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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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Villadsen A, Cameron C, Evans J, Van Herwegen J, Hill V, Hurry J, Roberts A, Wyse D, Johansen T. Longitudinal association of conduct and emotional problems with school exclusion and truancy: A fixed effect analysis of the UK Millennium Cohort Study. Child Adolesc Ment Health 2023. [PMID: 37942837 DOI: 10.1111/camh.12681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND There is a need for causally stronger research on the association between child mental health and school exclusion and truancy. This study examines school exclusion and truancy in relation to both conduct and emotional problems and considers these problems both as predictors and as outcomes of school exclusion and truancy. METHOD The sample included 15,236 individuals from the Millennium Cohort Study, a UK longitudinal birth cohort study. Conduct and emotional problems were assessed from childhood to adolescence (age 7, 11, 14 and 17 years), and reports of school exclusion and truancy were collected at age 11 and 14. Fixed effect analyses were used. RESULTS Increases in conduct problems and emotional symptoms were associated with subsequent exclusion (OR 1.22, [95% CI 1.08-1.37] and OR 1.16, [1.05-1.29], respectively). Emotional symptoms, but not conduct problems, predicted truancy (OR 1.17, [1.07-1.29]). These estimates were similar for males and females. Exclusion was associated with an increase in conduct problems at age 14 (0.50, [0.30-0.69]), and for males, it was associated with an increase in emotional symptoms both at age 14 (0.39, [0.12-0.65]) and 17 (0.43, [0.14-0.72]). Truancy was associated with an increase in conduct problems at age 14 (0.41, [0.28-0.55]), and for females also at age 17 (0.22, [0.03-0.42]), and it was associated with increased emotional symptoms at age 14 (0.43, [0.25-0.62]) and 17 (0.44, [0.21-0.66]), which was similar for males and females. CONCLUSION Results indicate a bidirectional association between emotional symptoms and school exclusion and truancy, as an increase in these symptoms was associated with later truancy and exclusion, and emotional symptoms increased following both school events. For conduct problems, the association was bidirectional for school exclusion, but unidirectional for truancy as these symptoms did not lead to truancy, but an increase in conduct problems was observed after both exclusion and truancy.
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Affiliation(s)
- Aase Villadsen
- Social Research Institute, University College London, London, UK
| | - Claire Cameron
- Social Research Institute, University College London, London, UK
| | - John Evans
- Social Research Institute, University College London, London, UK
| | - Jo Van Herwegen
- Psychology and Human Development, University College London, London, UK
| | - Vivian Hill
- Psychology and Human Development, University College London, London, UK
| | - Jane Hurry
- Psychology and Human Development, University College London, London, UK
| | - Amelia Roberts
- Psychology and Human Development, University College London, London, UK
| | - Dominic Wyse
- Learning and Leadership, University College London, London, UK
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Valdebenito S, Gaffney H, Jolliffe D. PROTOCOL: School-based interventions for reducing disciplinary school exclusion: An updated systematic review. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1344. [PMID: 37614764 PMCID: PMC10442604 DOI: 10.1002/cl2.1344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
The primary goal of the present mixed methods review is to systematically examine the available evidence for the effectiveness of different types of school-based interventions for reducing disciplinary school exclusion. Quantitative evidence will help to understand the overall size of the impact, as well as the factors that better explain it. Qualitative evidence will help to better understand how these programmes may work, and what factors aid or hinder implementation and success. The research questions underlying the quantitative review are as follows: Do school-based programmes reduce the use of exclusionary sanctions in schools?Are some school-based approaches more effective than others in reducing exclusionary sanctions?Do participants' characteristics (e.g., age, sex, or ethnicity) affect the impact of school-based programmes on exclusionary sanctions in schools?Do characteristics of the interventions, implementation, and methodology affect the impact of school-based programmes on exclusionary sanctions in schools?Do school-based programmes have an impact on reducing the involvement of children and young people in crime and violence?Do participants' characteristics (e.g., age, gender, ethnicity) affect the impact of school-based programmes on crime and violence? If sufficient data are available, we will compare different approaches (e.g., school-wide management, classroom management, restorative justice, cognitive-behavioural interventions) and identify those that could potentially demonstrate larger effects. We will also (potentially) run analysis controlling for characteristics of participants (e.g., age, ethnicity, level of risk); interventions (e.g., theoretical bases, components); implementation (e.g., facilitators' training, doses, quality); and methodology (e.g., research design). The research questions underlying the qualitative review are defined as follows: What are the barriers and facilitators to implementation of interventions to reduce school exclusions?What are the barriers and facilitators to implementation of interventions to reduce the involvement of children and young people in crime and violence?
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Affiliation(s)
| | | | - Darrick Jolliffe
- Department of Law and CriminologyRoyal Holloway University of LondonLondonUK
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Liu S, Ludvigsson JF, Lichtenstein P, Gudbjörnsdottir S, Taylor MJ, Larsson H, Kuja-Halkola R, Butwicka A. Educational Outcomes in Children and Adolescents With Type 1 Diabetes and Psychiatric Disorders. JAMA Netw Open 2023; 6:e238135. [PMID: 37052917 PMCID: PMC10102872 DOI: 10.1001/jamanetworkopen.2023.8135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Importance Research shows that children and adolescents with type 1 diabetes (T1D), compared with their peers without diabetes, have a greater risk of psychiatric disorders. However, no study has comprehensively examined whether having psychiatric disorders is associated with educational outcomes in children and adolescents with T1D. Objective To investigate educational outcomes in children and adolescents with T1D with and without psychiatric disorders. Design, Setting, and Participants This cohort study used data from multiple Swedish registers. The main study cohort included individuals born in Sweden between January 1, 1973, and December 31, 1997, who were followed up from birth through December 31, 2013. Data analyses were conducted from March 1 to June 30, 2022. Exposures Type 1 diabetes and psychiatric disorders (including neurodevelopmental disorders, depression, anxiety disorders, eating disorders, bipolar disorder, psychotic disorder, and substance misuse) diagnosed before 16 years of age. Main Outcomes and Measures Achieving educational milestones (completing compulsory school [primary and lower secondary education], being eligible to and finishing upper secondary school, and starting and finishing university) and compulsory school performances. Results Of 2 454 862 individuals (51.3% male), 13 294 (0.5%; 53.9% male) were diagnosed with T1D (median [IQR] age at diagnosis, 9.5 [6.0-12.5] years), among whom 1012 (7.6%) also had at least 1 psychiatric disorder. Compared with healthy individuals (without T1D and psychiatric disorders), individuals with T1D alone had slightly lower odds of achieving the examined educational milestones. However, those with both T1D and any psychiatric disorder had much lower odds of achieving milestones, including completing compulsory school (odds ratio [OR], 0.17; 95% CI, 0.13-0.21), being eligible for (OR, 0.25; 95% CI, 0.21-0.30) and finishing (OR, 0.19; 95% CI, 0.14-0.26) upper secondary school, and starting (OR, 0.36; 95% CI, 0.29-0.46) and finishing (OR, 0.30; 95% CI, 0.20-0.47) university. They also showed lower grade point averages for compulsory school subjects. These findings remained similar in sibling comparison analyses, suggesting independence from familial confounding. Conclusions and Relevance In this cohort study of Swedish-born children and adolescents, those with T1D alone had minor difficulties with their educational outcomes, whereas those with both T1D and psychiatric disorders had universal long-term educational underachievement. These findings highlight the importance of identifying psychiatric disorders in pediatric patients with T1D and the need for targeted educational intervention and support to minimize the education gap between the affected children and their peers.
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Affiliation(s)
- Shengxin Liu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Soffia Gudbjörnsdottir
- Swedish National Diabetes Register, Centre of Registers, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mark J Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Agnieszka Butwicka
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Child and Adolescent Psychiatry Stockholm, Stockholm Health Care Services, Region Stockholm, Sweden
- Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
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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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Russell AE, Moore D, Sanders A, Dunn B, Hayes R, Kidger J, Sonuga-Barke E, Pfiffner L, Ford T. Synthesising the existing evidence for non-pharmacological interventions targeting outcomes relevant to young people with ADHD in the school setting: systematic review protocol. Syst Rev 2022; 11:28. [PMID: 35168685 PMCID: PMC8848797 DOI: 10.1186/s13643-022-01902-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/07/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) have impairing levels of difficulty paying attention, impulsive behaviour and/or hyperactivity. ADHD causes extensive difficulties for young people at school, and as a result these children are at high risk for a wide range of poor outcomes. We ultimately aim to develop a flexible, modular 'toolkit' of evidence-based strategies that can be delivered by primary school staff to improve the school environment and experience for children with ADHD; the purpose of this review is to identify and quantify the evidence-base for potential intervention components. This protocol sets out our plans to systematically identify non-pharmacological interventions that target outcomes that have been reported to be of importance to key stakeholders (ADHD symptoms, organisation skills, executive-global- and classroom-functioning, quality of life, self-esteem and conflict with teachers and peers). We plan to link promising individual intervention components to measured outcomes, and synthesise the evidence of effectiveness for each outcome. METHODS A systematic search for studies published from the year 2000 that target the outcomes of interest in children and young people aged 3-12 will be conducted. Titles and abstracts will be screened using prioritisation software, and then full texts of potentially eligible studies will be screened. Systematic reviews, RCTs, non-randomised and case-series studies are eligible designs. Synthesis will vary by the type of evidence available, potentially including a review of reviews, meta-analysis and narrative synthesis. Heterogeneity of studies meta-analysed will be assessed, along with publication bias. Intervention mapping will be applied to understand potential behaviour change mechanisms for promising intervention components. DISCUSSION This review will highlight interventions that appear to effectively ameliorate negative outcomes that are of importance for people with ADHD, parents, school staff and experts. Components of intervention design and features that are associated with effective change in the outcome will be delineated and used to inform the development of a 'toolkit' of non-pharmacological strategies that school staff can use to improve the primary school experience for children with ADHD. TRIAL REGISTRATION PROSPERO number CRD42021233924.
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Affiliation(s)
- Abigail E Russell
- University of Exeter College of Medicine and Health, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Darren Moore
- University of Exeter College of Medicine and Health, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK
| | - Amy Sanders
- University of Exeter College of Medicine and Health, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK
| | - Barnaby Dunn
- University of Exeter College of Medicine and Health, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK
| | - Rachel Hayes
- University of Exeter College of Medicine and Health, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK
| | | | | | - Linda Pfiffner
- University of California San Francisco, San Francisco, USA
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John A, Friedmann Y, DelPozo-Banos M, Frizzati A, Ford T, Thapar A. Association of school absence and exclusion with recorded neurodevelopmental disorders, mental disorders, or self-harm: a nationwide, retrospective, electronic cohort study of children and young people in Wales, UK. Lancet Psychiatry 2022; 9:23-34. [PMID: 34826393 PMCID: PMC8674147 DOI: 10.1016/s2215-0366(21)00367-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/15/2021] [Accepted: 08/23/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Poor attendance at school, whether due to absenteeism or exclusion, leads to multiple social, educational, and lifelong socioeconomic disadvantages. We aimed to measure the association between a broad range of diagnosed neurodevelopmental and mental disorders and recorded self-harm by the age of 24 years and school attendance and exclusion. METHODS In this nationwide, retrospective, electronic cohort study, we drew a cohort from the Welsh Demographic Service Dataset, which included individuals aged 7-16 years (16 years being the school leaving age in the UK) enrolled in state-funded schools in Wales in the academic years 2012/13-2015/16 (between Sept 1, 2012, and Aug 31, 2016). Using the Adolescent Mental Health Data Platform, we linked attendance and exclusion data to national demographic and primary and secondary health-care datasets. We identified all pupils with a recorded diagnosis of neurodevelopmental disorders (ADHD and autism spectrum disorder [ASD]), learning difficulties, conduct disorder, depression, anxiety, eating disorders, alcohol or drugs misuse, bipolar disorder, schizophrenia, other psychotic disorders, or recorded self-harm (our explanatory variables) before the age of 24 years. Outcomes were school absence and exclusion. Generalised estimating equations with exchangeable correlation structures using binomial distribution with the logit link function were used to calculate odds ratios (OR) for absenteeism and exclusion, adjusting for sex, age, and deprivation. FINDINGS School attendance, school exclusion, and health-care data were available for 414 637 pupils (201 789 [48·7%] girls and 212 848 [51·3%] boys; mean age 10·5 years [SD 3·8] on Sept 1, 2012; ethnicity data were not available). Individuals with a record of a neurodevelopmental disorder, mental disorder, or self-harm were more likely to be absent or excluded in any school year than were those without a record. Unadjusted ORs for absences ranged from 2·1 (95% CI 2·0-2·2) for those with neurodevelopmental disorders to 6·6 (4·9-8·3) for those with bipolar disorder. Adjusted ORs (aORs) for absences ranged from 2·0 (1·9-2·1) for those with neurodevelopmental disorders to 5·5 (4·2-7·2) for those with bipolar disorder. Unadjusted ORs for exclusion ranged from 1·7 (1·3-2·2) for those with eating disorders to 22·7 (20·8-24·7) for those with a record of drugs misuse. aORs for exclusion ranged from 1·8 (1·5-2·0) for those with learning difficulties to 11·0 (10·0-12·1) for those with a record of drugs misuse. INTERPRETATION Children and young people up to the age of 24 years with a record of a neurodevelopmental or mental disorder or self-harm before the age of 24 years were more likely to miss school than those without a record. Exclusion or persistent absence are potential indicators of current or future poor mental health that are routinely collected and could be used to target assessment and early intervention. Integrated school-based and health-care strategies to support young peoples' engagement with school life are required. FUNDING The Medical Research Council, MQ Mental Health Research, and the Economic and Social Research Council. TRANSLATION For the Welsh translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Ann John
- Swansea University Medical School, Swansea University, Swansea, UK.
| | - Yasmin Friedmann
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Aura Frizzati
- Cedar Healthcare Technology Research Centre, Cardiff Medicentre, University Hospital of Wales, Cardiff, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
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The role of school enjoyment and connectedness in the association between depressive and externalising symptoms and academic attainment: Findings from a UK prospective cohort study. J Affect Disord 2021; 295:974-980. [PMID: 34706471 PMCID: PMC8572763 DOI: 10.1016/j.jad.2021.08.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous research on the relationship between children's depressive and externalising symptoms, experience of school, and academic attainment is inconclusive. The aims of this study were (i) to test bidirectional associations between children's school experience and depressive and externalising symptoms at age 10-11 and 13-14, (ii) to ascertain whether school experience age 13-14 is associated with academic attainment age 16, and (iii) to test whether school experience mediates the relationship between depressive or externalising symptoms and attainment. METHODS Data was used from the Avon Longitudinal Study of Parents and Children (n=6,409). A cross-lagged model was used to investigate bidirectional associations between school experience (enjoyment and connectedness) and depression and externalising at age 10-11 and 13-14. The same framework was used to test if school experience aged 13-14 mediated associations of depressive and externalising symptoms with later attainment. RESULTS Depressive and externalising symptoms at 10-11 were negatively associated with school connectedness (depressive: standardised β=-0.06, CI: -0.11, 0.01; externalizing: β=-0.13, CI: -0.17, -0.08), and school enjoyment at 13-14 (depressive β=-0.04, -0.08, 0.03; externalising: β=-0.08, CI: -0.13, -0.03). School enjoyment at 13-14 was positively associated with attainment at 16 (β=0.10, CI: 0.04, 0.15), and partially mediated associations between depressive and externalising symptoms at 10-11 and attainment at 16 (depressive: proportion mediated 2.2%, CI: -1.5, 5.9; externalising: proportion mediated; 4.7%, CI: 0.7, 10.1,). LIMITATIONS Results may be subject to residual confounding. CONCLUSIONS School enjoyment is a potentially modifiable risk factor that may affect educational attainment of adolescents with depressive or externalising symptoms.
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Fletcher-Watson S, Brook K, Hallett S, Murray F, Crompton CJ. Inclusive Practices for Neurodevelopmental Research. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2021. [DOI: 10.1007/s40474-021-00227-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Purpose of Review
Inclusive research practice is both a moral obligation and a practical imperative. Here we review its relevance to the study of neurodevelopmental diversity in particular, briefly describing a range of inclusive research models and justifying their use. The review itself is inclusively co-authored with three autistic collaborators and community leaders who all have extensive experience of research involvement.
Recent Findings
Drawing on theoretical arguments and specific exemplar projects, we describe six key considerations in the delivery of inclusive research. These are the following: taking the first steps towards inclusive practice; setting expectations; community-specific inclusion measures; inclusion and intersectionality; the role of empowerment; and knowledge exchange for inclusion. Together, these sections provide an illustrated guide to the principles and process of inclusive research.
Summary
Inclusive research practice is both beneficial to and a requirement of excellence in neurodevelopmental research. We call for greater engagement in this participatory research agenda from grant-awarding bodies to facilitate not just inclusive but also emancipatory research.
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Thompson I, Tawell A, Daniels H. Conflicts in professional concern and the exclusion of pupils with SEMH in England. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2021. [DOI: 10.1080/13632752.2021.1898769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ian Thompson
- Department of Education, University of Oxford, Oxford, England
| | - Alice Tawell
- Department of Education, University of Oxford, Oxford, England
| | - Harry Daniels
- Department of Education, University of Oxford, Oxford, England
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Fazel M, Newby D. Mental well-being and school exclusion: changing the discourse from vulnerability to acceptance. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2021. [DOI: 10.1080/13632752.2021.1898767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Mina Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Danielle Newby
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
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12
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Jiang H, Johnstone SJ, Sun L, Zhang DW. Effect of Neurocognitive Training for Children With ADHD at Improving Academic Engagement in Two Learning Settings. J Atten Disord 2021; 25:414-431. [PMID: 30265176 DOI: 10.1177/1087054718799931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: This preliminary study investigated effectiveness of neurocognitive training on academic engagement (AET) for children with ADHD. The training approach targeted working memory, inhibitory control, and attention/relaxation (via brain electrical activity). Method: A reversal design with a 2-week follow-up was used to assess the effectiveness of the treatment on two children with diagnosed ADHD in two learning settings. Direct observation was used to collect academic-related behavior. Results: Improvements in on-task expected behavior (ONT-EX) and general AET, as well as reductions in off-task motor activity (OFF-MA) and off-task passive behavior (OFF-PB) were observed for both students over baselines and across the settings. Moreover, differences in behavioral change were found between participants and settings. Conclusion: These findings support using the treatment for improving academic performance of children with ADHD. Future studies may investigate influences of contextual differences, nontreatment variables, or adult's feedback during the training session on treatment effectiveness.
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Affiliation(s)
- Han Jiang
- School of Special Education, Zhejiang Normal University, Hangzhou, China
| | - Stuart J Johnstone
- School of Psychology, Brain & Behaviour Reseach Institute, University of Wollongong, Australia
| | - Li Sun
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Da-Wei Zhang
- School of Psychology, Brain & Behaviour Reseach Institute, University of Wollongong, Australia
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Kearney CA. Integrating Systemic and Analytic Approaches to School Attendance Problems: Synergistic Frameworks for Research and Policy Directions. CHILD & YOUTH CARE FORUM 2021. [DOI: 10.1007/s10566-020-09591-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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14
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Murray J, Wickramasekera N, Elings M, Bragg R, Brennan C, Richardson Z, Wright J, Llorente MG, Cade J, Shickle D, Tubeuf S, Elsey H. The impact of care farms on quality of life, depression and anxiety among different population groups: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2019; 15:e1061. [PMID: 37131853 PMCID: PMC8534033 DOI: 10.1002/cl2.1061] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Care farming (also called social farming) is the therapeutic use of agricultural and farming practices. Service users and communities supported through care farming include people with learning disabilities, mental and physical health problems, substance misuse, adult offenders, disaffected youth, socially isolated older people and the long term unemployed. Care farming is growing in popularity, especially around Europe. This review aimed to understand the impact of care farming on quality of life, depression and anxiety, on a range of service user groups. It also aimed to explore and explain the way in which care farming might work for different groups. By reviewing interview studies we found that people valued, among other things, being in contact with each other, and feeling a sense of achievement, fulfilment and belonging. Some groups seemed to appreciate different things indicating that different groups may benefit in different ways but, it is unclear if this is due to a difference in the types of activities or the way in which people take different things from the same activity. We found no evidence that care farms improved people's quality of life and some evidence that they might improve depression and anxiety. Larger studies involving single service user groups and fully validated outcome measures are needed to prove more conclusive evidence about the benefits of care farming.
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Affiliation(s)
- Jenni Murray
- Academic Unit of Public Health, Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Nyantara Wickramasekera
- Academic Unit of Public Health, Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Marjolein Elings
- Plant Research InternationalWageningen UniversityWageningenThe Netherlands
| | | | - Cathy Brennan
- Academic Unit of Public Health, Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Zoe Richardson
- York Trials Unit, Department of Health Sciences, Faculty of ScienceUniversity of YorkYorkUK
| | - Judy Wright
- Leeds Institute of Health SciencesThe University of LeedsLeedsUK
| | - Marina G. Llorente
- Madrid Institute for Rural, Agricultural and Food Research and Development (IMIDRA), Social‐Ecological Systems Lab, Ecology DepartmentUniversidad Autónoma de Madrid (Spain)MadridSpain
| | | | - Darren Shickle
- Academic Unit of Public Health, Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Sandy Tubeuf
- Academic Unit of Public Health, Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Helen Elsey
- Academic Unit of Public Health, Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
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15
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Parker C, Tejerina-Arreal M, Henley W, Goodman R, Logan S, Ford T. Are children with unrecognised psychiatric disorders being excluded from school? A secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007. Psychol Med 2019; 49:2561-2572. [PMID: 30572975 DOI: 10.1017/s0033291718003513] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is limited research that explores the association between exclusion from school and mental health, but it seems intuitively plausible that the recognition of mental difficulties by key teachers and parents would influence the likelihood of exclusion from school. METHODS A secondary analysis of the British Child and Adolescent Mental Health survey 2004, (n = 7997) and the 2007 follow-up (n = 5326) was conducted. Recognition of difficulty was assessed via a derived variable that combined the first item of the Impact supplement of the Strengths and Difficulties Questionnaire which asked parents and teachers if they thought that the child has difficulties with emotions, behaviour and concentration, and the presence/absence of psychiatric disorder measured by the Development and Well-being Assessment. RESULTS Adjusted logistic regression models demonstrated that children with recognised difficulties were more likely to be excluded [adjusted odds ratio (OR) 5.78, confidence interval 3.45-9.64, p < 0.001], but children with unrecognised difficulties [adjusted OR 3.58 (1.46-8.81) p < 0.005] or recognised subclinical difficulties [adjusted OR 3.42 (2.04-5.73) p < 0.001] were also more likely to be excluded than children with no difficulties. Children with conduct disorder and attention deficit hyperactivity disorder were most likely to be excluded compared with other types of disorder. CONCLUSION Exclusion from school may result from a failure to provide timely and effective support rather than a failure to recognise psychopathology.
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Affiliation(s)
- Claire Parker
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - María Tejerina-Arreal
- College of Medicine and Health, University of Exeter, Exeter, UK
- Personality, Evaluation and Psychological Treatments Department, Faculty of Psychology, University of Murcia, Murcia, Spain
| | - William Henley
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Robert Goodman
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stuart Logan
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Tamsin Ford
- College of Medicine and Health, University of Exeter, Exeter, UK
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16
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Roberts S, Arseneault L, Barratt B, Beevers S, Danese A, Odgers CL, Moffitt TE, Reuben A, Kelly FJ, Fisher HL. Exploration of NO 2 and PM 2.5 air pollution and mental health problems using high-resolution data in London-based children from a UK longitudinal cohort study. Psychiatry Res 2019; 272:8-17. [PMID: 30576995 PMCID: PMC6401205 DOI: 10.1016/j.psychres.2018.12.050] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 11/23/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022]
Abstract
Air pollution is a worldwide environmental health issue. Increasingly, reports suggest that poor air quality may be associated with mental health problems, but these studies often use global measures and rarely focus on early development when psychopathology commonly emerges. To address this, we combined high-resolution air pollution exposure estimates and prospectively-collected phenotypic data to explore concurrent and longitudinal associations between air pollutants of major concern in urban areas and mental health problems in childhood and adolescence. Exploratory analyses were conducted on 284 London-based children from the Environmental Risk (E-Risk) Longitudinal Twin Study. Exposure to annualized PM2.5 and NO2 concentrations was estimated at address-level when children were aged 12. Symptoms of anxiety, depression, conduct disorder, and attention-deficit hyperactivity disorder were assessed at ages 12 and 18. Psychiatric diagnoses were ascertained from interviews with the participants at age 18. We found no associations between age-12 pollution exposure and concurrent mental health problems. However, age-12 pollution estimates were significantly associated with increased odds of major depressive disorder at age 18, even after controlling for common risk factors. This study demonstrates the potential utility of incorporating high-resolution pollution estimates into large epidemiological cohorts to robustly investigate associations between air pollution and youth mental health.
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Affiliation(s)
- Susanna Roberts
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, SE5 8AF, London, UK
| | - Louise Arseneault
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, SE5 8AF, London, UK
| | - Benjamin Barratt
- King's College London, Environmental Research Group, MRC-PHE Centre for Environment and Health, London, UK
| | - Sean Beevers
- King's College London, Environmental Research Group, MRC-PHE Centre for Environment and Health, London, UK
| | - Andrea Danese
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, SE5 8AF, London, UK,King's College London, Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, London, UK,National & Specialist CAMHS Clinic for Trauma, Anxiety and Depression, South London & Maudsley NHS Foundation Trust, London, UK
| | - Candice L. Odgers
- Sanford School of Public Policy, Duke University, Durham, NC, USA,Department of Psychology and Social Behavior, University of California Irvine, Irvine, CA, USA
| | - Terrie E. Moffitt
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, SE5 8AF, London, UK,Departments of Psychology and Neuroscience, Psychiatry and Behavioral Sciences, and Centre for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Aaron Reuben
- Departments of Psychology and Neuroscience, Psychiatry and Behavioral Sciences, and Centre for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Frank J. Kelly
- King's College London, Environmental Research Group, MRC-PHE Centre for Environment and Health, London, UK
| | - Helen L. Fisher
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, 16 De Crespigny Park, SE5 8AF, London, UK,Correspondence author.
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17
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Ford T, Parker C, Salim J, Goodman R, Logan S, Henley W. The relationship between exclusion from school and mental health: a secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007. Psychol Med 2018; 48:629-641. [PMID: 28838327 DOI: 10.1017/s003329171700215x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Children with poor mental health often struggle at school. The relationship between childhood psychiatric disorder and exclusion from school has not been frequently studied, but both are associated with poor adult outcomes. We undertook a secondary analysis of the British Child and Adolescent Mental Health Surveys from 2004 and its follow-up in 2007 to explore the relationship between exclusion from school and psychopathology. We predicted poorer mental health among those excluded. METHOD Psychopathology was measured using the Strengths and Difficulties Questionnaire, while psychiatric disorder was assessed using the Development and Well-Being Assessment and applying Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) criteria. Exclusion from school and socio-demographic characteristics were reported by parents. Multi-variable regression models were used to examine the impact of individual factors on exclusion from school or psychological distress. RESULTS Exclusion from school was commoner among boys, secondary school pupils and those living in socio-economically deprived circumstances. Poor general health and learning disability among children and poor parental mental health were also associated with exclusion. There were consistently high levels of psychological distress among those who had experienced exclusion at baseline and follow-up. CONCLUSIONS We detected a bi-directional association between psychological distress and exclusion. Efforts to identify and support children who struggle with school may therefore prevent both future exclusion and future psychiatric disorder.
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Affiliation(s)
- T Ford
- University of Exeter,Exeter,UK
| | | | - J Salim
- University of Exeter,Exeter,UK
| | | | - S Logan
- University of Exeter,Exeter,UK
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18
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Moore DA, Russell AE, Arnell S, Ford TJ. Educators' experiences of managing students with ADHD: a qualitative study. Child Care Health Dev 2017; 43:489-498. [PMID: 28233330 DOI: 10.1111/cch.12448] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 11/20/2016] [Accepted: 01/08/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND The symptoms of attention-deficit/hyperactivity disorder are associated with difficulty coping with the social, behavioural and academic components of school. Compared with medication and other non-pharmacological treatment, there is less evidence relating to school-based interventions to support children with ADHD. There is additionally an absence of any research focused on the experiences and practices of educators in the UK around how they work with children who are inattentive, impulsive and hyperactive. METHODS Forty-two educational practitioners from primary, secondary and alternate provision schools in the UK participated in focus groups or individual interviews that explored (1) their experiences of managing students with ADHD in the classroom and (2) factors that helped and hindered them in this endeavour. Transcripts were analysed using thematic analysis. RESULTS Analysis identified six themes: broad strategies, student-centred, inclusive strategies, labelling, medication and relationships. Participants' experiences of managing students with ADHD drew upon a wide range of strategies that typically involved responding to individual needs in an inclusive manner, so individuals with ADHD could access the classroom with their peers. Participants spoke about three factors that helped and hindered managing students with ADHD. Labelling of students with ADHD was reported, with the negative aspects of labelling, such as stigmatization, affecting the classroom. Educators reported mixed experiences regarding the helpfulness of medication; where helpful, it allowed the use of strategies in the classroom. Although students with ADHD were described as having rollercoaster relationships, positive relationships were considered key to the support of children with these difficulties. CONCLUSIONS This study suggests that factors such as attitudes towards ADHD, relationships experienced by students with ADHD and other treatments being delivered need to be carefully considered before strategies are put in place in the classroom. This study supports the need for further work on the implementation of evidence-based school interventions for ADHD.
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Affiliation(s)
- D A Moore
- University of Exeter Medical School, Exeter, UK
| | - A E Russell
- University of Exeter Medical School, Exeter, UK
| | - S Arnell
- Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - T J Ford
- University of Exeter Medical School, Exeter, UK
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19
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Finning K, Moore D, Ukoumunne OC, Danielsson-Waters E, Ford T. The association between child and adolescent emotional disorder and poor attendance at school: a systematic review protocol. Syst Rev 2017; 6:121. [PMID: 28659163 PMCID: PMC5490167 DOI: 10.1186/s13643-017-0523-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 06/16/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Anxiety and depression are common in young people and are associated with a range of adverse outcomes. Research has suggested a relationship between emotional disorder and poor school attendance, and thus poor attendance may serve as a red flag for children at risk of emotional disorder. This systematic review aims to investigate the association between child and adolescent emotional disorder and poor attendance at school. METHODS We will search electronic databases from a variety of disciplines including medicine, psychology, education and social sciences, as well as sources of grey literature, to identify any quantitative studies that investigate the relationship between emotional disorder and school attendance. Emotional disorder may refer to diagnoses of mood or anxiety disorders using standardised diagnostic measures, or measures of depression, anxiety or "internalising symptoms" using a continuous scale. Definitions for school non-attendance vary, and we aim to include any relevant terminology, including attendance, non-attendance, school refusal, school phobia, absenteeism and truancy. Two independent reviewers will screen identified papers and extract data from included studies. We will assess the risk of bias of included studies using the Newcastle-Ottawa Scale. Random effects meta-analysis will be used to pool quantitative findings when studies use the same measure of association, otherwise a narrative synthesis approach will be used. DISCUSSION This systematic review will provide a detailed synthesis of evidence regarding the relationship between childhood emotional disorder and poor attendance at school. Understanding this relationship has the potential to assist in the development of strategies to improve the identification of and intervention for this vulnerable group. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016052961.
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Affiliation(s)
- Katie Finning
- University of Exeter Medical School, South Cloisters, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Darren Moore
- University of Exeter Medical School, South Cloisters, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Obioha C. Ukoumunne
- University of Exeter Medical School, South Cloisters, St Luke’s Campus, Exeter, EX1 2LU UK
| | | | - Tamsin Ford
- University of Exeter Medical School, South Cloisters, St Luke’s Campus, Exeter, EX1 2LU UK
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20
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Parker C, Paget A, Ford T, Gwernan-Jones R. ‘.he was excluded for the kind of behaviour that we thought he needed support with…’ A qualitative analysis of the experiences and perspectives of parents whose children have been excluded from school. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2016. [DOI: 10.1080/13632752.2015.1120070] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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