School refusal (SR) signals a young person's difficulty attending school. It jeopardizes their development, often contributes to distress for parents, and places an extra burden on school personnel. ...Reviews of empirical studies indicate that intervention for SR helps to increase school attendance, but not for all youths. This practice-based manuscript aims to support practitioners and organisations addressing the needs of youths and families affected by SR. Specifically, we present 14 signposts for the development and delivery of intervention for SR. The signposts represent important conditions for effective intervention based on key findings from the Knowing What Works project in the Netherlands. During that project, 76 professionals shared their views about the important elements in SR interventions they delivered, and 39 youths and 86 parents shared their views about the helpful elements in SR interventions in which they participated. These 201 stakeholders were variously associated with 21 SR interventions across 9 of the 12 Dutch provinces, most situated in mainstream or special education settings. Their responses informed the development of the 14 signposts presented here, supported by the extant literature on SR intervention. We describe the essence of each signpost and conclude with suggestions for using the signposts and evaluating their utility.
A significant number of children worldwide struggle with school refusal. Games and digital tools represent a novel take on how to address this phenomenon. Our research aims to support children who ...are at risk or in an early phase of developing school refusal through serious games. In this paper we present current work, grounded in human-centered design, involving the application of a game design framework to elaborate on design elements and empirical evaluations of a serious game called Gnist (English: Spark). Based on this we discuss some implications for game design and key takeaways for researchers and practitioners working to design technologies for supporting children's well-being in attending school. We contribute to position serious games in a new context and anticipate our findings to be valuable to the Human-Computer Interaction community in general and specifically to the Child-Computer Interaction community.
Objective: This study aims to elucidate the process by which students with continuous school attendance refusal decide to return to school while attending Free School (an alternative school). ...Methods: Semi-structured interviews were conducted with six children who resumed school after a school attendance refusal, and interview data were analyzed using a modified grounded theory approach. Results: Children with continuous school attendance refusal felt that "it was not optimal to maintain their refusal" while "finding a place in their home," regained self-confidence, and decided to "prepare attending an alternative school and breaking with" the school attendance refusal. When they began attending the school, they felt "the weight of onlookers' gaze," a "difference between them and classmates" and that "the alternative school was not appropriate for them," but "changes in family relationships" occurred. With "the awareness of taking small steps," they "decided to go back to school" being "encouraged to resume school or advance to a higher school year" searching for "the meaning of their school attendance refusal." Conclusions: The findings suggest the importance of understanding the situations in which children gradually gain experience and self-confidence, and assisting them in finding opportunities for personal growth and development.
•School refusal behavior (SRB) is pervasive in students with ASD, aged 9–16 years.•SRB is equally common in primary and secondary students with ASD.•Expressions of SRB differ between primary and ...secondary school students with ASD.•Illness of other family members is associated to SRB in students with ASD.
School refusal behaviour in students with autism spectrum disorder (ASD) is poorly studied despite being considered a serious problem. This study assessed the frequency, duration, and expression of school refusal behaviour in students with ASD, aged 9–16 years, without intellectual disability. Further, the associations between school refusal behaviour and sociodemographic factors were explored. Teachers and parents assessed this behaviour over 20days in a cross-sectional study of 216 students, including 78 students with ASD and 138 typically developing (TD) students. School refusal behaviour was significantly higher in students with ASD as compared to TD students. Significant associations were found between school refusal behaviour and illness of other family members. The study concludes that school refusal behaviour is pervasive in students with ASD.
To guide school practitioners in the identification and intervention of youth with anxious school refusal, this systematic review used an ecological lens to examine the factors that differentiated ...children and adolescents with school refusal from those without. Based on the rigorous protocol from the Center for Reviews and Dissemination's (CRD) internationally recognized guidelines, 15 studies examining 67 different factors were identified. Results reveal 44 individual, social and contextual factors that differentiate youth with school refusal from peers without school refusal. Findings highlight the centrality of anxiety, or anxiety-related symptoms, and diverse learning needs as main points of contrast between youth with school refusal and those without. Implications of an ecological understanding of the factors associated with school refusal for selective and indicative prevention by school and mental health practitioners are discussed.
Reviews of the effectiveness of interventions for school refusal (SR) rely upon well-conducted primary studies. Currently there are no guidelines for those conducting primary studies about the ...measurement of outcome following intervention for SR. Most people would agree that it is important to measure school attendance as an outcome but there has been little discussion about other constructs that warrant measurement. To facilitate this discussion and support the development of guidelines, we conducted a scoping review of constructs measured in studies evaluating intervention for SR. We screened the title and abstract of 3,213 publications found in peer-reviewed journals between 1980 and 2019. After full text review of 271 publications, 50 publications describing 51 studies were included. Results address the frequency with which constructs were measured, along with instruments used, informants, and time-points for measurement. Based on the results, we offer guidelines for choosing constructs to measure following intervention for SR and considerations for how to measure the constructs. Guidelines can increase consistency across primary studies, with benefits for future meta-analyses and international comparisons. They also provide support for practitioners contemplating routine evaluation of their interventions for SR. Ultimately, a core outcome set for SR can be developed.
Background
Anxiety may be associated with poor attendance at school, which can lead to a range of adverse outcomes. We systematically reviewed the evidence for an association between anxiety and poor ...school attendance.
Methods
Seven electronic databases were searched for quantitative studies that reported an estimate of association between anxiety and school attendance. Anxiety had to be assessed via standardised diagnostic measure or validated scale. Articles were screened independently by two reviewers. Meta‐analyses were performed where possible, otherwise results were synthesised narratively.
Results
A total of 4930 articles were screened. Eleven studies from six countries across North America, Europe and Asia, were included. School attendance was categorised into: (a) absenteeism (i.e. total absences), (b) excused/medical absences, (c) unexcused absences/truancy and (d) school refusal. Findings from eight studies suggested associations between truancy and any anxiety disorder, as well as social and generalised anxiety. Results also suggested cross‐sectional associations between school refusal and separation, generalised and social anxiety disorders, as well as simple phobia. Few studies investigated associations with absenteeism or excused/medical absences.
Conclusions
Findings suggest associations between anxiety and unexcused absences/truancy, and school refusal. Clinicians should consider the possibility of anxiety in children and adolescents with poor attendance. However, there is a lack of high quality evidence, little longitudinal research and limited evidence relating to overall absenteeism or excused/medical absences, despite the latter being the most common type of absence. These gaps should be a key priority for future research.
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