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An activity based on Heather Moran’s Ideal Self technique, which helps to explore the hopes and aspirations of upper secondary aged and post-16 students in a meaningful and accessible way.

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Webinar based on her thesis research by Dr Rachel Sawyer

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Parents’ views on EBSNA with Dr Rachel Sawyer

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Document to go with Rachel Sawyer's thesis research and the webinar above.

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'Emotionally-based school non-attendance' (EBSNA) is increasingly understood as a multi-faceted difficulty, with a range of school, home and individual factors contributing to a child's or young person's anxiety around attending school.

The literature on this topic therefore highlights the importance of adopting a multi-systemic, or collaborative, approach to supporting EBSNA in line with Bronfenbrenner's 'Eco systemic' Theory, with a 'one size fits all approach' being viewed as unhelpful. Recently, the Department for Education have published guidance around 'Summary of responsibilities where a mental health issue is affecting attendance' (February 2023) . This references the need to involve parents when developing action plans around attendance, suggesting increased acknowledgement of the need for a joint-systems approach.

Despite this, however research suggests this may not be happening in practice, with parents reporting feelings of 'blame' and 'abandonment' from professionals*. To date, few studies have explored the parental voice on this topic, despite the responsibility placed upon them within legislation and statutory guidance, which ultimately will prevent effective collaboration and understanding across systems.

Within my research , I explored the views of five parents whose children had previously experienced EBSNA, hoping to learn more about 'what works' when supporting this difficulty, as well as what professionals can be doing more of when working with children and families, to inform a 'joined up' approach to support.

The six resulting themes are displayed below, and represent a framework ('SPIRAL') that both schools and external professionals can refer to when planning and implementing EBSNA support, as well as when evaluating existing support pathways. It is hoped that this framework, drawn directly from parental voice and experience, can inform developments in professional practice, leading to parents feeling included, supported and heard when addressing their child's needs.

Parents highlighted a need to access emotional and practical support in order to meet their child's needs and feel able to advocate for them, which included communicating with other parents, accessing emotional support and having their own needs met (e.g. health needs, transport, advocacy services etc,)
* Emotional support and reassurance
* Parent-to-parent support
* Understanding parents

Promoting CYP's Sense of Belonging

Parents highlighted the need for an individualised and person-centred approach to supporting EBSNA that promoted their child's sense of inclusion and moved at their pace. This included considering the child's wellbeing as well as learning and attendance.
* Relationship-based approach
* Person-centred approach
* Promoting psychological safety.

Informing and Including parents

Parents shared that regular communication and information sharing with schools, as well as consistency, contributed to the developing of trusting and collaboration home-school partnerships. This was viewed as critical for successful EBSNA support.
* Maintaining trusted relationships
* Listening to parents' views
* Signposting and navigating services.

Raising awareness of EBSNA

Parents discussed the need for increased understanding of anxiety within schools, and how this supports early identification and intervention for EBSNA-related difficulties.
* Professional knowledge and understanding.
* Need for early intervention.

Accessing external professionals

Parents shared the importance of involving different professionals depending on the child's needs and barriers to attendance, however highlighted that this is most effective when this involvement included parents in action planning. Parents also noted that long waiting lists and complex referral processes were currently preventing early intervention from taking place, and that easier access to professionals is need to support both schools and families experiencing EBSNA.
* Specialist knowledge in action planning.
* Working in collaboration with parents
* Difficulty accessing services

Lessons learnt from Covid

Parents spoke positively about the Covid-19 school closures, with their child's anxiety appearing to reduce with the removed pressure of attending school. Some shared how the remote learning provided this time allowed their child to re-engage and catch up with missed learning time, whilst others discussed how relationships were formed and maintained remotely, suggesting that adjustments made during this time could work well for CYP experiencing EBSNA.

EBSA Horizons Educational Psychologist CPD

EBSA Horizons is a comprehensive CPD course for EPs, which develops understanding and skills to support children and young people experiencing difficulties attending school. This course has been recently updated for 2023 with two new chapters -
Chapter 6: Supporting Autistic CYP Experiencing EBSA Chapter 7: Entrenched EBSA
Find out more aboutand register your interest to receive 3 FREE key resources from this course.

EBSA Horizons School Staff Training

EBSA Horizons School Training is an equally comprehensive CPD course for School Staff, which also develops understanding and skills to support children and young people experiencing difficulties attending school. This course has been updated for 2023 with a new chapter -
Chapter 6: The Systemic Change Model of EBSA
Find out more aboutEBSA Horizons School Training here and register your interest to receive 3 FREE key resources from this course.

See the Checklist for Attendance Tracking and Support from EBSA Horizons from this course.

References

[1] Nuttall, C., & Woods, K. (2013). Effective intervention for school refusal behaviour. Educational Psychology in Practice, 29(4), 347-366, doi: https://doi.org/10.1080/02667363.2013.846848

[1] Bronfenbrenner, U. (1992). Ecological systems theory. In R. Vasta (Ed.), Six theories of child development: Revised formulations and current issues (pp. 187-249). Jessica Kingsley Publishers

[1] Summary of responsibilities where a mental health issue is affecting attendance (publishing.service.gov.uk)

[1] Parents' views on EBSNA: A solution-based exploration into successful reintegration. - UEA Digital Repository

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Parent Views | EBSNA (Emotionally Based School Non-Attendance)

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EBSNA is increasingly understood as a multi-faceted difficulty, with a range of school, home and individual factors contributing to a CYP's anxiety around attending school. The literature on this topic highlights the importance of adopting a multi-systemic, or collaborative, approach to support.

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Pupil Views about support card sort - Primary

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Pupil Views about support card sort - Primary

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These cards are to be used when supporting children who may struggle to identify the things about school that they find positive and what they need in order to help them succeed. This set is designed for children of primary age. These can be used to support the ideal school/ ideal classroom activity.

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Shorter version of the whole staff EBSNA Training video. This video should not be used in isolation, but is ideal for helping staff who have received the training cascade it to others.

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The EBSA Horizons course for Educational Psychologists, presents an alternative model of Emotionally Based School Avoidance, in which the child's voice is at the heart of assessment and intervention, and emphasis is placed on understanding EBSA in the context of interacting, child, home and school-based factors.

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School Wellbeing Risk and Resilience Card Set

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Providing invaluable insight into how the young person views and makes sense of their experience of school and places their voice at the centre of any planning.

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Mapping the Landscape of Fear (Drag and Drop)

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Mapping the Landscape of Fear (Drag and Drop)

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Mapping the Landscape of Fear (Drag and Drop)

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Mapping the Landscape of Fear (Drag and Drop)

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MTLOF Cards specifically designed for primary age students

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Mapping the Landscape of Fear (Secondary)

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Mapping the Landscape of Fear (Secondary)

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MTLOF Cards specifically for secondary age pupils

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The Dr Karen Treisman Take What You Need Tokens allow you to explore a range of questions with young people (and their parents/ carers) to help prioritise needs and help set a focus.

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The Me, myself, and school workbook provides the opportunity for children to share their experiences about school in a relaxed, creative way.
This information can then be used to ensure that the child's voice is represented when planning support.

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Kerrie currently works as a manager for a regional autism charity, where she manages the support for families and leads the organisation's autism acceptance award. Having worked in the field of autism for 18 years, she is passionate about how we can change the narrative around autism, reduce inequalities and promote better well-being.

Kerrie recently completed her Masters's at the University of Strathclyde where her research focused on amplifying the experiences of autistic youth, and how they wanted to influence positive societal change. She is currently studying for her Education doctorate, focusing on autism.

Kerrie speaks at many events including conferences and podcasts.

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Me myself and School: A workbook for children and young people

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While school for some children is a positive experience, many children find school challenging and overwhelming. The Me, myself, and school workbook provides the opportunity for children to share their experiences about school in a relaxed, creative way. This information can then be used to ensur...

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Pooky Knightsmith: Understanding Emotionally Based School Avoidance

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Pooky Knightsmith: Understanding Emotionally Based School Avoidance

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Webinar and a series of resources to help schools understand and support young people experiencing EBSNA.

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WEBINAR: Emotionally Based School Avoidance

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Slides and resources from a session designed to get to the heart of emotionally based school avoidance and offer practical ideas to prevent and support.

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This short Bite Psych video, produced by the Educational Psychology Service highlights the importance of even the smallest interactions and encourages us to think about how this might be important for the young people we interact with.

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Video made with Biteable. The World's Simplest Video Maker

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This is a recording of the initial EBSNA training delivered by Newcastle EPS and is for use of schools who have already received the training who may want to cascade it to their staff. The document is password protected so please email the EP who delivered your training to get the password.

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Initial EBSNA Workshop WEBINAR version-protected

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Protective Factors to support attendance at school

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Protective Factors to support attendance at school

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Infographic inspired by the Resilience Ball, developed by Hampshire EPS. The second page offers conversation starters school can use to prompt conversations with parents/ carers.

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Examples of Push and Pull Factors that may affect school attendance

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Examples of Push and Pull Factors that may affect school attendance

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Four Functions of EBSNA and Suggested Interventions

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Four Functions of EBSNA and Suggested Interventions

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Emotionally Based School Non-Attendance Formulation Sheet (A3)

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Emotionally Based School Non-Attendance Formulation Sheet (A3)

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The Formulation Sheet should only be used by those who have had the EBSNA Training from Newcastle EPS or cascaded from staff within your school/ organisation.

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An example completed formulation sheet.

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Instructions to support the completion of the formulation sheet.

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EBSNA Formulation Example with Instructions and helpful resources

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Alongside the work the EBSNA team have been doing around family resilience, this model, using the Resilience Ball as a starting point, asks us to consider the key features that support family resilience.

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An opportunity to think about how push/pull factors affect the families that we are working with.

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Action For Children EBSNA Support Group Flyer

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Action For Children EBSNA Support Group Flyer

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The ATTEND framework is available to purchase from Brighton & Hove. This page also links with an introductory video about the framework.

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The ATTEND Framework was developed within BHCC as an early intervention programme for school-aged pupils between 5 and 16 years when attendance drops below 90%. It aims to identify all of the

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The Student Resilience Survey is a 47-item measure comprising 12 subscales measuring students’ perceptions of their individual characteristics as well as protective factors embedded in the environment

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The Student Resilience Survey is a 47-item measure comprising 12 subscales measuring students' perceptions of their individual characteristics as well as protective factors embedded in the environment:

Communication and cooperation, self-esteem, empathy, problem solving, goals and aspirations, family connection, school connection, community connection, autonomy experience, pro-social peers, meaningful participation in community activity and peer support

Each item was rated on a 5-point scale (1 = never to 5 = always).

Psychometric properties

The findings suggest that the SRS is a valid measure assessing these relevant protective factors, thereby serving as a valuable tool in resilience and mental health research.

Reliability
Degree to which respondents in a similar sample had similar scores

The internal consistency for all the subscales was good

All the SRS subscales had high reliability and the subscales (except for empathy) were negatively associated with mental health problems, global subjective distress and impact on health (Lereya et al.2016)

Internal consistency
The degree to which similar items within a scale correlate with each other

The internal consistency for all the subscales was good (Lereya at al, 2016)

Test-retest reliability
Degree to which the same respondents have the same score after period of time when trait shouldn't have changed
No information at present

Criterion validity
Extent to which a measure is related to an outcome

Our results showed that SRS subscales have loaded uniquely onto their respective 10-factor structure. All the SRS subscales had high reliability and the subscales (except for empathy) were negatively associated with mental health problems, global subjective distress and impact on health. Given the interest of investigating the relationship between risk, psychological outcomes and development, the SRS provides an exciting possibility to assess several different protective factors, and can thus be used as a valuable measurement tool in resilience and risk factor research (Lereya at al, 2016).

Suitability

The survey is appropriate for children aged 7 and older

Translation

None known.

Administration

The survey is appropriate for children aged 7 and older and comes in a single child reported version

Terms of use

Free to use. Please contact author for further information regarding the copyright.

Working remotely with the Student Resilience Survey

Provided below is a fillable PDF version of the Student Resilience Survey. To open and complete the PDF electronically you need access to PDF reader software on your computer, smartphone or tablet. If you don't have this, one option that is free to download is Adobe Acrobat Reader.
Download here
To find out more about working with outcome and experience measures remotely,please visit this page.

References

Lereya, S.T. et al. (2016). The student resilience survey: psychometric validation and associations with mental health. Child and Adolescent Psychiatry and Mental Health, 10:44.

Sun, J., & Stewart, D. (2007). Development of population-based resilience measures in the primary school setting. Health Education, 7(6), 575-599.

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The Student Resilience Survey is a 47-item measure comprising 12 subscales measuring students' perceptions of their individual characteristics and environment

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Webinar: Emotionally Based School Avoidance

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Webinar: Emotionally Based School Avoidance

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This webinar discussed Emotionally based school avoidance (EBSA) a term used to describe young people who have difficulty attending school due to emotional needs.

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Emotionally based school avoidance (recording) - ACAMH

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This webinar discussed Emotionally based school avoidance (EBSA) a term used to describe young people who have difficulty attending school due to emotional needs. Dr. Cat Halligan and Jemma Michelson who have developed and delivered the Royal Free Children’s Hospital School’s ‘LinkEdUP’ online reeng…

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Somerset EPS EBSNA Parent Training Webinar

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Somerset EPS EBSNA Parent Training Webinar

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Parents/ Carers EBSA Guidance | Support Services for Education

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What can I do if my child won't go to school?

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What can I do if my child won't go to school?

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A three part series on EBSA from a paren't perspective.

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Dr Tina Rae is a Child Psychologist and award winning author specialising in the mental health and wellbeing of children and young people.

She has recently produced a set of resources aimed at parents of children who struggle with the transition from home to school. This was a huge issue for many parents before 2020 but this year has gone further to exacerbate an already difficult situation. Many individuals came back to school very positively to start with but unfortunately for some, this positive start is beginning to waver.

The following ideas describe how parents can prepare for this transition with practical tips that include the importance of self care. I am delighted to be able to share these resources with you. Please also scroll down for details of other resources and Dr Tina's YouTube channel. You can catch up with her on Twitter as well: @DrTinarae.

Sunday evening:

Soothe- do some calming activities and make the last things at night soothing - gentle music, story for younger ones, soft lighting, talk about 3 good things before bed.

Understand- make sure you let them know that you do understand their feelings and you do not negate of dismiss them - you understand how hard it is but it will get better in time! Develop your script for this if appropriate.

Neutralise- record any worries in a worry book and then talk through each one helping the child to see a solution/where they are catastrophising and show them the evidence against any irrational thoughts/thinking patterns.

Decide- on a plan of action and go through it step by step - this is what we will do tomorrow. Work out the schedule and ensure that everything is ready - book, bag, PE kit etc and laid out for the next morning. Make the plan visual if needed.

Attend- be vigilant to the child's emotional state and give more time if they need it so that they feel nurtured and safe. Give reassurance and a transitional object for younger children.

Yourself- look after yourself and make sure that you are regulated and feel calm yourself. Engage in some relaxation and take time out after the bedtime routine for you to build up your own resources and remember that it is ok to feel worried but don't let it overwhelm you.

Monday Morning:

Manage- manage yourself FIRST! This is not selfish. This is not selfish. You cannot support a child or young person who is unregulated and stressed if you are too. Take time to sort your own needs and then manage your emotional state by using your usual stress management tools e.g. grounding/time alone/Mindfulness etc.

Organise- get everything ready ( by getting up earlier ) so the bags are in the hallway, the breakfast is set up and you own things for work/whatever you need are all organised. This means that you can attend to the child and do so in a regulated manner.

Neutralise- spend some time with your child talking through any worries and again helping them to see a solution/where they are catastrophising and show them the evidence against any irrational thoughts/thinking patterns.

Decide- this is the plan - make it clear to them that you have a plan to get to school, how you will get here, what music you might listen to in the car/stories you might tell to each other on the bus/as you walk/who else might be with you etc so that it all becomes clear and they feel prepared for each step.

Accept- accept the child's emotional state and give them reassurance that you love and care for them so that they feel nurtured and safe. Give reassurance and a transitional object for younger children. It is okay to feel anxious, but we all need to manage it and I will help you. I am with you
and will stay with you while you need me.

Yourself- again look after yourself and make sure that you are regulated and feel calm yourself. Engage in some relaxation and remember that it is ok to feel worried but don't let it overwhelm you. keep using the script - if I stay calm, I will make him/her feel safe.

Find your calm plan:

Focus on what you can control to reduce your anxiety
Identify 3 positives at the end of each day and revisit them at the start of the next day
Neutralise those negative thoughts by reframing them into more effective ones and remember a thought is not necessarily true
Develop a self-care plan and stick to it! Write it down and follow it each day and remember self-care is not selfish and you cannot pour from an
empty vessel
Yourself first - Attend to your own needs for calm so that you can share it with your child and remember you cannot regulate others if you are unregulated.
Observe your breathing and take deep breaths when it becomes shallow or tight and Put your hand on your heart and just PAUSE.
Understand that it is normal to feel anxious when we are in uncertain times and try to remain hopeful knowing that this too shall pass.
Regulate regularly and use Grounding, Best breathing, Mindfulness and exercise to soothe your nervous system - practice really does make it better!
CO-regulate with your child and show them how you do it - MIRROR.
ME - copy my breathing - 'Let's visualise together, lets draw out the worries or dance/jog them out together!'
Accept yourself in the moment and have some self-compassion - you cannot always get it right and it's okay to take some time out to vent.
Look and learn from what happens and the mistakes you and others make and be solution focused identifying what DID work well or better and problem solving instead of being problem focused.
Moderate and manage your self-care plan and adapt and be flexible in the moment knowing that finding your calm daily will only benefit you
and yours!

Share your calm plan:

Share and focus on the things your child can control - hand washing, keeping the rules around safety, not catastrophising but celebrating being safely with friends and learning again!
Help them to identify 3 positives at the end of each day and make up a good news book and revisit it at the start of the next day.
Acknowlege and do not dismiss their worries or concerns - listen and be there for them - 'I am here for you and I am going to make sure we are safe together' and support them to reframe those negative thoughts and remember a thought is not necessarily true.
Regulate together and show them how to use key tools from Mindfulness, Grounding, Deep breathing and Visualisation - let's do it together now!
Exercise regularly and help them to see the benefits of those feel good chemicals on their nervous system.
Yourself first - take the time you need to find your calm so you can share it effectively and let you child know that you need to do this too!
Observe your child's breathing and prompt them to take deep breaths when it becomes shallow or tight - use 5 finger breathing.
Understand that it is normal for us all to feel anxious and normalise this for them reinforcing that things will get better and we must not lose hope.
Regulate regularly at key points in the day - before and after school and during lessons/breaks etc and help them to keep a self-regulation diary/log -
see what works best and use it again!
Comfort your child when they need it - cuddles and kind words always help.
Accept your child in the moment and encourage them to have some selfcompassion - give the message it's ok to be scared or angry and to vent but not ok to bottle it all up.
Look for the positives and identify what DID work well or better every day and keep a list to remind them that happy moments stay with us and can be revisited.
Manage and develop their well being plan and support them to engage in happy relaxing activities on a daily basis - factor in the fun whilst regulating the nervous system!

Dr Tina also has a YouTube channel with a wealth of topics included in her Webinars such as emotional literacy and self-esteem. Click subscribe on her channel to stay to to date.

This webinar recognises the need for self care in the context of the new uncertainty of Covid-19. Defining the links between adult and child dysregulation and recognising the potential for vicarious trauma is also a key focus. There is also an opportunity to consider how to set up personal and whole school systems to effectively manage stress and anxiety as part of a holistic self care plan.

Finally, Dr Tina has also worked closely with Nurture UK ( https://www.nurtureuk.org/) to and produced The Wellbeing Toolkit. This is a training programme to build knowledge and skills in supporting the emotional health and mental wellbeing of children and young people. The key aims are to allow professionals and staff who work with children and young people to:
- Learn relevant therapeutic approaches and skills;
- Feel confident that they have developed the appropriate skills and knowledge base to identify at-risk students;
- Help prevent the escalation of any perceived difficulties and problems; and
- Fulfill Inclusion (Section 4) of the National Curriculum (2014) - by enhancing the emotional wellbeing of students and providing particular support for those experiencing social, emotional and/or behavioural difficulties, lessons can be planned to ensure that there are no barriers to every pupil achieving.

Find out more by clicking here: https://www.nurtureuk.org/news/wellbeing-toolkit-0

Thanks for reading,

Lynn

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Back To School Blues: Supporting school anxiety and reluctant returners with resources by Dr Tina Rae

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Dr Tina Rae is a Child Psychologist and award winning author specialising in the mental health and wellbeing of children and young people. She has recently produced a set of resources aimed at parents of

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Action for Children: Dealing with non-attendance

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Action for Children: Dealing with non-attendance

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Simple guidance for parents whose children are struggling to attend school. The website also offers phone call conversations.

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Support for Parents from Action For Children

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How do I deal with school refusal and school anxiety? - Support for Parents from Action For Children

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In this guide, you’ll find information on possible reasons for school refusal and anxiety and how you can get your child the support they need.

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Surrey EPS Whole School Audit Tool for schools

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Surrey EBSNA whole school INITIAL audit for schools

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Can't Not Won't: A Story About a Child Who Couldn't Go To School

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Can't Not Won't: A Story About a Child Who Couldn't Go To School

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Eliza Fricker gets it. Her compelling, hard-hitting and irreverently humorous illustrations follow a family through the early days of school avoidance, the process of accessing support and the challenges of coping in the meantime. Can't Not Won't illuminates the absurdity and frustrations that often arise when dealing with health, social and educational systems, and will help any parent in the same boat feel seen. This guide acts as a way to communicate these difficult circumstances with others.
Wonderfully relatable, the book also includes written guidance for parents and professionals on what works best when it comes to managing school avoidance.

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Can't Not Won't: A Story About A Child Who Couldn't Go To School

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I Can't Go To School: The School Non-Attender's Workbook

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I Can't Go To School: The School Non-Attender's Workbook

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A practical workbook for young people that can be used independently or with others which can be used to get help and offers activities you can try that will make being at school feel better..

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'I can't go to school!': The School Non-Attender's Workbook

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Dr Mollie Higgins, Educational Psychologist, shares the key themes and outcomes of her doctoral research around Autistic Young People experiencing Emotional Based School Avoidance (EBSA).

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Dr Mollie Higgins, Educational Psychologist, shares the key themes and outcomes of her doctoral research around Autistic Young People experiencing Emotional Based School Avoidance (EBSA). Mollie has been working alongside Dr Jerricah Holder to create a new chapter for the EBSA Horizons EP Course - Supporting Autistic CYP experiencing EBSA. To be released early next year. Sign up here to access the course. The Ideal School: EBSA and Autism
In addition to the risk factors for EBSA, autistic young people experience a number of differences which further increase their feelings of anxiety within the school environment. These include:

Differences in identifying and describing their own and others' emotions

Emotional regulation difficulties

Differences in sensory processing and finding the sensory environment overwhelming e.g. loud corridors, different smells, busy classrooms

Difficulties understanding and predicting social situations and managing interactions with others

Worries around change or transitions e.g. moving between classrooms, changes to timetables, supply teachers

Executive functioning and organisation difficulties - remembering books, homework, equipment

Masking - try to 'fit in' or attempting to appear more neurotypical by changing their behaviour and internalising any anxiety

Experiencing performance anxiety related to the schoolwork or exams

These challenges mean that some autistic students try and manage their anxiety by avoiding school altogether. This is reflected in statistics which show higher levels of EBSA amongst autistic students (Department for Education, 2021). I felt it was important to speak with students directly to hear their views and opinions about what might help them attend school.

I asked ten autistic secondary-age students to describe the best school ever and the worst school ever. This technique is known as The Ideal School and is based on Personal Construct Psychology. By asking students to describe their ideal and non-ideal schools, I was able to understand the type of adjustments that would help these students feel more able to attend school.

Five key themes were identified from the data and the key points are summarised below.

So What Can Schools Do?

This technique was adapted by Williams and Hanke (2005) using Moran's (2001) Drawing the Ideal Self.
If EBSA is an area which you're supporting CYP with, we've been fortunate to work with Dr Jerricah Holder on her EBSA Horizons courses for Educational Psychologists and School Staff. - New ** EBSA Horizons | School Training
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Sharing EP Practice: EBSA and Autism - What Can Schools Do?

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Dr Mollie Higgins, Educational Psychologist, shares the key themes and outcomes of her doctoral research around Autistic Young People experiencing Emotional Based School Avoidance (EBSA). Mollie has been working alongside Dr Jerricah Holder to create a new chapter for the EBSA Horizons EP Course - Supporting Autistic CYP experiencing EBSA.

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Supporting Children Struggling to attend School

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Supporting Children Struggling to attend School

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These slides and resources are from an online session for Creative Education in January 2023 entitled ’10 Ideas to Make School Feel Safe for Children Struggling to Attend’. The session shared practical ideas to promote attendance and engagement of children struggling with school anxiety / emotionally based school avoidance (EBSA).

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KEYNOTE | Supporting Children Struggling to Attend School

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Practical ideas to promote attendance and engagement of children struggling with school anxiety.

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Forth Valley and West Lothian RIC Attendance Webinar Series

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Forth Valley and West Lothian RIC Attendance Webinar Series

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A series of short, recorded videos by the team at FVWL RIC and based on findings from national and international research, summarising the key aspects of school attendance.

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Share your videos with friends, family, and the world

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Rewriting the Narrative: EBSA and Autistic Girls

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Rewriting the Narrative: EBSA and Autistic Girls

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The following video and supporting resources are from the popular Rewriting the Narrative webinar from May 2021 by Dr Ruth Moyse.

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Rewriting the Narrative

Lessons about inclusion from autistic adolescent girls who stop attending school﻿ A subtitled video of the webinar from May 2021 by Dr Ruth Moyse.﻿﻿ Children who stop attending school are often called truants or school refusers, placing the reason for their absence as a problem within the child. This session proposes a different way of interpreting their absence, by sharing lessons learnt from research with 10 autistic girls who stopped attending mainstream secondary schools.

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Resources from Rewriting the Narrative Webinar - NDTi

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Lessons about inclusion from autistic adolescent girls who stop attending school﻿ A subtitled video of the webinar from May 2021 by Dr Ruth Moyse.﻿﻿ Children who stop attending school are often called truants or school refusers, placing the reason for their absence as a problem within the child.

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Learner Centred Approaches to Improving Attendance and Engagement

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Learner Centred Approaches to Improving Attendance and Engagement

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Webinar by Education Scotland on how to support young people in school.

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SLF Online 2022Learner-centred Approaches to Improving Attendance and Engagement

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School attendance problems: A research update and where to go (2021)

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School attendance problems: A research update and where to go (2021)

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An anthology which collates the most up to date research from a range of international academic researchers providing up-to-date research on school attendance problems .

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A multidimensional multi-tiered system of supports model to promote school attendance and address absentee (2020)

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A multidimensional multi-tiered system of supports model to promote school attendance and address absentee (2020)

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A review of Kearney’s pyramid model and how this can be used to support the implementation of universal and targeted interventions to improve school attendance.

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A Multidimensional, Multi-tiered System of Supports Model to Promote School Attendance and Address School Absenteeism - Clinical Child and Family Psychology Review

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School attendance and school completion are important benchmarks of successful development. Unfortunately, school absenteeism and school dropout remain debilitating and prevalent conditions among youth. Stakeholders invested in promoting school attendance and reducing school absenteeism generally ag…

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School staff experiences of supporting children with school attendance difficulties in primary schools (2022)

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School staff experiences of supporting children with school attendance difficulties in primary schools (2022)

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Small survey of the experiences of primary staff (mainstream and special schools) on supporting pupils with attendance issues.

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Secondary school practitioners’ beliefs about risk factors for school attendance problems: a qualitative study

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Secondary school practitioners’ beliefs about risk factors for school attendance problems: a qualitative study

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Small sample research which provides a good outlines of the risk factors and the need for a multi-tiered approach.

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ABSTRACT

ABSTRACT
School staff have an important role to play in identifying and assisting pupils who require additional support to regularly attend school, but their beliefs about risk factors might influence their decisions regarding intervention. This qualitative study investigated educational practitioners' beliefs about risk factors for attendance problems. Sixteen practitioners from three secondary schools were interviewed via focus groups. Data were analysed using thematic analysis. Practitioners identified risk factors related to the individual, their family, peers and school. Poor mental health was identified as a risk factor, but practitioners primarily focused on anxiety rather than other mental health problems like depression or behavioural disorders. The overall perception was that school factors were less important than individual, family and peer factors. Implications include a need for increased awareness of the role of school factors in attendance problems, focus on promoting positive peer and pupil-teacher relationships, and collaborative working between young people, families and schools.

Introduction

School plays a crucial role in young people's academic, emotional and social development, and frequent absence from school is associated with a range of adverse consequences both in the short- and long-term, including poor academic outcomes (Credé, Roch, and Kieszczynka 2010), economic deprivation (Kearney 2008b), and adult unemployment (Attwood and Croll 2014). In the 2017/18 academic year, 8.7% of primary and 13.9% of secondary school pupils met criteria for persistent absence, defined by the Department for Education as missing 10% or more of available school sessions (Department for Education 2019). Furthermore, rates of authorised, unauthorised and persistent absence have increased in the last year, and unauthorised absences are now the highest since records began (Department for Education 2019).

Previous researchers have commonly divided risk factors for attendance problems into those related to the individual, their family, school, and peers (Gren-Landell et al. 2015; Ingul et al. 2012; Ingul, Havik, and Heyne 2019), in line with Bronfenbrenner's ecological theory, which recognises the important role of factors in all of these domains in child development (Bronfenbrenner and Morris 2006). In terms of factors related to the individual, research has demonstrated that poor physical health (Ingul et al. 2012), mental health problems (Egger, Costello, and Angold 2003), special educational needs (Havik, Bru, and Ertesvåg 2015b) and drug or alcohol use (Gase et al. 2014) are risk factors for poor attendance. Factors related to the family include neglectful parenting (Gase et al. 2014), lack of parental involvement in school activities (Hendron and Kearney 2016), unemployment (Ingul et al. 2012), family conflict (McShane, Walter, and Rey 2001) and family history of attendance problems (Dalziel and Henthorne 2005). School factors include poor school climate (including connectedness and perceptions of school safety (Van Eck et al. 2017)), poor pupil-teacher relationships (Egger, Costello, and Angold 2003; Malcolm et al. 2003) and school transition periods (Malcolm et al. 2003). Finally, factors related to peers include social isolation (Havik, Bru, and Ertesvåg 2015a), a lack of peer support (Hendron and Kearney 2016), peer conflict (McShane, Walter, and Rey 2001), bullying (Ingul et al. 2012) and pressure from peers to skip school (Malcolm et al. 2003).

Despite the common categorisation of risk factors into these four broad domains, in reality, complex interplays exist within and between these categories, as reflected by 'mesosystems' in Bronfenbrenner's ecological theory (Bronfenbrenner and Morris 2006). For example, poor pupil-teacher relationships and bullying can both negatively impact mental health (Lang et al. 2013; Barchia and Bussey 2010), and parents with a history of attendance problems may be less inclined to involve themselves in their child's school activities. In addition, some risk factors could be argued to fall under multiple domains. For example, a lack of parental involvement in school activities is often considered a family factor, but may also be influenced by the young person (individual factors) and/or the school environment (school factors). Whilst grouping risk factors into broad domains may be helpful for conceptualisation of the problem, in practice it is likely that attendance problems result from complex interactions between risk factors, and the best approaches are likely to involve interdisciplinary collaboration between professionals in the fields of education and healthcare, as well as between these professionals and families (Heyne 2019; Kearney 2008a; Gren-Landell et al. 2015).

A further complicating factor in school attendance research is the continued debate regarding terminology. A full discussion is outside the scope of this paper, but a brief description is provided and interested readers are directed towards more in-depth discussions provided elsewhere (e.g. (Elliott and Place 2017; Heyne et al. 2018; Kearney 2008b). School attendance has historically been divided into two subtypes: (a) school refusal, referring to pupils who miss school due to anxiety or emotional distress, with the knowledge of their parents; and (b) truancy, referring to pupils who miss school due to a lack of interest in school or defiance of authority, and who attempt to conceal the absence from their parents. School refusal is typically considered to be related to internalising problems such as depression or anxiety, while truancy is considered to be related to externalising problems. However, a study by Egger, Costello, and Angold ( 2003) demonstrated that school refusal and truancy are not mutually exclusive, and other studies, including two linked systematic reviews, have shown that truancy is strongly associated with internalising problems (Finning et al. 2019a, 2019b; Mandalia et al. 2018; Gase et al. 2014). It could therefore be argued that grouping attendance problems into subtypes such as school refusal and truancy lacks empirical support, and may result in adults around the young person making inaccurate assumptions about the underlying aetiology of the problem. Indeed, truancy is viewed less sympathetically by school staff than school refusal and is more likely to be approached punitively rather than therapeutically (Armstrong et al. 2011).

School staff are likely to be among the first to recognise poor or changing patterns of attendance and play a central role in identifying pupils who are struggling to attend. It is important, therefore, to understand the beliefs of school staff regarding risk factors for attendance problems. In a survey of Swedish teachers, family factors and child low mood/depression were believed to be the two leading causes of attendance problems in young people aged 12 to 15 years (Gren-Landell et al. 2015). In a quantitative survey in the UK, Malcolm et al. ( 2003) found that primary and secondary school teachers believed home factors such as inadequate parenting, a disorganised lifestyle, and low value placed on education, to be causes of truancy. Secondary school teachers additionally discussed the influence of non-familial factors such as bullying, pressure from peers to miss school, a curriculum not suited to the pupil's needs (e.g. over-academic or 'boring'), and school change or transition.

The majority of previous research has investigated teachers' views while overlooking the experiences of other school staff who play an important role in identifying and responding to attendance problems, including those with greater pastoral roles. A qualitative study by Cunningham ( 2017) explored the experiences of primary school practitioners in a variety of teaching and non-teaching roles. Practitioners in this study discussed a range of factors they believed increased pupils' risk of attendance problems, including anxiety, low academic confidence, peer difficulties, low family aspirations, parental anxiety and overprotection, family deprivation, and a chaotic home life. However, factors related to the school were rarely discussed, supporting findings from previous research that teachers perceive home-life as the primary cause of attendance problems, despite pupils and parents emphasising school factors (Gregory and Purcell 2014; Havik, Bru, and Ertesvåg 2014; Malcolm et al. 2003; Gren-Landell et al. 2015; Dannow, Esbjørn, and Risom 2018).

To the best of our knowledge there have been no qualitative studies to explore secondary school educational practitioners' beliefs about risk factors for attendance problems. Given that rates of overall and persistent absence are higher in secondary, compared to primary, school (Department for Education 2019), it is important to understand attendance problems from the perspective of those who have experience working with this age-group. This study aims to investigate secondary school educational practitioners' beliefs about risk factors for school attendance problems.

Methods

Sample

Opportunity sampling was used to recruit 16 secondary school educational practitioners from three schools in the South West of the UK, with one focus group conducted at each of the three schools. Table 1 provides further details of the three schools. Practitioners could be working in any teaching or non-teaching role, but were required to have experience of working with pupils with attendance problems. Table 2 provides further details of the 16 practitioners who participated.

Secondary school practitioners' beliefs about risk factors for school attendance problems: a qualitative study

01 August 2019

Secondary school practitioners' beliefs about risk factors for school attendance problems: a qualitative study

01 August 2019

Data collection

Procedure

Eighteen schools were initially approached, via an email from BD, which was followed up with a phone-call. Three schools agreed to participate. Practitioners from these schools were recruited to the study via word-of-mouth from a lead point of contact at the school. Focus groups were conducted within school grounds, during or at the end of the school day, by BD who had prior experience as a teacher and was undertaking an MSc in Psychology. Each focus group was additionally attended by a moderator, who assisted BD and took notes. Practitioners had no relationship with either researcher prior to their participation in the study. Written consent was provided by all practitioners. Focus groups lasted between 39 and 54 minutes, and were audio-recorded, transcribed and double-checked for accuracy by KF.

Analysis

Results

Analysis identified four major themes, related to individual, family, peer, and school factors. Figure 1 shows the four themes and the factors identified within each theme.

Secondary school practitioners' beliefs about risk factors for school attendance problems: a qualitative study

01 August 2019

Individual factors

Practitioners in all three groups expressed a belief that mental health problems, particularly anxiety, are a factor in the majority of cases of attendance problems, and that although missing school reduces anxiety in the short-term, it ultimately causes pupils' anxiety to build, thus creating a vicious cycle.

I do think that the majority that we've worked with have all been something to do with mental health issues, and it starts with a simple panic attack at school and then it escalates until it's full-blown school anxiety. And once they're there, it's very difficult to get them back in again. (P6, Head of Year Nine, Group One)

Mental health problems were considered a particular risk factor for secondary school pupils rather than younger children, and were highlighted as an issue that may be increasing. Anxiety was seen to fluctuate, which could make it difficult to identify:

The anxiety might manifest itself with a particular subject or particular teacher or particular friendship group, but that wouldn't be there in another lesson or at lunch-time ... so that's really hard to see that change. (P8, Assistant Principal, Group Two)

All three groups identified a lack of resilience as a key risk factor for attendance problems. Practitioners described pupils with difficult life circumstances who maintained regular attendance, which was believed to be a result of resilience. Pupils with a lack of resilience were described as being sensitive to seemingly small triggers such as minor peer conflict.

The kids that are strong, they've had a bit of conflict and come back the next day. (P9, Parent and Family Support Advisor, Group Two)

Groups One and Two described a perceived dichotomy between mental health and bad behaviour, and discussed pupils they believed had poor attendance because they were ' rebelling' (P6, Head of Year Nine, Group Two) or being a ' naughty kid' (P1, Head of Key Stage Four, Group One). Although such behaviours may be a sign of mental or neurodevelopmental disorders, practitioners appeared not to label these behaviours as mental health problems, and implied the use of tougher, more punitive approaches towards these pupils compared to those believed to have internalising problems such as anxiety.

You think well I'm just rewarding bad behaviour and if you do that you're just opening the flood gates, and that's always the fine line that you're always walking, with so many kids. (P1, Head of Key Stage Four, Group One)

A lack of enthusiasm towards school and low academic aspirations were considered risk factors, and practitioners discussed pupils who they believed simply 'can't be bothered' (P4, Head of Year, Group One) to attend school, or prefer to do other things such as hang out with friends or go to the park.

We used to have a girl like that who used to get on the bus and go to [name of park] for the day (laughs). (P14, Personalised Learning Assistant, Group One)

Used to have a lovely day. (P15, Personalised Learning Assistant, Group One)

Groups One and Two identified special educational needs as a risk factor for poor attendance, believing that mainstream school is not suitable for everyone and that for pupils who are struggling to attend school, alternative schooling should be considered.

Mainstream school's not for everyone, we're going to have that small group of kids that no matter how hard you try, school is just not the right place for them, they need something different. (P6, Head of Year Nine, Group One)

Only Group One acknowledged the role of physical health problems, although they did not discuss this at any great length and one practitioner was unconvinced of the validity of some pupils' medical absences:

You get these medical reasons but then you sort of think yeah, but I think if push had come to shove, that pupil could have been in more. (P1, Head of Key Stage Four, Group One).

Family factors

Family life was emphasised as playing a key role in attendance problems. Practitioners described parents with dismissive attitudes towards education and low aspirations for the family, often as a result of their own upbringing or cultural norms, and some parents were perceived to support non-attendance and be obstructive towards the school's attempts to engage the pupil.

Your biggest problem with school refusers is home sadly, and I hate to put it back onto the parents ... but the majority of cases, the parents aren't backing us, they might say that they are while on the phone but they're not backing us up. (P1, Head of Key Stage Four, Group One)

Group One highlighted the negative impact of chaos or conflict within the family home:

She's been better the past few weeks, there was today but that seemed to be a real conflict at home that's kinda, hard to resolve. (P3, Assistant Head of Sixth Form, Group One)

Her and mum just don't get on. (P6, Head of Year Nine, Group One)

On the other hand, practitioners described the positive impact of parents who consistently encourage their child to attend school even when they are struggling:

They'd come to me in the morning even if they were upset, so they knew that their parent would still bring them in and they wouldn't, whereas if you had a parent that was like 'oh well they're not coping, they can't do it' ... (P10, Pupil Support Worker, Group Two)

Yes then that could have developed into a different story. (P9, Parent & Family Support Advisor, Group Two)

Practitioners discussed the detrimental effect of a lack of positive role model at home, such as parents who are 'still in their pyjamas or not even up ... .then the child's got no motivation to get themselves out of bed to get an education' (P15, Personalised Learning Assistant, Group Three). Also perceived to be detrimental to attendance was a 'soft' parenting style such as not following through with consequences, a lack of boundaries, or prioritising avoidance of conflict over attendance. Parental anxiety was also considered a risk factor, making it difficult to engage parents and creating a barrier for their child to attend. As P11 explained:

' The anxious parents that you know, their kid wants to come to school but the parent's too anxious and that's really difficult.' (P11, Inclusion Manager, Group Two)

Attendance problems were considered to sometimes be a transgenerational issue; a 'trait' (P4, Head of Year, Group One) that runs through families, often having previously occurred with siblings, parents or grandparents. Practitioners implied that parental school anxiety and/or attitudes towards education were important factors in this respect:

And it runs in families as well doesn't it sometimes? (P11, Inclusion Manager, Group Two)

I was just going to say that, I don't know whether your research will look at sort of generational impact as well, you know the, the ethos or the mind-set of that family unit, you know, were parents, were grandparents attenders at school, were they successful at school, um, that has a huge bearing doesn't it? (P8, Assistant Principal, Group Two)

Two groups discussed the challenges of attendance for pupils with caring responsibilities at home, for example if there is parental illness or domestic abuse:

If parents have been through a traumatic time they don't want to leave their parent ... had one young lady that was probably caring for her younger siblings, um, and her mum had been subjected to some unpleasantness from her partner so it was easier to stay at home, protect mum and the siblings. (P14, Personalised Learning Assistant, Group Three)

Peer factors

Only two factors related to peers were identified by practitioners: peer conflict and negative peer influence. Peer conflict was considered a risk factor for attendance problems, especially for girls. In particular, Group One discussed the role of social media, which they believed prevents some pupils being able to escape from difficult social relationships. Peer conflict was considered to have the potential to cause sudden and severe attendance problems in pupils who previously had good attendance.

It could have been something as tiny as a little bit of, maybe, verbal bullying you know, bit of name-calling, that they would have gone home and dwelled on it, or it could be a really serious bullying. (P15, Personalised Learning Assistant, Group Three)

Practitioners in Group One also described the role of negative peer influence, for example when pupils were considered to 'get in with a bad group of kids' (P6, Head of Year Nine, Group One), or when a pupil with poor attendance caused classmates to question their own decision to attend:

There is a danger of it impacting on others as well isn't it because I used to have [pupil's name] and, and actually someone in the class would say 'well actually she's never in' and, you know, and 'why bother?', and they start questioning it as well. (P2, Special Educational Needs Co-ordinator, Group One)

School factors

Group One described the UK National Curriculum as unsuitable for some pupils and believed that offering more vocational subjects, as well as a curriculum that could be tailored to individual needs, would improve attendance. However, the group agreed that this would be difficult, as P2 explained: 'A lot of schools aren't able to offer the appropriate curriculum anymore because of the cost of, and the pressures and expectations' (P2, Special Educational Needs Co-ordinator, Group One).

Practitioners in Group Three identified academic stress, particularly during exam periods, as a potential cause of attendance problems. This was considered especially influential when combined with other life stressors:

I think the pressure, um, on achievement in the older years can be massive ... they've got all these pressures going on amongst the family, or you know, outside and so on and then you add on GCSEs. (P16, Deputy Safeguarding Lead, Group Three)

Times of change and transition were considered to be high-risk for the onset of attendance problems, including returning to school after the summer holidays, changing schools mid-term, and, in particular, the transition from primary to secondary school:

The difference is they have one teacher most of the time, you come here and they may have 15 different teachers in a week and those, not only the transition from primary to senior but transition to every hour of the day, across a big school can be just so mind blowing. (P11, Inclusion Manager, Group Two)

Although some school factors were identified, they were discussed less frequently than factors related to the individual, their family and their peers. Group One, in particular, did not discuss any school factors except for the Curriculum. Although previous studies have also reported that school staff de-emphasise the role of school factors (Dannow, Esbjørn, and Risom 2018; Gregory and Purcell 2014; Gren-Landell et al. 2015; Malcolm et al. 2003) practitioners in this study went one step further, with Groups One and Three concluding that they do not believe school contributes to the problem for the majority of pupils:

When it boils down to it it's not school related is it? (P14, Personalised Learning Assistant, Group Three)

No because if you removed all the barriers that they say are the issue with school, then you'd still have the same problems ... So yes it's everything that happens outside school. (P16, Deputy Safeguarding Lead, Group Three)

It's outside of school isn't it? (P1, Head of Key Stage Four, Group One)

Yes, it's not anything we are doing. (P6, Head of Year Nine, Group One)

Group Two, whilst not explicitly denying a role for school, did suggest that as young people spend most of their time away from school, the majority of influence comes from other sources:

Whilst we have continuing, consistency of them coming into school for five days perhaps, it is only 25% of their day isn't it, and 75% they're with others, so the influence we have is, is restricted, it's a big chunk of time but ... there's a much bigger chunk of time outside of school hours. (P8, Assistant Principal, Group Two)

Discussion

Family factors identified included dismissive attitudes towards education, chaos or conflict at home, a lack of positive role model, a 'soft' parenting style, parental anxiety, and young people with caring responsibilities. Similarly, previous research has demonstrated that family factors such as neglectful parenting, parental ill health, a lack of parental interest, and family conflict are associated with poor attendance (Gase et al. 2014; Hendron and Kearney 2016; McShane, Walter, and Rey 2001). Practitioners in this study identified family history of attendance problems as a risk factor, which is supported by a UK survey that reported 26% of children whose parents had poor attendance missed school for reasons other than illness, compared to 10% of children whose parents had good attendance (Dalziel and Henthorne 2005).

Practitioners identified two risk factors related to peers: peer conflict, and peer influence, for example when pupils were considered to make friends with a 'bad crowd' who encouraged them to skip school. Previous research has demonstrated that peer conflict and bullying negatively impact on attendance and on mental health (Ingul et al. 2012; McShane, Walter, and Rey 2001), although practitioners in this study believed that even mild conflict could result in attendance problems. The reference by one practitioner in this study to 'something as tiny as a little bit of ... verbal bullying' (P15, Personalised Learning Assistant, Group Three) aligns with previous research that has demonstrated school staff consider non-physical forms of bullying to be less severe than physical bullying (Hazler et al. 2001). Finally, practitioners discussed the role of school factors in attendance problems and identified academic stress, an unsuitable curriculum (lack of vocational subjects; inability to tailor to individual pupils' needs) and school change or transition, as potential factors. Previous research shows that parents also believe academic stress and pressure, particularly around exams, is a cause of attendance problems (Dalziel and Henthorne 2005). It is notable that overall, despite identifying several school factors, these were discussed less frequently than other factors, which supports findings from previous studies that teachers perceive individual and family factors to be the primary cause of attendance problems, while pupils and parents emphasise school factors (Dannow, Esbjørn, and Risom 2018; Gregory and Purcell 2014; Gren-Landell et al. 2015; Havik, Bru, and Ertesvåg 2014; Malcolm et al. 2003). Despite acknowledging some school-related risk factors, practitioners also stated that they do not believe school to be the cause of attendance problems. This is important given that a range of school factors are associated with poor attendance (Egger, Costello, and Angold 2003; Malcolm et al. 2003; Van Eck et al. 2017), and positive school factors such as supportive pupil-teacher relationships can reduce the impact of other stressors on negative educational outcomes (Hamre and Pianta 2005). In addition, parents believe that supportive school staff are crucial for re-engaging pupils with poor attendance (Havik, Bru, and Ertesvåg 2014).

Taken together, our findings suggest a perceived lack of agency by school practitioners in terms of their ability to influence risk factors for attendance problems. For example, practitioners recognised academic stress as a risk factor. Previous studies have shown that teachers contribute to academic stress, particularly leading up to GCSEs (Putwain 2011), but practitioners in this study did not acknowledge their potential role in contributing to, or being able to help mitigate, pupils' stress. Practitioners also recognised peer conflict and bullying as a risk factor but, again, did not discuss the role that they, either as individuals or at a school-level, might play in attenuating this risk, for example through emphasising a positive school culture or implementation of anti-bullying policies (Davies 2013). School-based issues are those that school staff are likely to have some influence over and it is important that school staff are encouraged to consider the ways in which they may be able to exert positive influence on attendance problems (Moore et al. Under Review). Small, positive shifts in some of the things that school practitioners can control could be the difference between attendance and non-attendance, particularly for pupils who are experiencing other life stressors. The framework presented here, which separated risk factors into those related to the individual, their family, school and peers, is a commonly utilised framework in the school attendance literature (Gren-Landell et al. 2015; Ingul et al. 2012; Ingul, Havik, and Heyne 2019). Practitioners in this study appeared to endorse these categories, particularly given their emphasis on the importance of risk factors in some domains but not others. In reality, however, complex interplays exist between the young person, their friends, home-life and school, as reflected by mesosystems in Bronfenbrenner's ecological model (Bronfenbrenner and Morris 2006). At times, the interplay between different domains was recognised by practitioners in this study. For example, practitioners believed that differences in resilience (individual factor) determines whether pupils who are experiencing peer conflict (peer factor) or difficulties at home (family factor) struggle to attend school, or manage to maintain good attendance. Practitioners in Group Three also discussed how the pressure of GCSEs (school factor) can be more problematic if the pupil also has pressures at home (family factor).

Given that risk factors for attendance problems were not included as a probe in the topic guide, it is notable that not only did all three groups spontaneously discuss this topic, but there was also a large degree of consistency both within and between the three groups in terms of the risk factors identified. In fact, while there were some subthemes that were only discussed by one or two of the groups, there were no instances where groups expressed opposing views. This is interesting given that there was variation both in terms of the three schools included in the study and in terms of the experience and job roles of individual practitioners. For example, participants included teachers, members of senior leadership, SENCOs and support staff. This finding confirms that risk factors are common across the schools included in this study, and salient to practitioners working in a variety of roles.

Strengths and limitations

This study was reported in accordance with best practice guidelines for the reporting of qualitative studies (Tong, Sainsbury, and Craig 2007). We interviewed practitioners in a variety of teaching and non-teaching roles, in order to gain diversity of experience. The three schools from which practitioners were sampled were also diverse in terms of their setting, size and absence rates. However, our opportunity sampling method was likely to have reduced diversity in other respects. All practitioners worked in mainstream state-funded academies, and all had experience of working with pupils with attendance problems and are likely to be interested in this topic area. Practitioners working in special education settings, and those less engaged with attendance problems may hold different views, which were not explored in this study. Practitioners in a variety of roles and with different levels of experience were interviewed in focus groups together, and it is possible that these differences may have prevented some practitioners from openly expressing their views. Data saturation was not formally assessed, and it is possible that additional themes may have been identified if further focus groups had been conducted. The option of conducting additional focus groups was discussed throughout the process of analysis, but was considered unnecessary as the data obtained was sufficiently rich in order for us to address our research aims.

Implications

Practitioners identified that pupils with caring responsibilities may be at increased risk of attendance problems, for example when parents or siblings have mental or physical health problems, or when there is abuse in the home. Developing strong school-family relationships may help to improve schools' knowledge of individual family circumstances, and enable them to offer additional support and flexibility for these pupils and signpost families to appropriate support services.

Conclusion

This study identifies a range of risk factors that secondary school educational practitioners believe contribute to school attendance problems. These include some school factors, but the perception was that these factors were less important than individual, family and peer factors. Practitioners recognised the influence of mental health on attendance, but focused on anxiety rather than depression, behavioural disorders or other mental health problems. Given that school staff are best placed to directly influence factors related to the school, we suggest a number of steps that school staff can take that may be beneficial. This includes implementation of anti-bullying policies, promoting positive peer and pupil-teacher relationships, and collaborative working between young people, families and schools.

Focus group

School type

Ofsted inspection rating

Total number of pupils

Pupils eligible for Free School Meals (%)

Rate of overall absence (%)

Rate of persistent absencea (%)

1

Mainstream city-centre faith academy b

3 - Requires improvement

1646

9.4

7.1

21.9

2

Mainstream rural academy

2 - Good

1518

4.5

5.1

11.8

3

Mainstream city-centre academy

2 - Good

908

11.5

6.9

20.4

Participant

Focus group

Gender

Age

Job role

Related Research Data

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for the article can be accessed here.

Additional information

Funding

This work was supported by a PhD studentship awarded to KF by the University of Exeter Medical School, via the Wellcome Trust (grant no 107496/Z/15/Z).

Notes on contributors

References

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Barbour, R. 2007. Doing Focus Groups. London: SAGE Publications Ltd. doi:10.4135/9781849208956.

Cunningham, A. M. 2017. "Primary School Staff Experiences of Managing Pupil Attendance Difficulties - a Qualitative Study." MSc diss., University of Reading.

Dalziel, D. , and K. Henthorne. 2005. Parents'/carers' Attitudes Towards School Attendance. Nottingham, UK: TNS Social Research.

Davies, S. C. 2013. Annual Report of the Chief Medical Officer, Public Mental Health Priorities: Investing in the Evidence. London: Department of Health.

Department for Education. 2019. Pupil Absence in Schools in England: 2017 to 2018. London: Department for Education. https://www.gov.uk/government/statistics/pupil-absence-in-schools-in-england-2017-to-2018

Gase, L. N. , T. Kuo, K. Coller, L. R. Guerrero, and M. D. Wong. 2014. "Assessing the Connection between Health and Education: Identifying Potential Leverage Points for Public Health to Improve School Attendance." American Journal of Public Health 104 (9): e47-54. doi:10.2105/AJPH.2014.301977.

Gren-Landell, M. , C. E. Allvin, M. Bradley, M. Andersson, and G. Andersson. 2015. "Teachers' Views on Risk Factors for Problematic School Absenteeism in Swedish Primary School Students." Educational Psychology in Practice 31 (4): 412-423. doi:10.1080/02667363.2015.1086726.

Heyne, D. 2019. "Developments in Classification, Identification, and Intervention for School Refusal and Other Attendance Problems: Introduction to the Special Series." Cognitive and Behavioral Practice 26: 1-7. doi:10.1016/j.cbpra.2018.12.003.

Lang, I. A. , R. Marlow, R. Goodman, H. Meltzer, and T. Ford. 2013. "Influence of Problematic Child-teacher Relationships on Future Psychiatric Disorder: Population Survey with 3-year Follow-up." British Journal of Psychiatry 202 (5): 336-341. doi:10.1192/bjp.bp.112.120741.

Malcolm, H. , Y. Wilson, J. Davidson, and S. Kirk 2003. Absence from school: A study of its causes and effects in seven LEAs, Research Report 424. London: Department for Education and Skills.

Morgan, D.L . 1998. The Focus Group Guide Book. London: SAGE Publications Ltd. doi:10.4135/9781483328164.

PSHE Association. 2017. A Curriculum for Life: The Case for Statutory Personal, Social, Health and Economic (PSHE) Education. London: PSHE Association.

Weale, S. "Stress and Serious Anxiety: How the New GCSE Is Affecting Mental Health." [online] The Guardian, 2018. https://www.theguardian.com/education/2018/may/17/stress-and-serious-anxiety-how-the-new-gcse-is-affecting-mental-health

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Secondary school practitioners' beliefs about risk factors for school attendance problems: a qualitative study

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ABSTRACT ABSTRACT School staff have an important role to play in identifying and assisting pupils who require additional support to regularly attend school, but their beliefs about risk factors might influence their decisions regarding intervention. This qualitative study investigated educational practitioners' beliefs about risk factors for attendance problems. Sixteen practitioners from three secondary schools were interviewed via focus groups.

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Reconciling Contemporary Approaches to School Attendance and School Absenteeism (Part 1)

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Reconciling Contemporary Approaches to School Attendance and School Absenteeism (Part 1)

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Part 1 gives a good outline on reasons for attendance and absenteeism. The spectrum of school attendance and its problems is useful.

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Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States

Department of Developmental Psychology and Teaching, University of Alicante, San Vicente del Raspeig, Spain

Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States

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.

Introduction

School attendance and successful graduation from high school or its equivalent have long been recognized as crucial foundational competencies for children and adolescents. Strong school attendance and successful graduation are closely linked to broad, positive outcome variables such as enhanced lifetime earning potential and economic empowerment ( Balfanz et al., 2014; Balfanz, 2016), opportunities for higher education and other avenues of adult and career readiness ( Darling-Hammond et al., 2014), improved health and reduced death rates ( Freudenberg and Ruglis, 2007; Allison and Attisha, 2019), better civic engagement and outcomes ( Zaff et al., 2017; DePaoli et al., 2018), and critical thinking, risk aversion, and life skills that impact positive economic and health-based choices ( Brunello and De Paola, 2014). In related fashion, strong school attendance and successful graduation may enhance quality of life and buffer against negative mental and physical health outcomes ( Rumberger, 2011; U.S. Census Bureau, 2012; Lee et al., 2016).

Conversely, school attendance problems, including school absenteeism, have long been recognized as a critical developmental challenge and limiting factor for children and adolescents ( Kearney, 2016). School attendance problems in various forms have been linked to a wide array of academic deficiencies such as reduced educational performance, lower reading and mathematics test scores, fewer literacy skills, grade retention, and school dropout ( Bridgeland et al., 2006; Burton et al., 2014; Smerillo et al., 2018). School attendance problems are closely linked as well to internalizing behavior problems such as anxiety, depression (including issues of suicidal behavior and bereavement), and social isolation ( Ek and Eriksson, 2013; Pompili et al., 2013; Miller et al., 2015; Finning et al., 2019; Knollmann et al., 2019) as well as externalizing behavior problems such as elevated alcohol, tobacco, marijuana, and other drug use ( Henry and Huizinga, 2007; Holtes et al., 2015), risky sexual behaviors ( Allison and Attisha, 2019), oppositional defiant and conduct problems ( Wood et al., 2012), impaired social functioning and poor relationships with peers ( Havik et al., 2015; Gonzalvez et al., 2019), and involvement with the juvenile justice system ( Anderson et al., 2016). School attendance problems are connected to myriad adverse childhood experiences such as trauma, school violence and victimization, and medical problems as well ( Hutzell and Payne, 2012; Ramirez et al., 2012; Emerson et al., 2016; Hsu et al., 2016; McLean et al., 2017; Stempel et al., 2017; Berendes et al., 2019).

School attendance problems have long-lasting effects even into adulthood, including enhanced risk for marital and psychiatric problems ( Hibbett and Fogelman, 1990), non-violent crime and substance use ( Henry et al., 2012; Rocque et al., 2017), and occupational problems and economic deprivation ( Christenson and Thurlow, 2004; Bridgeland et al., 2006). Students who drop out of high school are 24 times more likely than graduates to experience four or more negative life outcomes ( Lansford et al., 2016). The societal outlays for school dropout are substantial as well, including elevated economic costs due to increased crime, incarceration, public assistance, unemployment, and medical coverage as well as reduced mobility, tax revenues, earnings, entrepreneurship, and productivity ( Marchbanks et al., 2014; Latif et al., 2015; Levin, 2017).

Evolution of Concepts in School Attendance and School Absenteeism

The purpose of this article is to draw upon this rich and disparate literature base to begin to reconcile various contemporary approaches to SA/A and to develop a heuristic framework for conceptualizing this population moving forward. Such a framework is necessary given several needs: to promote school attendance as much as to reduce absenteeism, to respond nimbly to emerging school attendance problems, to inform policy review, to provide general applicability to various jurisdictions and cultures, and to adapt to future and rapid changes in education and technology. As such, a contemporary framework for SA/A will need to be inclusive, flexible, applicable, educational, and pliable.

Efforts to conceptualize SA/A are manifold, in part because of the heterogeneous nature of the constructs and because risk factors for these problems are multilayered and myriad ( van der Woude et al., 2017). However, these conceptualization efforts can be grouped generally into categorical and dimensional approaches. Historical efforts to conceptualize SA/A began with categorical terms, dichotomies, and distinctions to try to sort youth with school attendance problems into defined groups in an effort to better understand the mechanisms underlying such behaviors ( Kearney, 2001). Categorical approaches broadly aim for within-category homogeneity and between-category qualitative differences ( De Boeck et al., 2005), goals that have been somewhat elusive for SA/A ( DiBartolo and Braun, 2017).

Other efforts to conceptualize SA/A have focused more on dimensional approaches to better reflect the heterogeneity, fluidity, scalability, and complexity of these constructs ( Kearney and Silverman, 1996). Such approaches, described in more detail in later sections, focus on fluid or latent constructs such as attendance profiles, absenteeism severity, risk factors, functions, and interventions that can be arranged along various spectra or continua ( Maynard et al., 2012). Dimensional approaches generally aim for within-category heterogeneity and between-category quantitative differences ( De Boeck et al., 2005), goals that can also be challenging for SA/A ( Heyne et al., 2019).

Coghill and Sonuga-Barke (2012) described several avenues for reconciling this debate with respect to mental health and other challenges in children and adolescents. These avenues include replacing categorical with dimensional approaches at various levels or utilizing a mixed approach whereby categories and dimensions are considered alongside one another. With respect to the latter avenue, this could include allowing some phenomena to be described categorically (e.g., autism, endogenous depression) and other phenomena to be described dimensionally (e.g., psychopathy, exogenous depression). Or, in a mixed approach, both categorical and dimensional approaches could be used together within the same class of disorder (e.g., the category of attention-deficit/hyperactivity disorder with dimensions of inattentiveness and hyperactivity/impulsivity). Coghill and Sonuga-Barke (2012) maintained that systems based on both categorical and dimensional approaches can coexist within a single problem by serving different but equally useful purposes.

The next sections of this article (Part 1 of the review) contain brief descriptions of common categorical terms and distinctions as well as dimensional approaches to the study of SA/A. These sections also briefly describe the advantages and disadvantages of each method. In Part 2 of this review, we adopt Coghill and Sonuga-Barke's (2012) premise that both categorical and dimensional approaches can be applied to a given heterogeneous construct such as SA/A and, indeed, that these approaches are wholly compatible with one another with respect to SA/A. In addition, such compatibilities may be helpful for developing a roadmap for researchers, clinicians, and educators to follow as they work to develop preventiative and nimble responses to SA/A, disseminate research work, and adapt to future changes in education and technology.

Terminology

As mentioned, school attendance problems have no consensus definition, in part because of the various terms used to describe this population from different disciplines. This section provides general descriptions of common categorical terms utilized in the field, with the strong caveat that considerable controversy and heterogeneity remain even with respect to these characterizations ( Kiani et al., 2018). Most broadly, school attendance has traditionally referred to a student's complete in-class physical presence during an academic day and school absenteeism has traditionally referred to a student's complete in-class physical absence during an academic day ( Kearney, 2019). School absenteeism is sometimes categorized as excused or unexcused (or authorized or unauthorized) in nature, referring to absence due to some legitimate reason such as illness or absence due to some illegitimate reason such as peer association outside of school ( Gottfried, 2009). School attendance problems, which can include school absenteeism, refer generally to either a collection of different kinds of absences (e.g., late to school/tardiness; skipped class or missed time of day) or to general difficulties attending or getting to school that can involve a wide array of individual and contextual factors ( Kearney, 2016). School attendance problems can lead eventually to school stopout, which refers to temporary departure from school prior to graduation, and/or s chool dropout/stayout, which refers to permanent, premature departure from school prior to graduation ( Boylan and Renzulli, 2017).

Several terms in the literature refer generally, though not always, to youth-based school attendance problems, or absences initiated primarily by a child or adolescent, with the caveat that many different risk factor levels (e.g., parent, peer, school) apply to this population. Truancy is one of the oldest terms for school attendance problems and refers generally to illegal, unexcused (see later section) school absenteeism. Truancy is a term often utilized by school districts and/or larger entities to construct policies and definitions, such as 10 unexcused absences in a given semester or 15-week period, that trigger some legal, punitive, or administrative consequence ( Sutphen et al., 2010). From a research perspective, truancy is often associated as well with delinquency, externalizing behavior problems, and social conditions such as poverty ( Zhang et al., 2010).

School refusal refers broadly to school attendance problems due to emotional difficulties such as general and social and separation anxiety, worry, distress, and sadness ( Elliott and Place, 2019). A related but archaic term, school phobia, refers more specifically to fear-based school attendance problems such as avoidance of a specific object at school or related to school (e.g., alarm, animal, bus) that leads to absenteeism ( Inglés et al., 2015). School refusal behavior refers to a child-motivated refusal to attend school or difficulties remaining in classes for an entire day ( Kearney and Silverman, 1990, 1996). School refusal behavior may or may not be related to emotional distress about school, and thus serves as an umbrella term for constructs such as truancy and school refusal.

Other terms in the literature refer to school attendance problems initiated primarily by entities other than the child, again with the caveat that multiple risk factor levels apply to each. School withdrawal refers generally to parent-initiated school absenteeism ( Kahn and Nursten, 1962; Kearney and Fornander, 2018). Parents or other caregivers may deliberately keep a child home from school for employment or child care purposes, to conceal maltreatment, to protect a child from perceived harm (e.g., school violence or victimization, kidnapping by an ex-spouse), to punish a child, or to mitigate a parent's separation anxiety or psychopathology due to anxiety, depression, substance use, or other problem, among other reasons ( Kearney, 2001).

In addition, school exclusion refers generally to school-initiated absenteeism. Such exclusion may involve lawful exclusionary disciplinary practices such as suspension or expulsion for behavior problems or for, ironically, school absenteeism ( Maag, 2012). School exclusion practices are often associated with zero tolerance policies regarding certain student behaviors, particularly those related to violence and other dangerous behavior ( Theriot et al., 2010). School exclusion may also involve unlawful, unclear, or more nefarious reasons such as sending students (in particular special needs students) home or restricting their ability to attend school without official documentation ( McCluskey et al., 2016).

Categorical Distinctions

Related to these historical terms have been various broad-band and etiologically based categorical dichotomies and distinctions for SA/A. These dichotomies and distinctions have been generally designed to carve out groups of youth with different school attendance problems to help identify causal factors as well as basic treatment direction and scope ( Reid, 2013).

School Refusal-Truancy

A main advantage of a school refusal-truancy distinction is its face validity, as some children are clearly anxious and thus avoidant of school whereas some adolescents refuse or decline to attend school without emotional difficulty and with perhaps more delinquency ( Berg, 1997; Evans, 2000). The dichotomy carries a significant number of disadvantages, however. First, numerous studies and reviews have demonstrated considerable heterogeneity within each construct ( Inglés et al., 2015). School refusal is linked to a wide variety of anxiety- and mood-based conditions in addition to fairly broad terms such as emotional distress, avoidance, malingering, dread, worry, fear, somatic complaints, and negative affectivity (e.g., Sibeoni et al., 2018). In addition, truancy is a highly heterogeneous construct with multiple dimensions related to academic status, disability profile, location, race/ethnicity, activities in and out of school, individual-group-orientation, premediated-spontaneous, parental academic involvement, and type and number of classes skipped, among many other variables ( Reid, 1999; Chen et al., 2016; Dahl, 2016; Sälzer and Heine, 2016; Keppens and Spruyt, 2017; Maynard et al., 2017). Truancy as a legal construct is also highly variably defined across many jurisdictions ( Gentle-Genitty et al., 2015).

Second, many researchers have demonstrated substantial heterogeneity across the two constructs. Both school refusal and truancy have been associated, for example, with learning and health difficulties, effects from bullying, social interaction problems, maltreatment, chronic illness, and, of course, missing school ( Katz et al., 2016; Lum et al., 2017). In addition, both constructs can be similarly influenced by broader classes of contextual factors related to peers, schools, and communities ( Baier, 2016; Sugrue et al., 2016; Burdick-Will et al., 2019). Many historical and statistical studies have also demonstrated either considerable overlap of school refusal and truancy and/or other, large unclassified categories ( Torma and Halsti, 1975; Berg et al., 1985; Cooper, 1986; Atkinson et al., 1989; Bools et al., 1990; Dube and Orpinas, 2009). Many researchers historically have gravitated toward conclusions of dimensionality to describe this population (e.g., Rubenstein and Hastings, 1980; Kolvin et al., 1984; Hersov, 1985).

Excused-Unexcused Absences

Many school districts and some researchers also utilize an excused-unexcused absences dichotomy to categorize school attendance problems ( Hough, 2019). Key advantages of this approach include its administrative practicality and simplicity, linkage to district and state policies regarding excessive absenteeism, historical connection (unexcused absences) to truancy, and utility in examining ratios of excused to unexcused absences ( Gottfried, 2009). In addition, some have found that students absent without permission display approximately twice the odds of engaging in risky behaviors (e.g., unintentional injuries and violence, substance use, sexual behaviors) than students absent with permission ( Eaton et al., 2008). Others have found that anxiety and depression symptoms are good predictors of unexcused absences in sexual minority youth ( Burton et al., 2014).

An excused-unexcused absence dichotomy has several disadvantages, however. Numerous studies have illustrated ancillary problems associated with school absenteeism whether excused or unexcused, combine these absences when evaluating outcomes, or have found few differences based on this absence typology ( Baker and Jansen, 2000; Redmond and Hosp, 2008; Spencer, 2009; Wood et al., 2012; Morrissey et al., 2014). For example, Gottfried (2009) found that excused and unexcused absences were both significantly related to various demographic, academic, and behavioral variables. Dube and Orpinas (2009) similarly found no difference between excused and unexcused absences across various profiles of youth with school attendance problems. The fidelity of data collected by school districts in this regard remains problematic as well, particularly because the arbiter of whether an absence is excused or unexcused is typically a family member and sometimes not a parent ( Birioukov, 2016; Conry and Richards, 2018). In addition, excused absences may include legitimate reasons such as illness but also institutional or questionable reasons such as court dates, school suspensions, family vacations, or minor health conditions accommodated by physician notes ( Reid, 2007; Outhouse, 2012).

School Withdrawal and School Exclusion

Acute-Chronic

Diagnostic Categories

Other categorical distinctions with respect to school absenteeism have involved attempts at diagnostic groupings. Such groupings often involve anxiety, mood, and disruptive behavior disorders, including some combination of these ( Bernstein and Garfinkel, 1986; Last and Strauss, 1990; McShane et al., 2001; Kearney and Albano, 2004). Anxiety- and mood-based categories are sometimes clustered in some youth with school attendance problems, as are oppositional defiant and conduct problems ( King et al., 2001). As such, these distinctions are sometimes applied or related to school refusal-truancy or acute-chronic distinctions ( Ek and Eriksson, 2013). Prognosis may relate to a degree to specific diagnostic type in this population as well ( Layne et al., 2003; McShane et al., 2004).

Summary

Categorical and dichotomous approaches to school attendance problems have a rich scholarly history and have contributed substantially to the conceptualization of this population. In addition, such approaches are well inculcated into many legal statutes, school-based policies, and research frameworks regarding school absenteeism. Key challenges for categorical and dichotomous approaches to school attendance problems include the need to better account for the considerable heterogeneity of this population and to link specific intervention strategies to specific constructs. In addition, these traditional characterizations are becoming challenged in an era of virtual learning, distance-based classrooms, hybrid education, blended education (e.g., high school with community college or vocational training), and other forms of alternative approaches toward graduation or career/adult readiness (see also Part 2 of this review). Categorical and dichotomous approaches to school attendance problems also do not generally focus on promoting school attendance, instead adopting more of a tertiary approach.

Dimensional Approaches

As mentioned earlier, researchers and others have also examined dimensional approaches to SA/A to try to better account for the fluidity, scalability, and complexity of these constructs. These dimensional approaches include a focus on conceptualizing various aspects of SA/A along continua or spectra to more fully capture the heterogeneity, variability, diversity, and mutability of this population. General dimensions to be discussed over the next sections include definition, tiers of prevention/intervention, risk and contextual factors, absenteeism severity, developmental and school levels, and functional profiles.

School Attendance and Its Problems on a Definitional Continuum

Figure 1. Spectrum of school attendance and its problems.

Multi-tiered System of Supports

Figure 2. A multi-tiered system of supports model for SA/A.

An MTSS model for SA/A includes several dimensions designed to enhance inclusivity, flexibility, and adaptability to various disciplines, educational and health structures, and jurisdictions and possibly cultures. These dimensions include severity of absenteeism (e.g., percentage days missed in a given year, length of problem; see previous section), degree of risk or contextual factors present in a particular case (i.e., child, parent, family, peer, school, community), target of prevention/intervention (i.e., all students, some percentage of students, fewer percentage of students), and intensity and breadth level of interventions (e.g., less intense/broad for acute or mild to moderate absenteeism, more intense/broad for chronic and severe absenteeism). At the same time, however, an MTSS model for SA/A is designed to be fairly simple in scope to be more easily adapted to various individual cases and settings. The model is thus, essentially, a signpost or roadmap to chart available intervention strategies for SA/A.

A full description of preventative and intervention approaches to SA/A is beyond the scope of this article. In general, however, Tier 1 approaches for SA/A can include system-, district-, school-, or even community-wide or state/national approaches to promote school attendance and prevent school absenteeism, often in tandem (e.g., full service community schools; Coffey et al., 2018). These approaches are generally aimed at all students and may include methods to improve school climate and safety, to enhance mental and physical health and social-emotional functioning, to boost parent and family involvement, to reduce school violence and bullying, to review policies that may exacerbate attendance problems, and to implement orientation and readiness programs, among others (see comprehensive summaries by Sutphen et al., 2010; Maynard et al., 2013, 2018; Kearney, 2016). Similarly, school dropout prevention efforts typically focus on school-wide academic enhancement, mentoring and supportive relationships, psychosocial skill development, and effective classroom behavior management ( Ecker-Lyster and Niileksela, 2016). Many of these Tier 1 approaches have been shown to improve school attendance rates, and reduce school dropout rates, either directly or indirectly (e.g., Havik et al., 2015; Freeman et al., 2016; Taylor et al., 2017).

Still, schools that implement MTSS with higher fidelity have less school absenteeism than schools that implement with less fidelity ( Freeman et al., 2016). School districts may also include attendance measures in MTSS models ( Coffey et al., 2018). Others have also begun to utilize a general tiered framework to place their studies and interventions in this context (e.g., Skedgell and Kearney, 2018; Brouwer-Borghuis et al., 2019; Elliott and Place, 2019; Ingul et al., 2019). For example, Cook et al. (2017) evaluated a comprehensive program to reduce school attendance problems that included components of each tier of intervention. Tier 1 involved facilitating communication between teachers and parents via home visits and mobile telephone contact, Tier 2 involved attendance data monitoring and teacher intervention with students beginning to accrue excessive absences, and Tier 3 involved referrals to specialists for students with chronic absenteeism. A multidimensional MTSS framework will comprise a key piece for reconciling SA/A approaches in Part 2 of this review.

Risk/Contextual Factors, Absenteeism Severity, and Developmental Level

As mentioned, key dimensions of an MTSS model of SA/A involve risk and contextual factors, which are generally expected to accrue by tier in conjunction with greater absenteeism severity. Researchers commonly group risk or contextual (and, conversely, protective) factors for SA/A into various categories that include child-, parent-, family-, peer-, school-, and community-based variables ( Kearney, 2008; Zaff et al., 2017; Gubbels et al., 2019). Others have argued that broader societal or cultural variables also impact school attendance problems, including zero tolerance-based legal statutes, assimilation and language barriers, and immigration issues, among others ( Casoli-Reardon et al., 2012). Categories of risk and contextual factors for SA/A are sometimes studied singularly (e.g., Hendron and Kearney, 2016), though many recent approaches have utilized more sophisticated multilevel modeling and related statistical procedures to examine these categories collectively ( Dembo et al., 2016; Van Eck et al., 2017; Ramberg et al., 2019). An accumulation of risk/contextual factors appears to exacerbate risk of school attendance problems ( Catalano et al., 2012; Ingul et al., 2019) and thus may be more evident in Tier 3 than Tier 2 cases ( Vaughn et al., 2013).

Similarly, absenteeism severity is an important dimension of an MTSS model of SA/A and can be generally measured as percentage days missed from school in a given academic year (Fornander and Kearney, submitted). However, this dimension can also be more broadly conceptualized as developmental history of a child's SA/A across multiple academic years ( Veenstra et al., 2010). Risk and contextual factors as well as absenteeism severity can also change along a continuum of developmental and school levels ( Skedgell and Kearney, 2018). Risk factors for school absenteeism can manifest quite differently across primary, early secondary, and later secondary grades ( Suh and Suh, 2007). In addition, absenteeism severity rates in schools tend to spike in kindergarten and first grade, decline during elementary school years, spike again in middle school, and continue to increase through high school, peaking at 12th grade ( Balfanz and Byrnes, 2012).

Functional Profiles of School Attendance Problems

Another key aspect of the functional model is its amenability to support the study of various dimensions or profiles of youth with school attendance problems. Researchers have demonstrated across numerous studies that functions of school refusal behavior relate to different patterns of depression, anticipatory and school-based performance anxiety, stress, positive/negative affect, sleep problems, and social functioning (e.g., Kearney, 2002; Richards and Hadwin, 2011; Hochadel et al., 2014; Fernández-Sogorb et al., 2018; Gonzálvez et al., 2018; Sanmartín et al., 2018; Gonzalvez et al., 2019). Others have related the functions to clusters of absentee youth ( Gallé-Tessonneau et al., 2019) and family environment types ( Kearney and Silverman, 1995). In addition, functions of school refusal behavior may be superior to forms of behavior in predicting absenteeism severity ( Kearney, 2007).

Summary

Dimensionally oriented approaches to SA/A may help account for the considerable heterogeneity of this population by capturing a wide range of attendance/absenteeism expressions, prevention and intervention strategies, risk/contextual factors, absenteeism severity and developmental levels, and functional profiles of key maintaining factors. Dimensional approaches do consider school attendance as much as absenteeism and are helpful in informing treatment approaches for SA/A. As with categorical approaches, however, considerable barriers exist to implementing dimensional approaches in schools and other pertinent settings. In addition, dimensional approaches to SA/A will also have to adapt to rapid advancements in education and technology in future years.

General Summary

The plethora of conceptual approaches to SA/A is certainly a phenomenon worth celebrating. Researchers, educators, clinicians, and stakeholders such as parents have contributed immensely to the study and understanding of this complex population. Such study has involved definitions, classification systems, assessment protocols, and intervention strategies designed, in the end, to help children and adolescents attend school and to achieve better outcomes in adulthood. We salute all of those who have dedicated their time and careers to improving the lives of these students.

Part 1 of this two-part review concentrated on a broad classification and description of contemporary approaches to SA/A along categorical and dimensional orientations. Each orientation carries distinct advantages and disadvantages, a not uncommon circumstance across various problems and disorders that affect youth. Though meant to be comprehensive, this review focused on the primary methods of differentiating school attendance problems. Many nuanced distinctions based on multilevel and other statistical modeling should be noted, and many special circumstances such as intense school violence or extreme poverty likely override the distinctions mentioned here. In addition, prevention and intervention were not a primary focus of this part of the review, but are explored in greater depth in the second part of this review.

As suggested by several scholars, adopting both categorical and dimensional approaches to the study of complex and heterogeneous phenomena may be advisable. Such a juxtaposition has the potential advantage of identifying general categorical rules and cut-points for distinguishing broad groups of behavior as well as specific dimensions that are useful for providing data to adjust these cut-points along various spectra. Part 2 of this two-part review thus focuses on a possible pathway toward reconciling contemporary categorical and dimensional approaches to SA/A in this manner. This pathway also represents a heuristic framework as the field of SA/A grapples with challenges to dissemination and implementation as well as future changes in education and technology.

Author Contributions

CK, CG, PG, and MF contributed to the writing and editing of the manuscript.

Funding

This work was supported by the UNLV College of Liberal Arts and Lied Library.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

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Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 1)

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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.

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Reconciling contemporary approaches to school attendance and school absenteeism (Part 2)

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Reconciling contemporary approaches to school attendance and school absenteeism (Part 2)

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Part 2 promotes the multi-tiered system of support approach. This allows for early warning systems and opportunities for blended or alternative pathways.

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Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, United States

Department of Developmental Psychology and Teaching, Universidad de Alicante, San Vicente del Raspeig, Spain

Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States

As noted in Part 1 of this two-part review, 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. Categorical and dimensional approaches for this population have been developed. This article (Part 2 of a two-part review) discusses compatibilities of categorical and dimensional approaches for school attendance and school absenteeism and how these approaches can inform one another. The article also poses a multidimensional multi-tiered system of supports pyramid model as a mechanism for reconciling these approaches, promoting school attendance (and/or prevention of school absenteeism), establishing early warning systems for nimble response to school attendance problems, assisting with global policy review and dissemination and implementation, and adapting to future changes in education and technology.

Introduction

The field of school attendance and absenteeism (SA/A) remains, as it has always been, at various crossroads. Categorical and dimensional approaches to conceptualizing SA/A are manifold, and each approach has its own validity for defining, classifying, and providing assessment and prevention/intervention recommendations for this population (see Part 1 of this two-part review; Kearney et al., 2019). Categories generally refer to dichotomies and distinctions to identify groups, whereas dimensions generally refer to fluid or latent constructs arranged along various spectra or continua. Key categorical dichotomies and distinctions of SA/A include school refusal-truancy, excused-unexcused absences, school withdrawal and school exclusion, acute-chronic duration, and diagnostic categories. Key dimensional aspects of SA/A include defining school attendance and its problems along a continuum, multi-tiered system of supports for preventative and intervention strategies arranged according to student need, risk/contextual factors, absenteeism severity, developmental level, and functional profiles of school attendance problems.

As noted in Part 1 of this review, Coghill and Sonuga-Barke (2012) stated that both categorical and dimensional approaches can coexist within a given phenomenon by serving different but equally useful purposes. Both categorical and dimensional approaches can be applied to a given heterogeneous construct. Categories are useful for providing general rules and cut-points for distinguishing broad groups of behavior, and dimensions are useful for providing data to adjust these cut-points along various spectra such as age, gender, temperament/behavior, developmental level, and setting to improve the categorical rules. Categorical distinctions can be useful descriptors of a particular current state, and dimensional profiles can be used to determine if that categorical state changes in degree of intensity (e.g., to nonproblematic or to more problematic) over time to inform treatment, longitudinal, and prognostic analyses. Categories and dimensions together can thus form a synergistic and breathable system that allows for considerable adaptation to future scientific and other advances ( Hudziak et al., 2007).

Over the next sections of this article (Part 2 of a two-part review), we discuss a possible pathway toward reconciling contemporary categorical and dimensional approaches to SA/A. This discussion initially involves sample compatibilities across extant categories and dimensions of SA/A and how these constructs might be blended or matched with one another. This section focuses on pertinent or prominent examples and is not an exhaustive review of all possible affinities. This discussion then includes a multidimensional, multi-tiered system of supports (MTSS) pyramid model that may be used as a framework to include various categorical-dimensional aspects of SA/A. Finally, as mentioned, we explore how such a model could enhance promotion of school attendance and/or prevention of school absenteeism, expedite nimble clinical and other responses to emerging absenteeism via early warning system development, assist in policy review and dissemination across jurisdictions and disciplines, and adapt to future and rapid changes in education and technology. We emphasize that the framework presented here is a heuristic one, not meant to be necessarily optimal or capstone in nature, but rather one designed to help spur the field toward reconciliation, common language, and advancement. We fully expect and hope that the framework will evolve over time.

Compatibilities of Categories and Dimensions of School Attendance and Absenteeism

Compatibilities of categories and dimensions of SA/A (described in Part 1 of this two-part review) can be described in two main ways. First, many categorical approaches for SA/A actually have many dimensional features, and many dimensional approaches for SA/A actually have many categorical features. Second, many categorical and dimensional approaches for SA/A have striking similarities that may indicate general agreement about a particular construct and refer to that construct from somewhat different perspectives. The examples provided next include both ways of describing compatibilities among categories and dimensions of SA/A.

Categories of School Attendance and Absenteeism With Dimensional Features

As mentioned in Part 1 of this review (p. 3), truancy is one of the most venerable constructs in the field of SA/A. From a categorical perspective, truancy may refer to illegal, unexcused school absence without parental knowledge or sanction ( Gentle-Genitty et al., 2015). From a dimensional perspective, as noted in Part 1 of this review (p. 4), researchers have found many profiles of truancy along academic status, disability, location, race/ethnicity, in- and out-of-school activities, individual-group-orientation, premediated-spontaneous initiation, and parental academic involvement, among many other variables. Gentle-Genitty et al. (2015) noted as well that categorical definitions of truancy often involve dimensions of absenteeism along time such as arriving late to school, missing a class, and missing a full school day, similar to the definitional spectrum of SA/A presented in Part 1 (p. 7).

As mentioned in Part 1 of this review (p. 3), school refusal often refers to another child-initiated form of school absenteeism. From a categorical perspective, school refusal may refer to emotional distress and reluctance to attend school ( Elliott and Place, 2019). From a dimensional perspective, as noted in Part 1 (p. 4), researchers have found many profiles of school refusal along various spectra (e.g., Finning et al., 2018, 2019). Gallé-Tessonneau and Gana (2018), for example, found several main clusters of youth with school refusal involving anxiety and fear of confrontation, adolescent-parent relationships, interpersonal relationship difficulties, and coping difficulties that associated closely with functional dimensions or profiles. Researchers who study SA/A categorically generally examine forms of behavior such as anxiety, depression, and somatic complaints ( Jones et al., 2019). Researchers who study SA/A dimensionally generally examine functions or factors that maintain school refusal behavior such as avoidance of negative affectivity and escape from aversive social and/or evaluative situations ( Haight et al., 2011; Richards and Hadwin, 2011). Both research avenues, however, gravitate toward youth with more school-based distress ( Havik et al., 2015).

Other categorical constructs for SA/A also have dimensional features. For example, the construct of school withdrawal, or parent-initiated school absenteeism, includes a spectrum of parent behaviors such as knowledge, acquiescence, consent, approval, and accommodation, or more passive to more active responses ( Kearney and Albano, 2018; Marin et al., 2019). Similarly, school exclusion or school-initiated absenteeism can involve a spectrum of lawful or unlawful administrative responses such as loss of privileges, early school departure, detention, in-school suspension, out-of-school suspension, restorative or other interventions in another location, alternative educational placement, and expulsion as well as duration of the exclusion ( Valdebenito et al., 2018). In addition, Birioukov (2016) sought to reframe the categorical dichotomy of excused-unexcused absences along broader distinctions (i.e., voluntary and involuntary) with varying explanations. Voluntary absence, for example, might encompass more student agency involving spectra along motivation to attend school and perceptions of school as a hostile environment. Involuntary absence might encompass more contextual influences that affect a student's ability to attend school and include spectra along life conditions, opportunities for academic advancement, and access to education (see also Part 1 of this two-part review, p. 5).

Dimensions of School Attendance and Absenteeism With Categorical Features

As mentioned in Part 1 of this review (p. 10), a functional model of school refusal behavior focuses on dimensions or profiles of the relative strength of maintaining factors for school refusal behavior. The model was originally designed as a clinical strategy to help mental health professionals utilize descriptive and experimental functional analyses to identify a particular prescriptive treatment tailored to these maintaining factors ( Kearney and Silverman, 1990). Youth may refuse to attend school to (1) avoid school-based stimuli that provoke a sense of negative affectivity (anxiety and depression), (2) escape from aversive social and/or evaluative situations at school, (3) pursue attention from significant others, and/or (4) pursue tangible rewards outside the school. The functions were based on wide parameters of negative and positive reinforcement ( Kearney, 2001).

In this functional model, a dimensional profile of maintaining factors is derived via a comprehensive assessment that includes descriptive measures, rating systems, behavioral observations, and formal hypothesis testing, among other means. Some erroneously equate one descriptive instrument with the broader functional model, but the functional distinctions can be measured in many ways to derive detailed and nuanced clinical profiles of each ( Kearney and Tillotson, 1998). Indeed, the functional model was specifically designed to be flexibly applied to different clinical and educational settings to account for differences in local practices as well as the heterogeneity of school attendance problems and to enhance the treatment utility of assessment ( Nelson-Gray, 2003). With respect to the latter, a primary function based on relative strength to the others may be categorically chosen as a starting point for prescriptive intervention ( Kearney and Silverman, 1999). A categorical nature of the functional model is further reflected in research work examining differences between the functions (e.g., Haight et al., 2011). As such, the model is a flexible, prototypical categorical-dimensional approach for SA/A and has been generally utilized and studied in this manner (e.g., Lyon and Cotler, 2009; Gresham et al., 2013; Nuttall and Woods, 2013; Elsherbiny, 2017).

Similarly, a multi-tiered system of supports (MTSS) model of SA/A (see Part 1 of this review, pp. 7-9) involves several dimensional continua with respect to absenteeism chronicity and severity as well as degree of risk and contextual factors generally associated with increasingly higher levels of absenteeism. An MTSS model of SA/A also assumes a spectrum of needed supports for youth and their families ranging from (1) system-wide or universal preventative approaches to (2) targeted interventions for mild to moderate school attendance problems to (3) intensive interventions for chronic and severe absenteeism ( Kearney, 2016). The spectrum-based nature of MTSS is designed in part to enhance feasibility for, and thus applicability to, various educational and other settings ( Stoiber and Gettinger, 2016).

Other dimensions of SA/A, including those within an MTSS model, have been examined categorically as well. Risk and contextual factors of SA/A, for example, are commonly studied or grouped into child-, parent-, family-, peer-, school-, community-, cultural-, and even government-based distinctions, as well as how these distinctions change across locations ( Kearney, 2008; Lamb et al., 2010; Correia and Marques-Pinto, 2016; Şahin et al., 2016). Researchers examine these risk factors via spectra of accumulated risk as well as via statistical modeling to compare the contributed risk of each group ( Chen et al., 2016; Goodrich et al., 2017; Chung and Lee, 2019; Sansone, 2019). Similarly, researchers have examined absenteeism severity both as dimensional ranges and as categorical distinctions ( Skedgell and Kearney, 2016, 2018; Stempel et al., 2017).

Categories and Dimensions of School Attendance and Absenteeism: Informing One Another

A Multidimensional Multi-Tiered System of Supports Pyramid

Multi-tiered system of support (MTSS) models, including Response to Intervention and Positive Behavioral Interventions and Supports/School-wide Positive Behavior Support, are often represented via one-dimensional triangles as illustrated in Part 1 of this review (p. 8). As discussed, these approaches represent multiple tiers of preventative and intervention strategies for various academic, social, and behavioral issues. These tiers are arranged along a continuum of needs of support targeted toward all students (prevention), some percentage of students (early intervention), and some lesser percentage of students (intensive intervention). Kearney and Graczyk (2014) were the first to apply these principles to SA/A (see Part 1 of this review for greater detail, pp. 7-9).

A key constraint of the one-dimensional triangle representation of MTSS is that it assumes considerable homogeneity among the population at hand, such as all children in a particular elementary school who are learning to read or all adolescents in a particular high school with a disruptive behavior resulting in an office disciplinary referral ( Sugai and Horner, 2009). As such, preventative and intervention strategies are usually geared in similar fashion, albeit with some flexibility based on nuanced factors such as the function of misbehavior, intensity of punitive response, and responding administrator (e.g., teacher and dean) ( Crone et al., 2015). Such an approach appears reasonable at Tier 1 where the focus is on promoting a certain phenomenon (e.g., ability to read) and/or preventing a certain phenomenon (e.g., classroom disruption) for all (and generally similar) students in a given setting. The use of communal approaches at Tier 2 and Tier 3, however, may be less efficacious for as heterogeneous and complex a population as students with school attendance problems.

The basic conceptual structure of a multi-dimensional pyramid may fit well with the multifaceted nature of SA/A. In this structure ( Figure 1), different sides of a multi-dimensional pyramid could reflect different sets of key categorical-dimensional domains of SA/A. Such domains, among many others, could involve (1) child-, parent-, or school-initiated/oriented school attendance problems, (2) different dimensions of categories such as truancy, (3) functional or risk and protective factor profiles or clusters, (4) school attendance problems in preschool, elementary, middle, and high school students, and (5) schools at low, medium, and high risk for absenteeism. In addition, multi-dimensional pyramids could be developed and tailored to individual jurisdictions with different set points for movement across the tiers. Such pyramids would also allow for better cross-disciplinary work and enhance creativity and innovation about how this population is conceptualized. A multi-dimensional pyramid could vary according to the number of domains desired (e.g., four and six sides) as well. Most importantly, this approach mandates the development of preventative and intervention strategies for each tier no matter what domains are used.

Figure 1. Illustration of a sample multidimensional multi-tiered system of supports pyramid model for school attendance and school absenteeism.

As an example, Lyon and Cotler (2009) juxtaposed functional dimensions along microsystem, mesosystem, and exosystem levels of intervention for school refusal behavior. Microsystem interventions address more direct, proximal, or immediate influences on school attendance problems, and specific aspects within the microsystem can be linked to specific functional dimensions. In this framework, (1) peer microsystem interventions (e.g., mentoring and social skills) might best be linked to avoidance of social/evaluative situations and pursuit of tangible reinforcement; (2) family microsystem interventions (e.g., contingency management and contracting) might best be linked to avoidance of social/evaluative situations, pursuit of parental attention, and pursuit of tangible reinforcement; and (3) school microsystem interventions (e.g., incentive programs and academic support) might best be linked to avoidance of negative affectivity, avoidance of social/evaluative situations, and pursuit of tangible reinforcement.

Mesosystem interventions address connections between settings most relevant to a child such as parent-school official contacts. In this framework, mesosystem interventions (e.g., school engagement and parental involvement initiatives) might best be linked to pursuit of parental attention and pursuit of tangible reinforcement. Exosystem interventions (e.g., policy changes and statutes) address more distal social structures or settings that have an indirect influence on school attendance problems and may best be linked to all functions of school refusal behavior. The authors also discussed macrosystem influences, or societal or cultural/subcultural influences that envelop other levels (in this case, those involving school absenteeism). Such influences may include, for example, shifts in economic opportunities, globalization, migration/immigration, and labor markets that impact school dropout rates ( Brewer and McEwan, 2010; Coxhead and Shrestha, 2017).

Base of the Pyramid: Promoting School Attendance

The notion of a multidimensional MTSS/MTMDSS pyramid model carries some potential advantages as a heuristic for SA/A. First, the notion of a multidimensional pyramid implies a common base involving children and adolescents who are attending school without difficulty. The base of a pyramid is necessarily broad and strong and critical for the support of the upper tiers. As such, the base of the pyramid is the most fundamental aspect of the structure and must be well maintained. The notion of a pyramidal base thus means that all stakeholders in the field of SA/A begin with the common premise that school attendance is valued and that promoting school attendance (and/or preventing school absenteeism) must be the foundation for all other efforts in this area.

Second, the notion of a strong (and larger) pyramidal base means that most efforts in this area will need to focus on promoting school attendance and not simply on reducing absenteeism. With respect to SA/A, this means that school districts, health and mental health professionals, and lay persons must invest significant resources and efforts into Tier 1 practices to prevent youth from entering Tiers 2 and 3. All too often, stakeholders in this field concentrate on policies, procedures, sanctions, treatments, and other methods to react to student absenteeism as opposed to engaging in measures to proactively maintain and boost school attendance. The notion of a multidimensional base means that proactive, preventative efforts must be emphasized and can be tailored to individual schools, jurisdictions, and cultures.

Third, the notion of a strong pyramidal base means that researchers must focus as much on protective and promotional factors toward high school completion (or its equivalent) as on risk factors and other aspects of school absenteeism. Some continue to invest heavily in incremental distinctions of youth with school absenteeism with little investment toward identifying those who do complete school. Indeed, the absence of risk is not the same as the presence of growth. In addition, many researchers tend to focus on the negative consequences of school absenteeism and dropout and less so on the benefits of graduation. A better understanding of such protective factors would greatly inform prevention science in this and related areas ( Kieling et al., 2011; Lösel and Farrington, 2012).

Zaff et al. (2017) reviewed literature on factors that promote high school graduation, with a particular focus on dimensions of positive youth development as well as proximal and distal influences within a student's ecology. Such protective and promotive factors included malleable assets, or those potentially sensitive to intervention, and upstream factors, or those more systemic and likely more difficult to modify. The authors made an astute point that simple lack of risk factors in a particular child does not necessarily imply that the child is thriving or that development is optimized. Instead, researchers and others must focus on variables that actively promote educational attainment, not simply on those that predict school absenteeism and dropout.

Individual student factors found most to predict high school graduation or continued school enrollment included intrinsic motivation to achieve positive educational outcomes, enhanced school engagement, student expectations for academic attainment, and internal locus of control. School engagement can come in many forms, and the authors found that high levels of behavioral (e.g., attending school and completing assignments), emotional (e.g., connection with school and enjoying school), and cognitive (e.g., strategic learning and intellectual curiosity) were most related to academic success and graduation. Of these variables, particularly salient predictors included attendance, social and academic engagement, and arts and athletic participation. Expectations for, and perceived control of, positive academic outcomes were potent predictors as well. Effect sizes were small to moderate.

Parent factors found most to predict high school graduation or continued school enrollment included parental academic involvement and parent-child connection. The former may be associated with attending school-based meetings and conferences, participating in school-based organizations, communicating regularly with school officials, assisting with homework, and setting clear rules about homework and maintaining a good grade point average. Many of these effects remained even after controlling for demographic and school composition variables. Parental social support and regular parent-child communication comprised the parent-child connection construct. Effect sizes for parent influences were generally small. Peer-related factors were more limited and included positive peer norms, or expectations of what behaviors are valued within a particular group of friends. This may include enhanced expectations for maintaining grade point average and for valuing education. Effect sizes for peer influences were generally small.

School-related factors found most to predict high school graduation or continued school enrollment included positive student-teacher relationships, smaller schools, participation in school-based extracurricular activities, and career and technical education. Positive student-teacher relationships can include respectful interactions, teacher interest in students, and student belief in teacher competence. This may relate to smaller schools as well, where teachers and students may be more knowledgeable of one another. Extracurricular activities, including community service participation, may relate specifically to social competence, educational aspirations, and sense of agency among students. Career and technical education opportunities positively impact continued school enrollment in particular. Effects sizes for school variables ranged from small to large.

Finally, the primary community-related factor found most to predict high school graduation or continued school enrollment was participation in out-of-school time programs, or those collections of programs focused on community service, social-emotional learning, and academic enrichment. The authors concluded that more research is needed on how all of these protective factors interact with one another to enhance the trajectory toward graduation, how the factors operate differently across students and contexts, and how risk and demographic factors moderate the effect of assets to promote graduation ( Zaff et al., 2017).

Second Tier of the Pyramid: Early Warning and Nimble Response

The notion of a multidimensional MTSS/MTMDSS pyramid model also implies that screening and immediate, nimble response to early warning signs or Tier 2 cases of emerging school absenteeism must be a priority no matter the domain structure utilized on the sides of a pyramid. For example, domains of school attendance problems across elementary, middle, and high school levels must juxtapose with individualized, tailored strategies to identify these problems within the resources and logistical constraints of each domain. This may mean an attendance officer in an elementary school who can call parents immediately each day upon learning of a student absence, a school attendance team (e.g., counselor, dean, and school-based social worker) in a middle school that regularly reviews attendance data and intervenes with a family prior to a legal tripwire for truancy, and an integrated first period teacher-attendance team in high school that coordinates information about attendance, disciplinary referrals, and course grades ( Kearney, 2016; Rumberger and Losen, 2017). The ability to nimbly respond to these problems, particularly in school settings, depends heavily on valid early screening methods for SA/A in children and adolescents.

Recent endeavors have focused more on direct screening approaches for school attendance problems that include both categorical and dimensional aspects. Early warning systems that focus specifically on attendance, behavioral data/suspensions, and course grades have been found to consistently identify 50-75% of future school dropouts before the event occurred. These categories have been further informed by dimensional data indicating that attendance rates under 85-90%, two or more suspensions, and two or more semester course failures in any subject are particularly pertinent indicators and should be part of a customized multi-tiered response system ( Thomas, 2017; Balfanz and Byrnes, 2019). Such data could be collated via an online monitoring system, and many school districts utilize software applications to immediately inform parents of an absence as well as course assignments and grades (e.g., https://www.infinitecampus.com/audience/parents-students). Researchers have also utilized text and mobile telephone communications to immediately identify and mitigate school absences ( Cook et al., 2017; Smythe-Leistico and Page, 2018) within a dimensional multi-tiered intervention framework.

Other direct screening approaches for school attendance problems focus on spreadsheets listing student demographics, attendance status, behavior, course performance, and interventions ( Rumberger and Losen, 2017), brief pediatric consultations ( Katz et al., 2016), online self-report methods ( Pflug and Schneider, 2016), and checklist methods for categories of absences mixed with level of absenteeism severity ( Kearney, 2008; Heyne et al., 2019). A nimble response to a child's absence from school would benefit from immediate knowledge of whether the absence was due to school exclusion such as suspension or alternative educational placement or home instruction, school-based threat such as bullying, parent-based school withdrawal, legitimate reason such as illness or poor weather, or a child-based anxiety, mood, or conduct problem ( Ingul et al., 2019). Basic screening approaches have advantages for limiting the burden on school officials, though early warning systems that are too parsimonious may have limited validity ( O'Cummings and Therriault, 2015; Sansone, 2019).

More nuanced early warning systems have thus been developed. Chu et al. (2019) developed an online early detection system for school attendance problems, with a particular focus on teachers, administrative assistants, and school counselors as attendance monitors and trackers. The authors utilized a categorical cutoff of five absences (or 2.78% in a 180-day school year) that included dimensions of absenteeism severity ranging from full days missed to instances of tardiness to early departures from school. School attendance problems were assessed at the end of each of four marking periods throughout the academic year. Yearly absences were more closely associated with an accommodation plan and having a sibling with similar attendance problems. Instances of tardiness were more closely associated with higher grade level, divorced or separated parents, and having a sibling with similar attendance problems. Early departures were more closely associated with male gender, newness to a school, and having a sibling with similar attendance problems.

Several researchers have also recommended machine learning and related predictive modeling methods to study large SA/A-based data sets to help inform such algorithms and early warning systems ( do Nascimento et al., 2018). Chung and Lee (2019), for example, utilized random forests in machine learning to predict student dropout among 165,715 Korean students. Key indicators included unauthorized absence, early leave, class absence, and lateness as well as various test scores and school experiences. School dropout was predicted mostly by several risk factors that included all forms of unauthorized school attendance problems. In addition, several protective factors were identified that included self-regulated activity, career development, club activity, and volunteer work. The authors recommended that homeroom teachers utilize such markers to mitigate risk and enhance protective factors via appropriate supports and interventions. Indeed, some have advocated for restructuring the role of the homeroom or first-period teacher to quickly identify an absent and transmit the information to a school attendance team member who immediately contacts parents ( Lever et al., 2004).

Sansone (2019) also advocated for machine learning approaches to provide algorithms for predicting school dropout among 21,440 ninth-grade students. Key predictors selected by the statistical methods used included age, lack of important math and science courses, grade point average, and whether a student had ever been suspended or expelled from school. Other more secondary predictors included lack of plan to later enroll in college, parent contacted by school about poor attendance, and parent belief that the child will at best attain high school only. The author recommended identifying at-risk students based on these variables to identify effective academic and vocational approaches as well as informing parents of a particular student's risk level. The author concluded as well that early warning systems that are too parsimonious may lack reliability, and that identifying students at less risk for dropout may be as useful as identifying those at high risk.

More specific to school absenteeism, Kearney and colleagues ( Kearney, 2018; Skedgell and Kearney, 2018; Fornander and Kearney, 2019a,b, submitted) conducted several studies utilizing ensemble and classification and regression tree (CART) analyses to identify demographic, academic, behavioral, and family factors that best differentiated school absenteeism at various severity levels. Skedgell and Kearney (2018) examined records from 316,004 students across elementary, middle, and high schools to identify academic and demographic variables that best predicted distinctions between <1 and 1+% absenteeism, <10 and 10+% absenteeism, and <15 and 15+% absenteeism based on differentiations sometimes recommended in the literature.

Four predictors that best differentiated youth at <1 and 1+% absenteeism severity levels included ethnicity (Hispanic, African American, Caucasian, biracial, American Indian, or Pacific Islander), grade point average (0.00-2.00), grade level (1, 2, 9, 10, 11, or 12), and Individualized Education Plan (IEP) eligibility. Three predictors that best differentiated youth at <10 and 10+% absenteeism severity levels included age (>15.5 years), ethnicity, and low grade point average. Four predictors that best differentiated youth at <15 and 15+% absenteeism severity levels included age (>16.5 years), ethnicity, low grade point average, and grade level (1, 6, 7, 8, 10, 11, or 12). Post hoc analyses were also conducted for developmental school levels. At the elementary school level, ethnicity and grades 1 and 2 were most predictive of all absenteeism severities. At the middle school level, ethnicity and IEP eligibility were most predictive of <1 and 1+% absenteeism, whereas ethnicity was most predictive of the other absenteeism severity levels. At the high school level, low GPA was most predictive of all absenteeism severity levels.

Fornander and Kearney (2019a,b, submitted) further used ensemble and CART analyses to examine predictors of various absenteeism severity levels (1+, 3+, 5+, 10+, 15+, 20+, 30+, 40+%) in youth with school attendance problems referred for clinical services or to a truancy or family court. As with the demographic and academic variables described in the previous study, predictive risk factors tended to be more homogeneous at higher levels of absenteeism severity. These studies included analyses of family environment variables as well as internalizing symptoms of anxiety and depression.

With respect to family environment, higher levels of absenteeism (i.e., 15+%) were more closely related to lower achievement orientation, active-recreational orientation, cohesion, and expressiveness. Many findings were quite nuanced, however. For example, lower expressiveness was evident at less severe (3, 5%) and more severe (20, 30%) levels of absenteeism, though elevated expressiveness was predictive of 10+% absenteeism. In addition, family cohesion was not predictive at 1+ and 3+% absenteeism but less cohesion was more predictive of higher levels of absenteeism. Elevated conflict was more predictive of 5+% absenteeism severity; whereas lower conflict was more predictive of 10+% absenteeism severity. In addition, less family control was more predictive of higher levels of absenteeism severity (20+, 30+%).

With respect to internalizing symptoms, one consistent item that distinguished levels of higher from lower absenteeism severity was a depression item related to lack of enjoyment. Predictive items at 1 and 3% absenteeism were less informative than items at higher absenteeism levels. For example, endorsement of less anxiety was more predictive of higher levels of absenteeism severity, a finding similar to Skedgell and Kearney (2016) who found that very high levels of absenteeism were generally marked by less anxiety. This could mean that extensive absence from school mitigates anxiety at the time of assessment.

The nascent development of valid early warning systems of SA/A (as well as continuous screening devices) has tremendous potential for informing more nimble responses on the part of school officials. This is especially critical now that schools are a primary site of mental health care for most youth ( Green et al., 2013; Lyon et al., 2019). Screening devices with set algorithms or rules would allow for nearly simultaneous assessment and intervention, such as quicker use of informed clinical, referral, and other strategies to mitigate emerging school attendance problems. Such devices may also help school officials triage or narrow the focus of these nimble responses, such as toward child, parent, and peer microsystems ( Lyon and Cotler, 2009; Kearney, 2019). The studies also reveal a fine line between parsimony and validity, however, meaning that researchers must thread the needle of identifying informative early warning systems that are acceptable and not burdensome to school-based professionals.

Global Policy Review and Dissemination and Implementation

One of the most significant challenges for researchers of SA/A has been effective dissemination and implementation of conceptualization, assessment, and intervention approaches into schools, physical and mental health agencies, and the corridors of policy makers. Reasons for this are myriad and may include lack of consensus among scholars, the complexity and heterogeneity of this population, disconnect between disciplines, school resistance, and substantial administrative, logistical, legal, and other restrictions uniquely faced by school officials ( Kearney, 2003; Graeff-Martins et al., 2006; Keppens and Spruyt, 2017). With respect to the latter, for example, many schools have been restricted by zero tolerance laws that mandate specific sanctions for absenteeism that may displace clinical and other approaches ( Gage et al., 2013). Exclusionary discipline policies, reporting guidelines, legal definitions of truancy, and disincentives for early school response likely play a role in this process as well ( Marchbanks et al., 2015; Brouwer-Borghuis et al., 2019). Of course, many jurisdictions and countries have no legal or other policy regarding school absenteeism whatsoever ( UNESCO, 2012). Furthermore, statewide truancy policies appear unrelated to chronic absenteeism levels and may actually be pernicious in that diverse students are subjected to more restrictive policies ( Conry and Richards, 2018). Such policies also institutionalize the concept of truancy and thus color approaches taken for the problem ( Spruyt et al., 2017).

Markussen and Sandberg (2011) noted that policy measures to address school absenteeism and dropout vary widely across countries, range from considerable to little impact, and are often affected more by economic shifts and labor markets. Still, the authors identified several policy measures across various countries that may have some impact on school absenteeism and dropout at system-wide levels, such as career guidance and counseling, income support for students, and vocational education and alternative educational programs. Markussen and Sandberg (2011) noted that these and other policy measures must be based on a deep understanding of local conditions, including the unique attributes of those with school absenteeism and dropout, as well as on a common commitment to develop better theory for addressing these issues within the context of each country. Global policy review with respect to school absenteeism must therefore focus on pruning counterproductive measures in addition to disseminating and implementing theoretical models that can be uniquely tailored to cross-cultural settings.

A multidimensional multi-tiered system of supports pyramid model of SA/A could be one such vehicle for policy review and dissemination. The model is consistent with whole-school reform models of education and eschews policies and practices that focus on exclusionary discipline (and unlawful school exclusion), immediate referrals to legal and other outside agencies, tacit acceptance of low-performing students who leave school, inflexible curricula, and rigid standardized testing ( Kearney, 2016). In addition, the model and associated algorithms can be flexibly and practically tailored to idiosyncratic differences related to local norms, calendars, and educational practices. The model is designed to be inclusive, simple, and easily adaptable to extant modes of service delivery in schools, which are key parameters of successful dissemination and implementation ( Lyon and Bruns, 2019). In addition, the multidimensional model may be well positioned because it can dovetail with (1) already existing school-based multi-tier frameworks devoted to academic performance, school climate/positive school culture, social and emotional competencies, and career readiness and (2) functional behavioral assessment practices, both of which are already understood and utilized by many school officials ( Freeman and Simonsen, 2015; Eklund et al., 2019).

Adaptability to the Future of Education and Technology

One of the biggest challenges for educators, researchers, clinicians, and others who study and address SA/A will be massive and rapid changes in education and technology over the next several decades. Any SA/A model will thus need to be pliable enough to be adapted not only to different cultures and countries but also to broad, systemic trends. This section discusses expected future trends in education and technology and then how a multidimensional, multi-tiered systems of support model for SA/A could be adapted. For brevity purposes, we group these trends into two broad categories: competency-based education and virtual learning ( Kearney, 2016).

Competency-based education refers generally to mastery of academic and related material based on key benchmarks, and at a variable pace and timeline, rather than a strict focus on formal in-seat class time, examination scores, and credit accrual ( Colby, 2017). Many schools in different countries have moved, or are moving toward, more holistic models of education that emphasize comprehension, innovation, conceptual connections, and critical thinking skills rather than simple recall and procedural steps ( Jukes and Schaaf, 2019). In these authentic or ubiquitous learning environments, students are more apt to engage in project-, portfolio-, experiential-, and service-based activities to solve real-world problems, conduct experiments, interpret findings and literature, and make recommendations and presentations rather than simply taking multiple-choice tests, for example ( Virtanen et al., 2018). Many such environments also emphasize personalized, customized learning and curricula, including core social and behavioral competencies, for preparing individualized adult and career readiness plans ( Ekstrand, 2015; Taylor et al., 2017).

Virtual learning generally refers to online programming to deliver academic coursework and content ( Brinson, 2015). Virtual learning environments are increasingly common at high school and postsecondary levels of education, but all future learning environments are expected to have at least some virtual component over the next several decades ( Miron and Gulosino, 2016). Virtual learning environments can range in scope from adjunctive to hybrid to immersive in nature. An adjunctive scope may involve the introduction of greater technology into traditional classroom settings (e.g., game-based student-teacher interactions via tablets or smartphones; a hybrid or blended scope may combine online learning with direct (in-person) instructor contact; an immersive scope may involve a wholly digital network rather than a physical space that includes students from many different locations) ( Hainey et al., 2016; Boelens et al., 2017; Xie et al., 2019). Virtual learning environments, particularly immersive ones, can also vary with respect to time of individual and group work and perhaps be modified more quickly via learning analytics than traditional classrooms ( Williamson, 2017).

Future trends in education and technology have serious ramifications for contemporary SA/A models. Researchers' traditional focus on outcomes such as percentage time missed from school as well as on concepts such as truancy or reluctance to attend school will need to be reconfigured in light of increasingly decentralized approaches to learning. In related fashion, researchers and others will likely need to reconsider traditional grade-level systems and academic calendars as schools increasingly modify the pace at which individual students learn, accrue credits (if relevant), and graduate.

A multidimensional multi-tiered system of supports model may be adaptable to these changes in education and technology. Indeed, various Tier 3 approaches for students largely disconnected or disengaged from school often focus on virtual, hybrid, project-based, and credit recovery and personalized learning approaches to provide alternative or blended pathways to adult and career readiness. In addition, many dimensional constructs associated with SA/A can dovetail with more dimensional aspects of the educational experience, including those linked to competencies, progression, completion, skill, and readiness for career paths. Finally, the model posed in this review is atheoretical, independent of academic timeline, and dexterous and malleable enough to accommodate rapid growth and immediate level change. Perhaps most importantly, the model emphasizes the promotion of school attendance and education in some form, an ever-present goal for all in this field.

Conclusion

School attendance and school absenteeism remain important avenues of focus for many different professionals across education, mental health, public policy, and myriad other areas. As noted in Part 1 of this two-part review, though meant to be comprehensive, this article focused on the primary methods of differentiating school attendance problems. Many nuanced distinctions based on multilevel and other statistical modeling should be noted, and many special circumstances such as intense school violence, extreme poverty, and geopolitical factors likely override the distinctions mentioned here. However, the main goal was to provide a heuristic model to help spur the field toward reconciliation, common language, and advancement while considering important aspects of prevention and intervention, particularly within schools.

Also as noted in Part 1 of this two-part review, we offer deep appreciation to all those who have dedicated their time and careers to helping youth succeed in school and move to a more productive and healthy adulthood. The frameworks presented in this review are designed as looking glasses both into the past and future of SA/A and thus represent only a snapshot of the present state of affairs in this rapidly changing field. We look forward to learning about new and innovative developments in this field and hope that the ideas posed here offer some assistance.

Author Contributions

All authors (CK, CG, PG, and MF) contributed to the writing and editing of the manuscript.

Funding

This work was supported by the UNLV Lied Library.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

DePaoli, J. L., Fox, J. H., Ingram, E. S., Maushard, M., Bridgeland, J. M., and Balfanz, R. (2015). Building a grad nation: progress and challenge in ending the high school dropout epidemic. Annual Update 2015. Civic Enterprises. Available at: https://www.civicllc.com/ (Accessed June 14, 2019).
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# data[].attributes.attachment_link.title
Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 2)

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As noted in Part 1 of this two-part review, 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. Categorical and dimensional approaches for this population have been developed.

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Improving school attendance by enhancing communication among stakeholders

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Improving school attendance by enhancing communication among stakeholders

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A report on the formation, purpose and objectives of the International Network for School Attendance (INSA)

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Improving school attendance by enhancing communication among stakeholders: establishment of the International Network for School Attendance (INSA) - European Child & Adolescent Psychiatry

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European Child & Adolescent Psychiatry -

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Effective Intervention for School Refusal Behaviour

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Effective Intervention for School Refusal Behaviour

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Article exploring successful reintegration when linking interventions with the causes of the absence.

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School factors associated with school refusal

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School factors associated with school refusal

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Norwegian study which is good for developing an understanding of the school based factors behind non attendance.

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A review of the definitions of school attendance problems and effective interventions.

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Article which explores the impact of and subsequent solutions to, a range of school avoidance behaviours

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Is there a link between school violence and absenteeism?

Violence on school campuses across the country naturally makes many parents skittish about possible copycat incidents. In fact, some parents acquiesce to their children's pleas to remain home on school shooting anniversaries-particularly the Columbine tragedy of April 20, 1999.

Student and parental fears likely are exacerbated by new episodes of violence, such as three school shootings in 2006:

On September 27, a 53-year-old man entered a high school in Bailey, Colorado, and shot one girl before killing himself.

On September 29, a high school student near Madison, Wisconsin, killed his principal after being disciplined for carrying tobacco.

On October 2, a heavily armed man barricaded himself in a one-room Amish schoolhouse in Paradise, Pennsylvania. He bound and shot 11 girls before killing himself, and five of the girls died.

Compared with highly publicized school violence, however, personal victimization is a much stronger factor in absenteeism. Specifically, school violence is related to school absenteeism especially for youths who have been previously victimized. The literature shows:

Students who have been bullied are 2.1 times more likely than other students to feel unsafe at school.

20% of elementary school children report they would skip school to avoid being bullied.

High school students' fear of attending classes because of violence is directly associated with victimization by teachers or other students.

Missing school because of feeling unsafe is a strong risk factor for asthma and, potentially, being sent home early from school.

Assessment scale. One method for quickly assessing the role of these functions is the School Refusal Assessment Scale-Revised. This scale poses 24 questions, the answers to which measure the relative strength of each of the 4 functions. Versions are available for children and parents, who complete their respective scales separately ( see Related resources). Item means are calculated across the measures to help determine the primary reason for a child's school refusal.

In addition to using the assessment scale, you may ask interview questions regarding the form and function of school refusal behavior ( Tables 4,5). Take care to assess attendance history and patterns, comorbid conditions, instances of legitimate absenteeism, family disruption, and a child's social and academic status. Specific questions about function can help narrow the reason for school refusal.

Assess specific school-related stimuli that provoke absenteeism such as social and evaluative situations, whether a child could attend school with a parent (evidence of attention-seeking), and what tangible rewards a child receives for absenteeism throughout the school day. Information about the form and function of school refusal behavior may also be evident during in-office observations of the family. Data from the School Refusal Assessment Scale-Revised, interviews, and observations can then be used to recommend particular treatment options.

Questions related to forms of school refusal behavior

What are the child's specific forms of absenteeism, and how do these forms change daily?

What specific school-related stimuli are provoking the child's concern about going to school?

Is a child's school refusal behavior relatively acute or chronic in nature (in related fashion, how did the child's school refusal behavior develop over time)?

Is the child's refusal to attend school legitimate or understandable in some way (eg, school-based threat, bullying, inadequate school climate)?

What comorbid conditions occur with a child's school refusal behavior (), including substance abuse?

What family disruption or conflict has occurred as a result of a child's school refusal behavior?

What is the child's degree of anxiety or misbehavior upon entering school, and what specific misbehaviors are present in the morning before school ()?

What is the child's academic and social status? (This should include a review of academic records, formal evaluation reports, attendance records, and individualized education plans or 504 plans as applicable.)

Questions related to functions of school refusal behavior

Have recent or traumatic home or school events influenced a child's school refusal behavior?

Is the child willing to attend school if a parent accompanies him or her?

Are symptoms of school refusal behavior evident on weekends and holidays?

What specific tangible rewards does the child pursue outside of school that cause him or her to miss school?

Are there any nonschool situations where anxiety or attention-seeking behavior occurs?

Is the child willing to attend school if incentives are provided for attendance?

What specific social and/or evaluative situations at school are avoided?

Treatment success will be better assured if you work closely with school personnel and parents to gather and share information, coordinate a plan for returning a child to school, and address familial issues and the child's comorbid medical problems that impact attendance.

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Solutions to school refusal for parents and kids

# data[].attributes.attachment_link.description
Is there a link between school violence and absenteeism? Violence on school campuses across the country naturally makes many parents skittish about possible copycat incidents. In fact, some parents acquiesce to their children's pleas to remain home on school shooting anniversaries-particularly the Columbine tragedy of April 20, 1999.

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Planning for a return to school (Suffolk EPS)

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Planning for a return to school (Suffolk EPS)

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Pupil Views about support card sort - Secondary

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Pupil Views about support card sort - Secondary

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These cards are to be used when supporting children who may struggle to identify the things about school that they find positive and what they need in order to help them succeed. This set is designed for children of secondary age. These can be used to support the ideal school/ ideal classroom activity.

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Secondary Ideal School Sorting Statements

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Link to the Newcastle EPS Local Offer page for EBSNA with links to the formulation sheets and training webinar.

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Emotionally Based School Non Attendance, or EBSNA, is a type of absenteeism driven by emotional factors (e.g. stress, anxiety, low mood, low motivation), which is used by children/ young people as a strategy to avoid educational situations and/or seek something which better meets their needs outside of an educational context.

Newcastle Educational Psychology Service is currently delivering initial EBSNA training to a number of educational provisions and staff working with young people in education this year, with schools currently being held on a waitlist for the coming year. For those who have accessed the training, there are additional resources offered here, as well as access to the webinar version of the training provided (below).

The EBSNA Padlet created by Newcastle EPS Service can be accessed by clicking or scanning the QR Code below.

For any additional queries, please contact EPSadmin@newcastle.gov.uk

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Emotionally Based School Non Attendance (EBSNA)

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Emotionally Based School Non Attendance, or EBSNA, is a type of absenteeism driven by emotional factors (e.g. stress, anxiety, low mood, low motivation), which is used by children/ young people as a strategy to avoid educational situations and/or seek something which better meets their needs outside of an educational context.

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East Riding EBSNA Consultation Framework

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East Riding EBSNA Consultation Framework

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Hampshire EPS Info for Children and Young People

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Hampshire EPS Info for Children and Young People

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Information for Young People (Suffolk EPS)

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Information for Young People (Suffolk EPS)

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Self Regulation Suggestions (Suffolk EPS)

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Self Regulation Suggestions (Suffolk EPS)

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Suffolk EPS Guidance for Schools (Part 1)

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Suffolk EPS Guidance for Schools (Part 1)

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Suffolk EPS Guidance for Schools (Part 2)

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Suffolk EPS Guidance for Schools (Part 2)

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West Sussex EPS Guidance for Young People

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West Sussex EPS Guidance for Young People

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Young People - Emotionally Based School Avoidance

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Parents - Emotionally Based School Avoidance

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Advice for Classroom Teachers (Devon EPS)

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Advice for Classroom Teachers (Devon EPS)

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School Refusal and Bullying (Ochi et al, 2020)

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School Refusal and Bullying (Ochi et al, 2020)

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Ochi et al (2020) School refusal and bullying in children with ASD

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EBSNA and Successful Returns to School (Corcoran et al, 2022)

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EBSNA and Successful Returns to School (Corcoran et al, 2022)

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EBSNA two successful returns following lockdown 2022

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Factors associated with EBSNA (Shilvock, 2010)

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Factors associated with EBSNA (Shilvock, 2010)

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Shilvock (2010) Thesis - EBSA from the YP perspective

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Parent/ carer views of EBSNA (Lissack & Boyle, 2022)

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Parent/ carer views of EBSNA (Lissack & Boyle, 2022)

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Review of Education - 2022 - Lissack - Parent carer views on support for children s school non‐attendance   How can they

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Factors associated with emotionally based non attendance

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Thoughts feelings bodily sensations EBSA

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School refusal is more common than we think, and we need to be aware of that. This film wants to give you a perspective of a young student who is  struggling with school refusal.

The short film is available in English, Dutch, French, Turkish and Arabic voices. All have the possibility to add English subtitles to follow along.

More information on school refusal on www.hogent.be/schoolrefusal

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Addressing Emotionally Based School Avoidance (Anna Freud Centre)

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Addressing Emotionally Based School Avoidance (Anna Freud Centre)

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Emotionally-based school avoidance is a term referring to reduced or nonattendance at school by a child or young person.

Rather than the term 'school refusal', the term EBSA recognises that this avoidance has its root in emotional, mental health or wellbeing issues.

The 2022 Attendance Audit from the Children's Commissioner found that in Autumn 2021, 1 in 4 children were persistently absent. In 2018/2019, this figure was 1 in 9 - meaning that persistent absence has more than doubled in this time period.

This resource:

introduces the topic of EBSA

explores some of the potential risk factors

provides strategies and tips to help education staff tackle the issue.

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This resource looks at the topic of emotionally-based school avoidance (EBSA) and shares ideas to help education staff address the issue.

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Classroom Wellbeing Toolkit (Anna Freud Centre)

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Classroom Wellbeing Toolkit (Anna Freud Centre)

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This evidence-based toolkit, created in partnership with the Early Intervention Foundation (EIF), will help secondary school staff take steps to improve students' mental health and wellbeing through everyday practices.

This new resource will help build teachers' confidence to address the needs of their students, covering five strategy areas on:

building supportive relationships

creating a classroom environment where all students feel they belong

promoting good mental health

responding to stress, low mood and anxiety

preventing bullying, cyberbullying and sexual harassment.

It is designed for secondary school subject teachers, but will also be useful for teaching assistants, librarians and other support staff.

It is not about asking teachers to be mental health professionals, but instead focuses on enhancing the quality of the classroom environment and staff-student relationships.

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A toolkit for secondary school staff, sharing practical steps to promote and support mental health through everyday interactions with students.

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Fight Flight Freeze – Anxiety Explained For Teens

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The Friendship Programme (East Midlands ESS)

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The Friendship Programme (East Midlands ESS)

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Friendship Programme | The East Midlands Education Support Service

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Friendship Programme resources by Nottinghamshire EPS

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The Resilience Ball is an evidence informed tool to help mental health, education and social care practitioners and parents/carers think about resilience in a different way. It also presents ways in which to boost resilience in self and others. It was developed by Dr Cath Lowther, an educational ...

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CBT and Reframing Thoughts With Cognitive Restructuring

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Q&A | Emotionally Based School Avoidance

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5 Tips for Helping Young People Attend School

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5 Tips for Helping Young People Attend School

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SCHOOL ANXIETY ('REFUSAL') | 5 ideas for supporting children who are struggling to attend school

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This colourful deck of playing cards is an easy-to-use resource designed to support building the resilience of children and young people in school settings. The cards offer a playful, child-friendly way to assess a young person's resilience and are particularly useful for schools wanting to offer early interventions in order to support the resilience of students who are vulnerable because of their exposure to adverse childhood experiences.

The resource includes:

The Roots of Resilience Tool (a downloadable, printable resource)

The cards have been designed for use in groups or on a 1:1 basis by teachers, professionals and parents. They can be used independently or alongside the book Nurturing Emotional Resilience in Vulnerable Children and Young People (Ttofa, 2018), which elaborates on the research supporting the cards in more depth. An indispensable resource, the cards place a strong emphasis on the healing power of relationships, particularly the role of a nurturing trusted adult in building resilience in children and young people.Intended for use in educational settings and/or therapy contexts under the supervision of an adult. This is not a toy.

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A Nurturing Resilience Card Deck: A Resource for Use with Vulnerable Children and Young People

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Buy A Nurturing Resilience Card Deck: A Resource for Use with Vulnerable Children and Young People 1 by Ttofa, Juliette (ISBN: 9780367514112) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders.

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Supporting Young People with EBSA by Tina Rae

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Supporting Young People with EBSA by Tina Rae

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CPD Coffee time with Dr Tina Rae 21  Supporting those with emotionally based school phobia in COVID

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Understanding and Supporting CYP with EBSA by Tina Rae

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Understanding and Supporting CYP with EBSA by Tina Rae

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A practical user-friendly toolkit of resources providing an overview of EBSA and strategies to support return to school, with a focus on transition from primary to secondary school and the effects of the COVID-19 pandemic.

Children and young people miss school for a variety of reasons - as a response to personal, family, school or wider environmental issues. Emotionally Based School Avoidance or Refusal (EBSA) is a pattern of absence where reluctance, or refusal, to attend or stay in educational settings is rooted in anxiety or fear.

Risk factors vary, and it is important to understand the reasons for poor or non-attendance. This resource provides an overview of EBSA, useful assessments and key tools to help identify and support those young people who find school attendance a struggle owing to anxiety or fear.

Many children and young people - especially those with existing mental health issues have found the experience of lockdown as a result of the COVID-19 pandemic particularly stressful and increased levels of anxiety are widespread. As a result, the need to provide support for increased levels of anxiety will be ongoing.

This toolkit of resources will give confidence to anyone working with or looking after young people in understanding the basis for EBSA and will provide practical, helpful strategies that can be implemented by parents and school-based staff to support young people back into the learning environment.

Contents Include:

How EBSA differs from truancy.

Recognising warning signs and triggers.

Different types of anxiety and stress & links with school avoidance.

Transition from primary to secondary school.

Practical techniques and activities for supporting children & young people.

Developing individualised support plans.

The role of the key adult & nurturing relationships.

Top tips for home and school to support transition back to the classroom.

Resources include Checklists, Assessments, Handouts & Activity Resources for use by SENCOs, Mental Health Leads, Learning Mentors, Teachers, Counsellors, Social Care Professionals and Parents/Carers Parents & Cares.

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Understanding & Supporting Children & Young People with Emotionally Based School Avoidance (EBSA)

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Buy Understanding & Supporting Children & Young People with Emotionally Based School Avoidance (EBSA) by Tina Rae (ISBN: 9781912112517) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders.

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School Refusal Assessment Scale - Parent Version (Kearney & Silverman)

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School Refusal Assessment Scale - Parent Version (Kearney & Silverman)

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School Refusal Assessment Scale (Kearney & Silverman)

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School Refusal Assessment Scale (Kearney & Silverman)