School quality ratings are weak predictors of students' achievement and well-being

A population-wide gene-environment interaction study on how genes, schools, and residential areas shape achievement

A child's environment is thought to be composed of different levels that interact with their individual genetic propensities. However, studies have not tested this theory comprehensively across multiple environmental levels. Here, we quantify the contributions of child, parent, school, neighbourhood, district, and municipality factors to achievement, and investigate interactions between polygenic indices for educational attainment (EA-PGI) and environmental levels. We link population-wide administrative data on children's standardised test results, schools and residential identifiers to the Norwegian Mother, Father, and Child Cohort Study (MoBa), which includes >23,000 genotyped parent-child trios. We test for gene-environment interactions using multilevel models with interactions between EA-PGI and random effects for school and residential environments (thus remaining agnostic to specific features of environments). We use parent EA-PGI to control for gene-environment correlation. We found an interaction between students' EA-PGI and schools suggesting compensation: higher-performing schools can raise overall achievement without leaving children with lower EA-PGI behind. Differences between schools matter more for students with lower EA-PGI, explaining 4 versus 2% of the variance in achievement for students 2 SD below versus 2 SD above the mean EA-PGI. Neighbourhood, district, and municipality variation contribute little to achievement (<2% of the variance collectively), and do not interact with children's individual EA-PGI. Policy to reduce social inequality in achievement in Norway should focus on tackling unequal support across schools for children with difficulties.

How interactions between ADHD and schools affect educational achievement: a family-based genetically sensitive study

BACKGROUND

Children with ADHD tend to achieve less than their peers in school. It is unknown whether schools moderate this association. Nonrandom selection of children into schools related to variations in their ADHD risk poses a methodological problem.

METHODS

We linked data on ADHD symptoms of inattention and hyperactivity and parent-child ADHD polygenic scores (PGS) from the Norwegian Mother, Father, and Child Cohort Study (MoBa) to achievement in standardised tests and school identifiers. We estimated interactions of schools with individual differences between students in inattention, hyperactivity, and ADHD-PGS using multilevel models with random slopes for ADHD effects on achievement over schools. In our PGS analyses, we adjust for parental selection of schools by adjusting for parental ADHD-PGS (a within-family PGS design). We then tested whether five school sociodemographic measures explained any interactions.

RESULTS

Analysis of up to 23,598 students attending 2,579 schools revealed interactions between school and ADHD effects on achievement. The variability between schools in the effects of inattention, hyperactivity and within-family ADHD-PGS on achievement was 0.08, 0.07 and 0.05 SDs, respectively. For example, the average effect of inattention on achievement was β = -0.23 (SE = 0.009), but in 2.5% of schools with the weakest effects, the value was -0.07 or less. ADHD has a weaker effect on achievement in higher-performing schools. Schools make more of a difference to the achievements of students with higher levels of ADHD, explaining over four times as much variance in achievement for those with high versus average inattention symptoms. School sociodemographic measures could not explain the ADHD-by-school interactions.

CONCLUSIONS

Although ADHD symptoms and genetic risk tend to hinder achievement, schools where their effects are weaker do exist. Differences between schools in support for children with ADHD should be evened out.

Polygenic scores: prediction versus explanation

During the past decade, polygenic scores have become a fast-growing area of research in the behavioural sciences. The ability to directly assess people's genetic propensities has transformed research by making it possible to add genetic predictors of traits to any study. The value of polygenic scores in the behavioural sciences rests on using inherited DNA differences to predict, from birth, common disorders and complex traits in unrelated individuals in the population. This predictive power of polygenic scores does not require knowing anything about the processes that lie between genes and behaviour. It also does not mandate disentangling the extent to which the prediction is due to assortative mating, genotype-environment correlation, or even population stratification. Although bottom-up explanation from genes to brain to behaviour will remain the long-term goal of the behavioural sciences, prediction is also a worthy achievement because it has immediate practical utility for identifying individuals at risk and is the necessary first step towards explanation. A high priority for research must be to increase the predictive power of polygenic scores to be able to use them as an early warning system to prevent problems.

Impact of counselling provision in primary schools on child and adolescent mental health service referral rates: a longitudinal observational cohort study

BACKGROUND

In the United Kingdom, schools play an increasingly important role in supporting young peoples' mental health. While there is a growing evidence base to support the effectiveness of school-based interventions, less is known about how these provisions impact on local Child and Adolescent Mental Health Service (CAMHS) referral rates. There is a concern that an increase in school-based provision might lead to an increase in CAMHS referrals and overwhelm services. We aimed to examine the longitudinal association between Place2Be counselling provision in primary schools on CAMHS referral rates in South London.

METHOD

This was a retrospective cohort study using linked data from the National Pupil Database (NPD) and CAMHS referrals to the South London and Maudsley's NHS Foundation Trust (SLaM) identified through the Clinical Record Interactive Search (CRIS) tool. The cohort included a total of 285 state-maintained primary schools in four London boroughs for the academic years of 2007-2012. During the study period, 23 of these schools received school-based mental health provision from Place2Be. The primary outcome was the incident rate ratio (IRR) of school-level accepted CAMHS referrals in 2012/13 in schools with, or without, Place2Be provision.

RESULTS

There was no significant association between elevated rates of CAMHS referral and Place2Be provision, even after comprehensive adjustment for school-level and pupil characteristics (IRR 0.91 (0.67-1.23)). School-level characteristics, including higher proportion of white-British pupils (IRR 1.009 (1.002-1.02)), medical staff ratio (IRR 6.49 (2.05-20.6)) and poorer Ofsted school inspection ratings (e.g. IRR 1.58 (1.06-2.34) for 'Requires Improvement' vs. 'Outstanding') were associated with increased CAMHS referral rates.

CONCLUSIONS

Place2Be provision did not result in increased specialist mental health referrals; however, other school-level characteristics did. Future research should investigate pupils' Place2Be clinical outcomes, as well the outcomes of individuals referred to CAMHS to better understand which needs are being met by which services.