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Chockalingam M, Skinner K, Melvin G, Yap MBH. Modifiable Parent Factors Associated with Child and Adolescent School Refusal: A Systematic Review. Child Psychiatry Hum Dev 2023; 54:1459-1475. [PMID: 35397716 PMCID: PMC10435607 DOI: 10.1007/s10578-022-01358-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 03/21/2022] [Accepted: 03/26/2022] [Indexed: 11/03/2022]
Abstract
School refusal is a complex problem that refers to difficulty attending/remaining at school due to emotional distress about attendance. Despite its occurrence being associated with negative outcomes, many are unresponsive to the current treatment options. While parent factors have a key role to play in school refusal, they are not adequately addressed in existing treatments. Further research is needed to consolidate understanding and implement new treatments. Employing the PRISMA method, this review aims to identify modifiable parent factors associated with child and/or adolescent school refusal. Eight studies met inclusion criteria from which nine factors were identified. Factors found to be associated with school refusal included: parent psychopathology, family functioning and maternal overprotection (communication subdomain). Other factors such as maternal overprotection (affection, assistance and travel subdomains) and parental self-efficacy had weak or inconsistent results warranting further investigation. Overall, findings call for action in this field that has sparse and dated literature.
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Affiliation(s)
- Meena Chockalingam
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
| | - Kayan Skinner
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
| | - Glenn Melvin
- School of Psychology, Centre for Social and Early Emotional Development, Deakin University, Melbourne, Australia.
| | - Marie B H Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
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2
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ŞANAL GÜNGÖR B, KOÇTÜRK N. School Refusal and Cognitive Behavioral Therapy: A Review. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1052813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
School refusal is a problem area that can turn into difficult trouble for the family, school, and students by affecting children and adolescents' academic and psychosocial development. This scoping review aims to examine the effectiveness of interventions based on the cognitive behavioral therapy approach on children and adolescents experiencing school refusal. The study was carried out following the "Standards Used in Reporting of Systematic Compilation and Meta-Analysis Results." For this purpose, the databases of DergiPark, Google Scholar, PsycARTICLES, PubMed, TR Index, and Web of Science were searched without any year restriction. As a result of the search, 233 studies were reached, and according to the inclusion criteria, ten research articles were evaluated. According to the findings, cognitive-behavioral interventions applied to children with school refusal: cognitive restructuring (n = 10, 100%), exposure (n = 10, 100%), psychoeducation (n = 6, 60%), social skills training (n = 6, 60%), problem solving training (n = 4, 40%), relaxation training (n = 4, 40%) and homework (n = 4, 40%) are predominantly used techniques. In 80% of the studies, it was determined that interventions based on the cognitive behavioral therapy approach to school refusal were effective. Parental involvement was also included in 80% (n = 8) of the studies, and 100% had effective results. Cognitive behavioral interventions are effective on school refusal as a result of the studies reviewed.
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Affiliation(s)
- Beyza ŞANAL GÜNGÖR
- HACETTEPE ÜNİVERSİTESİ, EĞİTİM BİLİMLERİ ENSTİTÜSÜ, PSİKOLOJİK DANIŞMA VE REHBERLİK (DR)
| | - Nilüfer KOÇTÜRK
- HACETTEPE ÜNİVERSİTESİ, EĞİTİM FAKÜLTESİ, EĞİTİM BİLİMLERİ BÖLÜMÜ
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3
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Leduc K, Tougas AM, Robert V, Boulanger C. School Refusal in Youth: A Systematic Review of Ecological Factors. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01469-7. [PMID: 36422762 PMCID: PMC9686247 DOI: 10.1007/s10578-022-01469-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Karissa Leduc
- Department of Educational and Counseling Psychology, McGill University, Montreal, QC, Canada.
- Groupe de recherche sur les inadaptations sociales de l'enfance (GRISE), Sherbrooke, QC, Canada.
| | - Anne-Marie Tougas
- Groupe de recherche sur les inadaptations sociales de l'enfance (GRISE), Sherbrooke, QC, Canada
- Department of Psychoeducation, Faculty of Education, Université de Sherbrooke, Sherbrooke, QC, Canada
- Institut universitaire de première ligne en santé et services sociaux (IUPLSSS), Sherbrooke, QC, Canada
| | - Virginie Robert
- Department of Learning Sciences, Faculty of Education, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Camille Boulanger
- Department of Psychoeducation, Faculty of Education, Université de Sherbrooke, Sherbrooke, QC, Canada
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4
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Heyne D. Developmental Issues Associated with Adolescent School Refusal and Cognitive-Behavioral Therapy Manuals. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2022; 50:471-494. [PMID: 35762908 DOI: 10.1024/1422-4917/a000881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
It is important to consider developmental issues when addressing school refusal (SR) in adolescence. Referral rates appear to be higher among adolescents relative to children, and treatment appears to be less effective among adolescents. This paper provides an in-depth review of developmental issues associated with adolescent SR and treatment via cognitive-behavioral therapy (CBT). It begins by considering the reasons for the higher referral and poorer treatment outcomes, including the higher level of absenteeism in adolescence, higher rates of concurrent social anxiety disorder and depressive disorder, and the developmental challenges inherent to adolescence. Such challenges include increased academic and social demands in the secondary-school environment, and increasing autonomy which may contribute to family conflict. These developmental issues may potentiate and exacerbate an adolescent's difficulty attending school, make it difficult for families to cope, and complicate practitioners' efforts to provide effective treatment for SR. Further, the review describes CBT manuals for SR and the extent to which they are developmentally sensitive. There are five CBT manuals, which vary in their sensitivity to developmental issues. Various multimodal treatments employ interventions in addition to CBT, such as medication or inpatient treatment, to address the complexity of SR in adolescence. Nevertheless, nonresponse to treatment for adolescent SR ranges from one-third to two-thirds of youths. Attention thus needs to be given to ways of improving treatment outcomes.
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Affiliation(s)
- David Heyne
- Institute of Psychology, Leiden University, The Netherlands
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5
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Liu L, Gu H, Zhao X, Wang Y. What Contributes to the Development and Maintenance of School Refusal in Chinese Adolescents: A Qualitative Study. Front Psychiatry 2021; 12:782605. [PMID: 34975580 PMCID: PMC8714792 DOI: 10.3389/fpsyt.2021.782605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/23/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: Although, there has been a growing number of studies on school refusal in Western cultures, the underlying factors that contribute to school refusal in Chinese adolescents remain unclear. This study aimed to better understand why Chinese adolescents refuse to go to school and to further interpret what they want to express through their school refusal behaviors. Methods: We performed a qualitative study using an interpretative phenomenological analysis. Twenty adolescents with school refusal experiences were recruited from the clinical psychology department of two mental health hospitals in Shanghai, China. They participated in semistructured, face-to-face in-depth interviews. The interviews were transcribed verbatim and analyzed according to the guidelines of interpretative phenomenological analysis. Findings: Five main superordinate themes emerged from data analysis: (a) competition-oriented social environment; (b) family living space dominated by conflicts; (c) personal living space lacking meaningful support; (d) conflict between the pros and cons of being labeled with a psychiatric diagnosis; and (e) reintegration in school life. Conclusions: Our analysis emphasized the complex interacting effects of the social environment, family interpersonal conflicts, personal psychological factors and mental health complaints on the development and maintenance of Chinese adolescents' school refusal. These factors contributed to school refusal at each level and influenced each other's effects on school refusal behaviors. Therefore, interventions for Chinese teenagers with school refusal may need to integrate strategies that inspire reorganization and changes in different ecosystems, such as strategies related to government policy, peer relationships, family systems and individual inner dynamics.
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Affiliation(s)
- Liang Liu
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Hong Gu
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xudong Zhao
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
- Department of Psychosomatic, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
- Division of Medical humanities and Behavioral Sciences, School of Medicine, Tongji University, Shanghai, China
| | - Yanbo Wang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
- Division of Medical humanities and Behavioral Sciences, School of Medicine, Tongji University, Shanghai, China
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6
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Li A, Guessoum SB, Ibrahim N, Lefèvre H, Moro MR, Benoit L. A Systematic Review of Somatic Symptoms in School Refusal. Psychosom Med 2021; 83:715-723. [PMID: 33951013 DOI: 10.1097/psy.0000000000000956] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE School refusers often display somatic symptoms that are temporally related to school attendance. The aim of this systematic review is to summarize characteristics and causes of somatic symptoms and their management in the context of school refusal. Findings of this review may help clinicians in their daily practice. METHODS PubMed and PsycINFO databases were systematically searched (according to PRISMA guidelines) for articles mentioning somatic symptoms in school refusal by May 2020. Among 1025 identified studies, 148 were included. RESULTS Unspecific somatic symptoms were frequently the first complaints in school refusal. Abdominal pain, headache, nausea, vomiting, muscular or joint ache, diarrhea, dizziness, fatigue, and palpitation were the most commonly encountered symptoms and were usually not accounted for by an identifiable physical disease. Anxiety was the most recurrent etiology found, but physicians' lack of awareness about psychological comorbidities often delayed psychological/psychiatric referral. Successful therapies consisted of dialectical behavior therapy, anxiety management through relaxation/breathing training, and ignoring the somatic symptoms. CONCLUSIONS Somatic symptoms in school refusal are frequent but poorly understood. Their management could include interventions targeting anxiety, psychotherapies such as emotional awareness and expression therapy, third-wave behavioral therapies, and psychoeducation. A multidisciplinary approach through strengthened collaboration between school staff, physicians, and psychologists/psychiatrists is needed to improve well-being in children who experience somatic symptoms as related to school avoidance.
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Affiliation(s)
- Anne Li
- From the AP-HP, Cochin Hospital, Maison des Adolescents-Maison de Solenn, Integrated Youth Health Care Service (Li, Guessoum, Ibrahim, Lefèvre, Moro, Benoit), Paris; Faculty of Medicine, Paris-Saclay University (Li), Orsay; University of Paris, PCPP (Guessoum, Ibrahim, Moro), Boulogne-Billancourt; Paris-Saclay University, UVSQ, Inserm, CESP, Team DevPsy (Guessoum, Ibrahim, Lefèvre, Moro, Benoit), Villejuif, France; Yale School of Medicine, Yale University (Benoit), New Haven, Connecticut; and French Clinical Research Group in Adolescent Medicine and Health (Li, Ibrahim, Lefèvre), Paris, France
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7
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Nathwani G, Shoaib A, Shafi A, Furukawa TA, Huy NT. Impact of COVID-2019 on school attendance problems. J Glob Health 2021; 11:03084. [PMID: 34386209 PMCID: PMC8325878 DOI: 10.7189/jogh.11.03084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Gina Nathwani
- American University of Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Adeel Shoaib
- American University of Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Alliya Shafi
- American University of Caribbean School of Medicine, Cupecoy, Sint Maarten
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, Japan
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Japan
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8
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Strömbeck J, Palmér R, Sundberg Lax I, Fäldt J, Karlberg M, Bergström M. Outcome of a Multi-modal CBT-based Treatment Program for Chronic School Refusal. Glob Pediatr Health 2021; 8:2333794X211002952. [PMID: 33855128 PMCID: PMC8013532 DOI: 10.1177/2333794x211002952] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
School refusal (SR) can have several negative consequences, but effective treatments are available. When chronic, school absence requires comprehensive treatment. This study evaluates an intervention for SR based on a Cognitive Behavioral Therapy (CBT) model, Hemmasittarprogrammet (HSP). Attendance, anxiety, depression, quality of life, and emotional and behavioral symptoms were measured at pre-treatment, post-treatment, and follow-up. The participants (n = 84; 69% male) were SR students between 10 and 17 years old and their parents. School attendance increased after treatment and at follow-up. The proportion of students totally absent from school decreased and the number of students with an acceptable level of school attendance increased. Levels of anxiety and depression were lower both post-treatment and at follow-up for the youths and their parents. HSP, a promising treatment program for school refusal, builds on the literature of CBT-based programs, which has been shown to be effective for SR treatment. However, more research about the effectiveness of the program is needed. Future studies should have a stronger research design, include a measure of fidelity, and be evaluated independent of the founders of the program under investigation.
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Affiliation(s)
- Johan Strömbeck
- Åbo Akademi University, Turku, Finland.,Magelungen Utveckling AB, Stockholm, Sweden
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9
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Fukuya Y, Matsuyama Y, Isumi A, Doi S, Ochi M, Fujiwara T. Toothbrushing and School Refusal in Elementary School: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207505. [PMID: 33076373 PMCID: PMC7602552 DOI: 10.3390/ijerph17207505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/01/2020] [Accepted: 10/10/2020] [Indexed: 11/25/2022]
Abstract
The aim of this study was to examine the association between toothbrushing frequency and school refusal among elementary school children. We used data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) longitudinal study conducted between 2015 and 2016 in Adachi City, Tokyo, Japan. A questionnaire was distributed to all first-grade children aged 6 to 7 years (N = 3697, follow-up rate: 86.2%). Propensity score (PS) matching was applied to collapse the known covariates on toothbrushing frequency in grade 1 on the association with school refusal in grade 2. Among the followed children, 2.4% showed school refusal in grade 2 (89 children) and 23.5% (870 children) brushed their teeth once or less than once daily in grade 1. After propensity score matching, children with toothbrushing once or less than once daily in grade 1 were 2.25 (95% CI: 1.25–4.05) times more likely to show school refusal in grade 2, compared with those with toothbrushing twice or more a day. Our findings suggest that toothbrushing once or less than once daily is an independent risk factor for school refusal among children. Oral health promotion to recommend toothbrushing more than once a day could prevent school refusal. Further intervention studies investigating the mechanism and causality are warranted.
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Affiliation(s)
- Yoshifumi Fukuya
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (Y.F.); (Y.M.); (A.I.); (S.D.)
| | - Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (Y.F.); (Y.M.); (A.I.); (S.D.)
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (Y.F.); (Y.M.); (A.I.); (S.D.)
- Japan Society for the Promotion of Science, Tokyo 102-0083, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (Y.F.); (Y.M.); (A.I.); (S.D.)
- Japan Society for the Promotion of Science, Tokyo 102-0083, Japan
| | - Manami Ochi
- National Institute of Public Health, Department of Health and Welfare Services, Saitama 351-0104, Japan;
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (Y.F.); (Y.M.); (A.I.); (S.D.)
- Correspondence: ; Tel.: +81-3-5803-5187
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10
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Martens BK, Baxter EL. Pediatric Prevention: Academic Behavior. Pediatr Clin North Am 2020; 67:469-479. [PMID: 32443987 DOI: 10.1016/j.pcl.2020.02.002] [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] [Indexed: 11/24/2022]
Abstract
Many children in the United States are performing below basic standards in reading, mathematics, and writing. Children at risk for academic problems often have comorbid classroom behavior problems and/or are diagnosed with high-incidence disabilities. Early intervention to prevent academic problems is a key goal of school-wide response-to-intervention models. The goal of school-based instructional intervention is to increase children's strength of responding so basic academic skills can be combined to solve more complex tasks. Parents and caregivers can support intervention efforts at school by engaging in frequent communication with student assistance teams and helping children with academic work completion at home.
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Affiliation(s)
- Brian K Martens
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244-2340, USA.
| | - Emily L Baxter
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244-2340, USA
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11
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Gallé-Tessonneau M, Heyne D. Behind the SCREEN: identifying school refusal themes and sub-themes. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2020. [DOI: 10.1080/13632752.2020.1733309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - David Heyne
- Leiden University Institute of Psychology , Leiden, The Netherlands
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12
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Martin R, Benoit JP, Moro MR, Benoit L. School Refusal or Truancy? A Qualitative Study of Misconceptions Among School Personnel About Absenteeism of Children From Immigrant Families. Front Psychiatry 2020; 11:202. [PMID: 32265757 PMCID: PMC7099978 DOI: 10.3389/fpsyt.2020.00202] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/02/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND School refusal is a form of school attendance problem (SAP) distinct from truancy, school withdrawal, and school exclusion; it requires specific mental health care. Schools' identification and referral to care of school refusers depends on school personnel's interpretation of the reasons for absences. Because cultural factors can induce misunderstanding of the young people's behavior and of their parents' attitudes toward school attendance, school personnel can have difficulty understanding these reasons for children with transcultural backgrounds (migrants or children of migrants). The aim of this study was to explore the experiences and opinions of school personnel, mainly teachers, related to school refusal among these students. METHODS Grounded theory methodology was used to conduct 52 qualitative interviews of school personnel in two regions of France. Their daily practices with students presenting with school refusal were addressed in general (i.e., in response to absence of all youth) and in transcultural contexts (i.e., absence of migrant children or children of migrants). This study analyzed the interviews of the 30 participants who reported working with students from transcultural backgrounds. RESULTS Many school personnel reported experiencing difficulties, ambivalence, and destabilizing feelings in situations involving immigrant families whose school culture differed from their own. Talking about culture appeared to be taboo for most participants. These situations challenged the participants' usual strategies and forced them to devise new ones to deal with these young people and their families. Although some personnel were at risk of developing exclusionary attitudes, others dealt with school refusal with both commitment and creativity. CONCLUSION The tensions experienced by these participants reveal contradictions between the French universalist ideology and the reality of daily life in schools becoming increasingly multicultural. School personnel's attitudes toward children with transcultural backgrounds presenting with school refusal can affect children's access to care and shape social inequalities. Further research should develop, implement, and assess interventions including transcultural training of school personnel, improved use of interpreters at school for migrant families, and the addition of a transcultural dimension to SAP assessment scales, especially for school refusal.
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Affiliation(s)
- Robin Martin
- Maison des Adolescents de Saint-Denis, Saint-Denis Hospital, Saint Denis, France
| | - Jean Pierre Benoit
- Maison des Adolescents de Saint-Denis, Saint-Denis Hospital, Saint Denis, France
| | - Marie Rose Moro
- Maison des Adolescents-Maison de Solenn, Hôpital Cochin, APHP, Paris, France.,University of Paris, Medical School, Faculty of Psychology, PCPP, Boulogne-Billancourt, France.,Center for Research in Epidemiology and Population Health (CESP), Paris-Sud and UVSQ Medical Schools, French National Institute of Health and Medical Research (Inserm), Team DevPsy, Villejuif, France
| | - Laelia Benoit
- Maison des Adolescents-Maison de Solenn, Hôpital Cochin, APHP, Paris, France.,University of Paris, Medical School, Faculty of Psychology, PCPP, Boulogne-Billancourt, France.,Center for Research in Epidemiology and Population Health (CESP), Paris-Sud and UVSQ Medical Schools, French National Institute of Health and Medical Research (Inserm), Team DevPsy, Villejuif, France
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13
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Maeda N, Heyne D. Rapid Return for School Refusal: A School-Based Approach Applied With Japanese Adolescents. Front Psychol 2019; 10:2862. [PMID: 31920885 PMCID: PMC6934052 DOI: 10.3389/fpsyg.2019.02862] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 12/03/2019] [Indexed: 11/29/2022] Open
Abstract
Cognitive behavioral therapy (CBT) is often effective in the treatment of school refusal (SR). Its usefulness is limited, however, if youth displaying SR also refuse to attend treatment sessions. In these cases parents and school staff may consider using school-based interventions that do not rely on face-to-face assessment and treatment with the young person. The current study examined the effectiveness of a school-based intervention applied in Japan to achieve rapid return to school among adolescents displaying SR. Between 2009 and 2015, the parents of 62 adolescents displaying SR were invited to implement a school-based rapid return approach. Thirty-nine parents agreed to implement the approach and 23 decided to wait until their child spontaneously attended school. Of the 39 cases in which the approach was implemented, 28 adolescents (72%) resumed attendance at their original school, 2 (5%) transferred to another school, and 9 (23%) did not resume attendance. In contrast, all 23 non-intervention cases continued to refuse to attend school for 3 months or longer, and none of these adolescents returned to regular school attendance within 9 months. This study tentatively suggests that the rapid return approach may be an effective form of intervention for adolescents displaying SR and simultaneously refusing to attend individual therapy. Because this approach is ethically complex, involving forced school attendance in adolescence, it should only be employed under specific circumstances. These circumstances are discussed.
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Affiliation(s)
- Naoki Maeda
- School of Social Welfare, Kyushu University of Health and Welfare, Nobeoka, Japan
| | - David Heyne
- Institute of Psychology, Leiden University, Leiden, Netherlands
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14
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Kearney CA, Gonzálvez C, Graczyk PA, Fornander MJ. Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 1). Front Psychol 2019; 10:2222. [PMID: 31681069 PMCID: PMC6805702 DOI: 10.3389/fpsyg.2019.02222] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/17/2019] [Indexed: 12/22/2022] Open
Abstract
School attendance is an important foundational competency for children and adolescents, and school absenteeism has been linked to myriad short- and long-term negative consequences, even into adulthood. Many efforts have been made to conceptualize and address this population across various categories and dimensions of functioning and across multiple disciplines, resulting in both a rich literature base and a splintered view regarding this population. This article (Part 1 of 2) reviews and critiques key categorical and dimensional approaches to conceptualizing school attendance and school absenteeism, with an eye toward reconciling these approaches (Part 2 of 2) to develop a roadmap for preventative and intervention strategies, early warning systems and nimble response, global policy review, dissemination and implementation, and adaptations to future changes in education and technology. This article sets the stage for a discussion of a multidimensional, multi-tiered system of supports pyramid model as a heuristic framework for conceptualizing the manifold aspects of school attendance and school absenteeism.
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Affiliation(s)
| | - Carolina Gonzálvez
- Department of Developmental Psychology and Teaching, University of Alicante, San Vicente del Raspeig, Spain
| | - Patricia A. Graczyk
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Mirae J. Fornander
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States
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15
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Brouwer-Borghuis ML, Heyne D, Sauter FM, Scholte RH. The Link: An Alternative Educational Program in the Netherlands to Reengage School-Refusing Adolescents With Schooling. COGNITIVE AND BEHAVIORAL PRACTICE 2019. [DOI: 10.1016/j.cbpra.2018.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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16
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Ingul JM, Havik T, Heyne D. Emerging School Refusal: A School-Based Framework for Identifying Early Signs and Risk Factors. COGNITIVE AND BEHAVIORAL PRACTICE 2019. [DOI: 10.1016/j.cbpra.2018.03.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Antidepressant Medication: Is It a Viable and Valuable Adjunct to Cognitive-Behavioral Therapy for School Refusal? COGNITIVE AND BEHAVIORAL PRACTICE 2019. [DOI: 10.1016/j.cbpra.2018.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Heyne D, Gren-Landell M, Melvin G, Gentle-Genitty C. Differentiation Between School Attendance Problems: Why and How? COGNITIVE AND BEHAVIORAL PRACTICE 2019. [DOI: 10.1016/j.cbpra.2018.03.006] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chu BC, Guarino D, Mele C, O’Connell J, Coto P. Developing an Online Early Detection System for School Attendance Problems: Results From a Research-Community Partnership. COGNITIVE AND BEHAVIORAL PRACTICE 2019. [DOI: 10.1016/j.cbpra.2018.09.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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McKay-Brown L, McGrath R, Dalton L, Graham L, Smith A, Ring J, Eyre K. Reengagement With Education: A Multidisciplinary Home-School-Clinic Approach Developed in Australia for School-Refusing Youth. COGNITIVE AND BEHAVIORAL PRACTICE 2019. [DOI: 10.1016/j.cbpra.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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Gallé-Tessonneau M, Grondin O, Koleck M, Doron J. Considérations méthodologiques pour la construction de questionnaires : l’exemple de la SChool REfusal EvaluatioN (SCREEN). ANNALES MEDICO-PSYCHOLOGIQUES 2018. [DOI: 10.1016/j.amp.2017.03.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gallé-Tessonneau M, Gana K. Development and Validation of the School Refusal Evaluation Scale1 for Adolescents. J Pediatr Psychol 2018; 44:153-163. [DOI: 10.1093/jpepsy/jsy061] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 07/12/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Kamel Gana
- Department of Psychology, University of Bordeaux
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Londono Tobon A, Reed MO, Taylor JH, Bloch MH. A Systematic Review of Pharmacologic Treatments for School Refusal Behavior. J Child Adolesc Psychopharmacol 2018; 28:368-378. [PMID: 29741917 PMCID: PMC6909768 DOI: 10.1089/cap.2017.0160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE School refusal is an important pediatric problem with significant negative short- and long-term outcomes. Specific psychosocial treatments appear effective in reducing school refusal, but many children do not respond to these treatments. Although systematic reviews have examined the efficacy of psychological interventions for school refusal, no systematic reviews on pharmacological interventions exist. METHODS We conducted a comprehensive literature search of MEDLINE, PsycINFO, Scopus, and Embase for randomized controlled trials (RCTs) or quasi-experimental pharmacologic trials in children and adolescents with school refusal reported in English or Spanish until July 1, 2017. Two authors screened study titles and abstracts for eligibility. Data regarding the population, intervention, comparison, and outcomes for each trial were extracted and reported. Effect sizes for school attendance are presented. RESULTS The search identified 6 articles, including 7 trials (6 RCTs and 1 open label) and 306 youths. Pharmacologic treatments investigated for school refusal included antidepressants (imipramine, clomipramine, and fluoxetine) and benzodiazepines (alprazolam). All pharmacotherapies studied had pretreatment to posttreatment improvements on school refusal, depression, and anxiety symptoms. However, included trials were severely underpowered and did not demonstrate significant improvement compared to placebo. CONCLUSIONS Data regarding pharmacological treatments for school refusal are sparse. Most trials in this area were conducted before development of newer antidepressants, were underpowered, and have significant methodological limitations that are characteristic of the time in which they were conducted. This systematic review highlights the need for more trials with newer pharmacologic agents, larger sample sizes, and improved systematic assessments of school refusal and comorbidities. School refusal represents an important functional outcome for many children, especially those with anxiety and depression. Future pharmacologic studies of anxiety and depression in children may benefit from incorporating specific school refusal measures as secondary outcomes.
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Affiliation(s)
- Amalia Londono Tobon
- Yale Child Study Center, New Haven, Connecticut
- Yale Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Margot O. Reed
- Yale Child Study Center, New Haven, Connecticut
- College of the Holy Cross, Worcester, Massachusetts
| | - Jerome H. Taylor
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael H. Bloch
- Yale Child Study Center, New Haven, Connecticut
- Yale Department of Psychiatry, Yale University, New Haven, Connecticut
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Gallé-Tessonneau M, Doron J, Grondin O. Des critères de repérage aux stratégies de prise en charge du refus scolaire : une revue de littérature internationale systématique. PRAT PSYCHOL 2017. [DOI: 10.1016/j.prps.2016.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Clinicians have been describing individuals with chronic fatigue states for over 100 years, although chronic fatigue syndrome is often regarded as a modern disease. The aetiology of chronic fatigue syndrome is uncertain. For young individuals with chronic fatigue syndrome there are neither reliable prevalence figures nor scientific evidence concerning the effectiveness of treatments. Information obtained from research into adult individuals with chronic fatigue syndrome may be helpful but is not necessarily directly applicable to children and adolescents. Developmental factors and the influence of other family members on the course of the disorder in young sufferers should be considered. The uncertainties surrounding chronic fatigue syndrome should not deter child and adolescent mental health workers from becoming involved in the assessment and management of individual patients. The mainstay of treatment is rehabilitation with an emphasis on gradually increasing activities. Considerable attention will need to be given to engaging the young people and their families and working effectively with a multidisciplinary team. If mental health workers do not become involved in treating young people with chronic fatigue syndrome there is a risk that psychological factors will not be addressed and that chronic functional impairment will ensue.
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Katz F, Leith E, Paliokosta E. Fifteen-minute consultation for a child not attending school: a structured approach to school refusal. Arch Dis Child Educ Pract Ed 2016; 101:21-5. [PMID: 26239652 DOI: 10.1136/archdischild-2013-304055] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 06/29/2015] [Indexed: 11/04/2022]
Abstract
Paediatric consultations in school refusal cases need to explore the presenting medical symptoms and discuss with families any psychological function of the problems that have led to non-attendance. Understanding possible reinforcements of the child's avoidant behaviour, liaising with school and reassurance of the parents are often enough to manage the situation. However, more chronic and persistent refusal often require support from an extended team around the child, often requiring input from mental health professionals. Behavioural strategies are the recommended approach to improve school attendance and to tackle the underlying anxiety or depression, or both, that may be the root cause of their non-attendance.
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Affiliation(s)
- Felicity Katz
- Camden MOSAIC, Integrated Service for Disabled Children, Kentish Town Health Centre, London, UK
| | - Elizabeth Leith
- SSC in Community Child Health MOSAIC Camden, UCL Medical School, London, UK
| | - Eleni Paliokosta
- Camden MOSAIC, Integrated Service for Disabled Children, Kentish Town Health Centre, London, UK
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27
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Developmentally sensitive cognitive behavioral therapy for adolescent school refusal: rationale and case illustration. Clin Child Fam Psychol Rev 2015; 17:191-215. [PMID: 24338067 DOI: 10.1007/s10567-013-0160-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
School refusal can be difficult to treat and the poorest treatment response is observed among older school refusers. This poor response may be explained, in part, by the impact of developmental transitions and tasks upon the young person, their family, and the treatment process. This paper describes and illustrates the @school program, a cognitive behavioral therapy (CBT) designed to promote developmental sensitivity when planning and delivering treatment for adolescent school refusal. Treatment is modularized and it incorporates progress reviews, fostering a planned yet flexible approach to CBT. The treatment is illustrated in the case of Allison, a 16-year-old female presenting with major depressive disorder and generalized anxiety disorder. A case formulation guided the selection, sequencing, and pacing of modules targeting predisposing, precipitating, perpetuating, and protective factors. Treatment comprised 16 sessions with Allison (interventions addressing depression, anxiety, and school attendance) and 15 concurrent sessions with her mother (strategies to facilitate an adolescent's school attendance), including two sessions with Allison and mother together (family communication and problem solving to reduce parent-adolescent conflict). Two treatment-related consultations were also conducted with Allison's homeroom teacher. Allison's school attendance improved during the course of treatment. By post-treatment, there was a decrease in internalizing behavior, an increase in self-efficacy, and remission of depressive disorder and anxiety disorder. Clinically significant treatment gains were maintained at 2-month follow-up. Factors influencing outcome may include those inherent to the @school program together with less specific factors. Special consideration is given to parents' use of both authoritative and autonomy-granting approaches when helping an adolescent to attend school.
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School factors associated with school refusal- and truancy-related reasons for school non-attendance. SOCIAL PSYCHOLOGY OF EDUCATION 2015. [DOI: 10.1007/s11218-015-9293-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Havik T, Bru E, Ertesvåg SK. Parental perspectives of the role of school factors in school refusal. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2013. [DOI: 10.1080/13632752.2013.816199] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Maeda N, Hatada S, Sonoda J, Takayama I. School-Based Intensive Exposure Therapy for School Refusal Behavior. Clin Case Stud 2012. [DOI: 10.1177/1534650112457456] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although previous studies have demonstrated the effectiveness of intensive exposure therapy for school refusal behavior, there have been few recent case studies on this subject. This article discusses the successful treatment of a 14-year-old student with school refusal behavior using intensive exposure therapy. In consultation sessions, the school counselor provided psychoeducation about the mechanism of school refusal behavior from a behavioral point of view, and developed the plan for intensive exposure therapy. The parents, school officials, and school counselor consecutively escorted the school refusal child from home to school. Through a series of treatments, the student was able to return to classes on a daily basis. This case study suggests that intensive exposure might be applied as an effective school-based approach for treating school refusal behavior.
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Affiliation(s)
- Naoki Maeda
- Kyushu University of Health and Welfare, Miyazaki, Japan
| | | | - Junichi Sonoda
- Kyushu University of Health and Welfare, Miyazaki, Japan
| | - Iwao Takayama
- Kyushu University of Health and Welfare, Miyazaki, Japan
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Conroy JL, Conroy PM, Newman RJ. School absence in children with fractures: is it unnecessary school regulations that keep children away from school? Injury 2006; 37:398-401. [PMID: 16504192 DOI: 10.1016/j.injury.2006.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Revised: 01/10/2006] [Accepted: 01/10/2006] [Indexed: 02/02/2023]
Abstract
We retrospectively reviewed school absence in 142 consecutive children aged 5-16 years who attended our clinic following upper or lower limb fractures that required hospital admission. A questionnaire was sent to all parents and the head teachers of the involved schools requesting details of their return to school policy following trauma. One hundred and forty-two children had fractures in the study period. One hundred and four parent questionnaires were completed. All 29 head teachers' responded. Children lost an average of 4 and 21 school days, respectively as a result of upper and lower limb fractures. Parents 92 or child 7 made the decision to return to school, this totals 95%. We concluded that school regulations rarely delay a child's return to school after a fracture.
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Affiliation(s)
- Jonathan L Conroy
- Department of Trauma and Orthopaedic Surgery, Harrogate District Hospital, UK.
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