VM, Krassel KF. Panelanalyse af bekymrende skolefravær. 2020.
- Gottfried MA. Excused Versus Unexcused: How Student Absences in Elementary School Affect Academic Achievement. 2009.
- Balfanz R, Herzog L, Mac Iver DJ. Preventing student disengagement and keeping students on the graduation path in urban middle-grades schools: Early identification and effective interventions. Educ Psychol. 2007;42(4):223–35.
- Attwood G, Croll P. Truancy in secondary school pupils: prevalence, trajectories and pupil perspectives. Res Pap Educ [Internet]. 2006;21(4):467–84. Available from: .
- Eaton DK, Brener N, Kann LK. Associations of health risk behaviors with school absenteeism. Does having permission for the absence make a difference?. J Sch Health [Internet]. 2008;78(4):223–9. Available from: . doi: 10.1111/j.1746-1561.2008.00290.x
- Egger HL, Costello EJ, Angold A. School refusal and psychiatric disorders: A community study. J Am Acad Child Adolesc Psychiatry [Internet]. 2003;42(7):797–807. Available from: doi: 10.1097/01.CHI.0000046865.56865.79
- McShane G, Walter G, Rey JM. Characteristics of adolescents with school refusal. Aust N Z J Psychiatry [Internet]. 2001;35(6):822–6. Available from: . doi: 10.1046/j.1440-1614.2001.00955.x
- Marin CE, Anderson T, Lebowitz ER, Silverman WK. Parental Predictors of School Attendance Difficulties in Children Referred to an Anxiety Disorders Clinic. Eur J Educ Psychol. 2019;12(1):31.
- Henry KL. Who’s skipping school: Characteristics of truants in 8th and 10th grade. J Sch Health [Internet]. 2007;77(1):29–35. Available from: . doi: 10.1111/j.1746-1561.2007.00159.x
- Olson LS. Why September Matters: Improving Student Attendance. 2014;4–5. Available from: .
- Schoeneberger JA. Longitudinal Attendance Patterns: Developing High School Dropouts. 2012;7–14.
- Ehrlich SB, Gwynne JA, Allensworth EM. Pre-kindergarten attendance matters: Early chronic absence patterns and relationships to learning outcomes. Early Child Res Q [Internet]. 2018;44:136–51. Available from: 10.1016/j.ecresq.2018.02.012.
- Ingul JM, Nordahl HM. Anxiety as a risk factor for school absenteeism: what differentiates anxious school attenders from non-attenders? Ann Gen Psychiatry [Internet]. 2013;12(1):25. Available from: . doi: 10.1186/1744-859X-12-25
- Melvin GA, Dudley AL, Gordon MS, Klimkeit E, Gullone E, Taffe J, et al.. Augmenting Cognitive Behavior Therapy for School Refusal with Fluoxetine: A Randomized Controlled Trial. Child Psychiatry Hum Dev [Internet]. 2016;1–13. Available from: . doi: 10.1007/s10578-015-0538-y
- Maynard BR, Vaughn MG, Nelson EJ, Salas-Wright CP, Heyne DA, Kremer KP. Truancy in the United States: Examining temporal trends and correlates by race, age, and gender. Child Youth Serv Rev [Internet]. 2017;81(May):188–96. Available from: doi: 10.1016/j.childyouth.2017.08.008
- Keppens G, Spruyt B. Truancy in Europe: Does the type of educational system matter? 2018;2020:414–26.
- Vaughn MG, Maynard BR, Salas-Wright CP, Perron BE, Abdon A. Prevalence and correlates of truancy in the US: Results from a national sample. J Adolesc [Internet]. 2013;36(4):767–76. Available from: doi: 10.1016/j.adolescence.2013.03.015
- Havik T, Bru E, Ertesvåg SK. Assessing Reasons for School Non-attendance. Scand J Educ Res. 2015;59(3):316–36.
- Pflug V, Schneider S. School Absenteeism: An Online Survey via Social Networks. Child Psychiatry Hum Dev. 2016;47(3):417–29. doi: 10.1007/s10578-015-0576-5
- Stone AA, Bachrach CA, Jobe JB, Kurtzman HS, Cain VS. The science of self-report: Implications for research and practice. Psychology Press; 2000.
- Keppens G, Spruyt B, Dockx J. Measuring School Absenteeism: Administrative Attendance Data Collected by Schools Differ From Self-Reports in Systematic Ways. Front Psychol. 2019;10(December):1–10. doi: 10.3389/fpsyg.2019.00001
- Lomholt JJ, Johnsen DB, Silverman WK, Heyne D, Jeppesen P, Thastum M. Feasibility Study of Back2School, a Modular Cognitive Behavioral Intervention for Youth With School Attendance Problems. Front Psychol [Internet]. 2020. Apr 6;11(April):1–15. Available from: . doi: 10.3389/fpsyg.2020.00001
- Heyne D, Sauter FM, Van Widenfelt BM, Vermeiren R, Westenberg PM. School refusal and anxiety in adolescence: Non-randomized trial of a developmentally sensitive cognitive behavioral therapy. J Anxiety Disord [Internet]. 2011;25(7):870–8. Available from: doi: 10.1016/j.janxdis.2011.04.006
- Nayak A, Sangoi B, Nachane H. School Refusal Behavior in Indian Children: Analysis of Clinical Profile, Psychopathology and Development of a Best-Fit Risk Assessment Model. Indian J Pediatr [Internet]. 2018;85(12):1073–8. Available from: doi: 10.1007/s12098-018-2631-2
- Gonzálvez C, Díaz-herrero Á, García-fernández JM. School refusal behavior: Latent class analysis approach and its relationship with psychopathological symptoms. 2020.
- Lomholt JJ, Arendt JN, Bolvig I, Thastum M. Children with School Absenteeism: Comparing Risk Factors Individually and in Domains. Scand J Educ Res [Internet]. 2021;0(0):1–16. Available from: 10.1080/00313831.2020.1869085.
- Reissner V, Jost D, Krahn U, Knollmann M, Weschenfelder AK, Neumann A, et al.. Therapie von Schulvermeidern mit psychiatrischen Erkrankungen: Eine randomisiert-kontrollierte Studie. Dtsch Arztebl Int. 2015;112(39):655–62. doi: 10.3238/arztebl.2015.0655
- Hannan S, Davis E, Morrison S, Gueorguieva R, Tolin DF. An Open Trial of Intensive Cognitive-Behavioral Therapy for School Refusal. Evidence-Based Pract Child Adolesc Ment Heal [Internet]. 2019;0(00):1–13. Available from: 10.1080/23794925.2019.1575706.
- Heyne D, King NJ, Tonge BJ, Rollings S, Sych MP, Young D, et al.. Evaluation of Child Therapy and Caregiver Training in the Treatment of School Refusal. 2002;687–95.
- Thastum M, Johnsen DB, Silverman WK, Jeppesen P, Heyne D, Lomholt JJ. The Back2School modular cognitive behavioral intervention for youths with problematic school absenteeism: study protocol for a randomized controlled trial. 2019;1–12. Available from: .
- Spence S. A measure of anxiety symptoms among children [Internet]. Vol. 36, Behaviour research and therapy. 1998. p. 545–66. Available from: . doi: 10.1016/s0005-7967(98)00034-5
- Arendt K, Hougaard E, Thastum M. Journal of Anxiety Disorders Psychometric properties of the child and parent versions of Spence Children ‘ s Anxiety Scale in a Danish community and clinical sample. J Anxiety Disord [Internet]. 2014;28(8):947–56. Available from: doi: 10.1016/j.janxdis.2014.09.021
- Daviss WB, Birmaher B, Melhem NA, Axelson DA, Michaels SM, Brent DA. Criterion validity of the Mood and Feelings Questionnaire for depressive episodes in clinic and non-clinic subjects. J Child Psychol Psychiatry Allied Discip. 2006. doi: 10.1111/j.1469-7610.2006.01646.x
- Eg J, Bilenberg N, Costello EJ, Wesselhoeft R. Self- and parent-reported depressive symptoms rated by the mood and feelings questionnaire. Psychiatry Res [Internet]. 2018;268(May):419–25. Available from: doi: 10.1016/j.psychres.2018.07.016
- Goodman R. The Strengths and Difficulties Questionnaire: A research note. J Child Psychol Psychiatry. 1997;38:581–6. doi: 10.1111/j.1469-7610.1997.tb01545.x
- Niclasen J, Teasdale TW, Andersen AMN, Skovgaard AM, Elberling H, Obel C. Psychometric properties of the Danish strength and difficulties questionnaire: The SDQ assessed for more than 70,000 raters in four different cohorts. PLoS One. 2012;7(2):1–8. doi: 10.1371/journal.pone.0032025
- Arnfred J, Svendsen K, Rask C, Jeppesen P, Fensbo L, Houmann T, et al.. Danish norms for the Strengths and Difficulties Questionnaire. 2019;66(6):3–9.
- King NJ, Tonge BJ, Heyne D, Pritchard M, Rollings S, Young D, et al.. Cognitive-behavioral treatment of school refusing children: A controlled evaluation. Vol. 37, Journal of the American Academy of Child and Adolescent Psychiatry. 1998. p. 395–403. doi: 10.1097/00004583-199804000-00017
- Danish Ministry of Children and Education. Elevfravær—Skole, Skoletrin [Internet]. 2020. Available from: .
- Ingul JM, Havik T, Heyne D. Emerging School Refusal: A School-Based Framework for Identifying Early Signs and Risk Factors. Cogn Behav Pract [Internet]. 2018; Available from: 10.1016/j.cbpra.2018.03.005.
- Chu BC, Guarino D, Mele C, Connell JO, Coto P. Developing an Online Early Detection System for School Attendance Problems: Results From a Research-Community Partnership. Cogn Behav Pract [Internet]. 2018; Available from: 10.1016/j.cbpra.2018.09.001.
- Gubbels J, van der Put CE, Assink M. Risk Factors for School Absenteeism and Dropout: A Meta-Analytic Review. J Youth Adolesc [Internet]. 2019;48(9):1637–67. Available from: doi: 10.1007/s10964-019-01072-5
- Dalsgaard S, Thorsteinsson E, Trabjerg BB, Schullehner J, Plana-Ripoll O, Brikell I, et al.. Incidence Rates and Cumulative Incidences of the Full Spectrum of Diagnosed Mental Disorders in Childhood and Adolescence. JAMA Psychiatry. 2019;1–10.
- Department for Education. School attendance parental responsibility measures [Internet]. 2015. Available from: .
- De Gregorio J, Lee J. Education and income inequality: new evidence from cross-country data. Rev Income Wealth. 2003;48(3):395–416.
- Heyne D. School Refusal. In: Fisher JE, O’Donohue WT, editors. Practitioner’s Guide to Evidence-Based Psychotherapy [Internet]. Boston, MA: Springer US; 2006. p. 600–19. Available from: .
- Tolin DF, Whiting S, Maltby N, Diefenbach GJ, Lothstein MA, Hardcastle S, et al.. Intensive (Daily) Behavior Therapy for School Refusal: A Multiple Baseline Case Series. Cogn Behav Pract [Internet]. 2009;16(3):332–44. Available from: 10.1016/j.cbpra.2009.02.003.
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