Emerging School Refusal: A School-Based Framework for Identifying Early Signs and Risk Factors

A student’s academic and social-emotional development is increasingly jeopardized with mounting absence from school. School refusal (SR) is one type of school attendance problem (SAP) that is often associated with absence from school. Once established, it can sometimes be difficult to treat. To prevent established SR and associated problems, indicators of emerging SR and risk for SR should be efficiently identified and acted upon. Risk factors are often discussed in relation to SAPs generally rather than considering risk for specific types of attendance problems. Based on literature review, this paper provides an account of the likely signs and risks for emerging SR. A school-based framework is provided to support school personnel and parents in working together to identify these signs and risks. Several challenges associated with the implementation of the framework are discussed.     

Developing an Online Early Detection System for School Attendance Problems: Results From a Research-Community Partnership

School refusal and other school attendance problems are vexing problems for school-aged youth, families, school personnel, and clinicians. However, few resources exist to detect problematic attendance. The current report describes three steps of a research-community partnership to develop an early identification program to detect youth at risk for problematic attendance. First, a survey was conducted to estimate the scope and cost of school refusal across grades K–12. School administrators estimated relatively few youth exhibiting significant school refusal (missing 5 or more days per year) but estimated the costs associated with services for these youth to be very high (mean cost of in-district programs: $94,052; mean cost of out-of-district placements: $496,657). Second, elementary school counselors were tasked with tracking absenteeism among at-risk youth using an online attendance tracking prototype. Counselors identified a high number of youth who showed elevated absences, lates, or early departures (17.2% of enrolled students), and counselor ratings were significantly related to whether the student (a) had received an individualized education plan or 504 plan, (b) had a sibling with similar attendance problems, (c) was older, or (d) had divorced or separated parents. In a final step, counselor feedback was sought and revisions were incorporated in the attendance tracker. Findings reinforce the prevalence and cost of school attendance problems, provide guidance for using technology to monitor attendance and related indices (tardies, early departures), and direct attention to youth factors that may be useful in identifying youth at risk for poor attendance.     

Behavioral Strategies to Reduce School Violence

SUMMARY

Public schools that use punitive approaches toward student discipline can unwittingly promote violence and other antisocial behavior. This article reviews constructive and preventive methods to reduce school violence and vandalism. Various strategies are presented and discussed.     

Adolescent school experiences and dropout,adolescent pregnancy,and young adult deviant behavior

Outside of the family, schools are the most proximal socializing agent available to convey societal norms and prohibitions to young people. In some cases, a positive school experience can compensate for the antisocial influence of family and community. The present study investigated the predictive ability of school-related factors on later deviancy in a random sample of 452 US adolescents 12-18 years of age attending 150 junior or senior high schools in upstate New York and enrolled in a broader prospective study. A measure of conduct problems, obtained 2 years before measurement of school factors, was used to control for the predisposing effects of problematic behavior on later deviance. Academic achievement, academic aspirations, and a learning-focused school environment had deterrent effects on all deviant outcomes assessed--dropping out of school, adolescent pregnancy, engaging in criminal activities, criminal conviction, antisocial personality disorder, and alcohol abuse--independent of age, gender, intelligence quotient, socioeconomic status, childhood conduct problems, and proportion of deviance-oriented friends in adolescence. Given the persistence of deviant behavioral patterns of adolescence into adulthood, the systems-level influences identified in this study should be given careful attention.     

Implementing Family-Centered Interventions Within the Public Middle School: Linking Service Delivery to Change in Student Problem Behavior

The Adolescent Transitions Program is a family-centered intervention strategy designed to reduce problem behavior and prevent drug use within a public school environment. A parent consultant within a Family Resource Center (FRC) provided universal, selected, and indicated interventions that enhanced and supported positive parenting practices known to serve as protective factors. Implementation of the 3-year FRC model involved 584 students and their families in 4 middle schools. Analyses focused on the dynamics and effects of parent consultant activities and services. Differences in school “adoption” of the FRC services were found to be a function of both passage of time and school environment. Despite significant variation in implementation across schools, FRC services significantly reduced the growth in problem behavior over the course of the middle-school years. The implications of these findings for dissemination of empirically supported, school-based, family-centered interventions are discussed.     

A Preventive Approach to School Violence and Vandalism: An Experimental Study

School violence and vandalism are at crisis level. The investigators attempted to employ strategies that would attack identified procreators of school violence and vandalism existing within our schools. The effects of these strategies on vandalism costs, student attendance, off-task and disruptive behaviors, and on various kinds of positive teacher-student contacts were investigated in 19 elementary schools. Results indicated that the dollar costs of vandalism and frequency of inappropriate student behaviors decreased more in experimental than in control schools. Student attending and positive teacher-student contacts improved, or remained higher, in the experimental than in the control schools.     

Children's antisocial behavior, mental health, drug use, and educational performance after parental incarceration: a systematic review and meta-analysis

Unprecedented numbers of children experience parental incarceration worldwide. Families and children of prisoners can experience multiple difficulties after parental incarceration, including traumatic separation, loneliness, stigma, confused explanations to children, unstable childcare arrangements, strained parenting, reduced income, and home, school, and neighborhood moves. Children of incarcerated parents often have multiple, stressful life events before parental incarceration. Theoretically, children with incarcerated parents may be at risk for a range of adverse behavioral outcomes. A systematic review was conducted to synthesize empirical evidence on associations between parental incarceration and children's later antisocial behavior, mental health problems, drug use, and educational performance. Results from 40 studies (including 7,374 children with incarcerated parents and 37,325 comparison children in 50 samples) were pooled in a meta-analysis. The most rigorous studies showed that parental incarceration is associated with higher risk for children's antisocial behavior, but not for mental health problems, drug use, or poor educational performance. Studies that controlled for parental criminality or children's antisocial behavior before parental incarceration had a pooled effect size of OR = 1.4 (p < .01), corresponding to about 10% increased risk for antisocial behavior among children with incarcerated parents, compared with peers. Effect sizes did not decrease with number of covariates controlled. However, the methodological quality of many studies was poor. More rigorous tests of the causal effects of parental incarceration are needed, using randomized designs and prospective longitudinal studies. Criminal justice reforms and national support systems might be needed to prevent harmful consequences of parental incarceration for children.     

The mental health of children of migrant workers in Beijing: The protective role of public school attendance

The present study aims to understand the mental health status of an understudied group of migrant children – children of migrant workers in China. A total of 1,466 children from Beijing participated in the study that compared migrant children (n = 1,019) to their local peers (n = 447) in public and private school settings. Results showed that overall, migrant children reported more internalizing and externalizing mental health problems and lower life satisfaction than local peers. However, public school attendance served as a protective factor for migrant children's mental health. The mental health status of migrant children attending public schools, including externalizing problems as well as friend and school satisfaction, was not different from local children. In addition, our data indicates that the protective effect of public school attendance for migrant children may be even more salient among girls than boys, and for younger children than older children.     

Reflections on the Field of School Attendance Problems: For the Times They Are a-Changing?

This article presents reflections on the seven articles included in this special series. The classification of school attendance problems (SAPs) based on structured checklists of SAP types (school refusal, truancy, school withdrawal, and school exclusion) together with functional analysis opens the way for establishing norms and social referents. We discuss how authorized nonattendance can also be problematic if it is persistent, and that it is important to take this type of SAP into account if the field is to effectively understand and respond to the complex range of bio-psycho-socio-cultural determinants of absenteeism. We highlight other gaps in the current literature, one of which is the lack of attention to evidence-based prevention and early intervention strategies. Avenues for future research are suggested, with emphasis on the need for pragmatic approaches to address the complexities of SAPs. Promising work is beginning to address the SAPs that are prevalent in special populations such as those with autism spectrum disorder. Overall, our reflections highlight the incremental changes that have characterized the field, exemplified by this series of articles, and the promise of transformational change in tackling the major challenge of SAPs as research in the field continues.     

Factors associated with antisocial behavior in combat veterans

The objective of this study was to identify factors associated with antisocial behavior in 1,543 Marines who deployed to combat zones in support of conflicts in Iraq and Afghanistan during 2002–2007. Five factors were associated with antisocial behavior in multivariate analyses: post‐traumatic stress disorder (PTSD) symptoms, deployment‐related stressors, combat exposure, younger age, and being divorced. PTSD symptoms had a stronger association with antisocial behavior than any other variable. A unique and important finding of this study was the association between deployment‐related stressors and a higher incidence of antisocial behavior. Because deployment‐related stressors are potentially modifiable, the military may be able to address them in concrete ways such as by shortening deployments and improving communication with home. Aggr. Behav. 36:330–337, 2010. Published 2010 by Wiley‐Liss, Inc.     

Modification of school attendance for an elementary population

The staff and students of a school composed of Grades 1 through 3 participated in a program to increase school attendance. Children earned the opportunity to attend part or all of a monthly party by their attendance. Immediate feedback occurred each morning by placing stars on a classroom chart for each child present. The school's attendance during the program was compared both with attendance during preceding years and with attendance at other schools. The experimental school's attendance improved dramatically to become the best of all elementary schools in the system.     

Evaluation of the First 3 Years of the Fast Track Prevention Trial with Children at High Risk for Adolescent Conduct Problems

Fast Track is a conduct-problem prevention trial that derives its intervention from longitudinal research on how serious and chronic adolescent problem behaviors develop. Over 9,000 kindergarten children at 4 sites in 3 cohorts were screened, and 891 were identified as high risk and then randomly assigned to intervention or control groups. Beginning in Grade 1, high-risk children and their parents were asked to participate in a combination of social skills and anger-control training, academic tutoring, parent training, and home visiting. A multiyear universal classroom program was delivered to the core schools attended by these high-risk children. By the end of third grade, 37% of the intervention group was determined to be free of serious conduct-problem dysfunction, in contrast with 27% of the control group. Teacher ratings of conduct problems and official records of use of special education resources gave modest effect-size evidence that the intervention was preventing conduct problem behavior at school. Parent ratings provided additional support for prevention of conduct problems at home. Parenting behavior and children's social cognitive skills that had previously emerged as proximal outcomes at the end of the 1st year of intervention continued to show positive effects of the intervention at the end of third grade.     

Patterns and correlates of gun ownership among nonmetropolitan and rural middle school students

Examined prevalence of gun ownership and the links among gun ownership, reasons for gun ownership, and antisocial behavior in a sample of nonmetropolitan and rural middle school students. Participants completed the Questionnaire for Students (Olweus, 1995) and included 6,263 students from 36 elementary and middle schools, of whom most were African American (range = 46%-95% per school). Reasons for gun ownership were strongly associated with rates of antisocial behavior. Youths who owned guns for sporting reasons reported rates of antisocial behavior that were only slightly higher than those reported by youths who did not own guns. Youths who owned guns to gain respect or to frighten others reported extremely high rates of antisocial behavior. These high-risk adolescent gun owners were likely to come from families of high-risk gun owners, associate with friends who were high-risk gun owners, and engage in high rates of bullying behavior. Findings suggest that effective violence prevention programs must target high-risk youths, address risk factors that go beyond individual settings, and address a comprehensive array of risk factors.     

School Counselors' Experiences With Lockdown Drills: A Phenomenological Investigation

Lockdown drills are used in pre-K–12 public schools throughout the country; however, little research exists regarding their impact on students and school staff (Ilk, 2018). Because of school counselors' role in both prevention of and response to school gun violence (American Counseling Association, 2018), we used a phenomenological approach to investigate their experiences with lockdown drills (N = 26). Results included the following three themes: (a) school counselors' sense of duty to follow school protocol, (b) unintended emotional consequences related to lockdown drills, and (c) school counselors navigating complexities. Implications for school counselors and corresponding school procedures are discussed.     

SOME STRUCTURAL ASPECTS OF DEVIANT CHILD BEHAVIOR1

Covariation within behavior repertoires of problem children were examined. Two boys, referred for psychological help, were observed both at school and at home for about 3 yr. A coded observation system permitted scoring of 19 child-behavior categories and six social-environment categories. After a two-month baseline, behavior categories were intercorrelated, demonstrating that each child showed a group of behaviors that covaried. These groupings were specific to the home and school settings. Contingency management procedures were then applied to each child's problem behaviors in one setting. Next, a reversal phase was instituted, followed by resumption of the initial contingency management phase. These three phases lasted seven months, until the end of the children's public school terms. Results showed that the baseline group of covarying behaviors continued to covary over the three experimental phases. The children then entered a remedial education setting for three summer months, and then returned to schools and were observed in follow-up for 2 yr. The baseline group of behaviors continued to covary during both phases. The behavior covariations could not be accounted for on the basis of temporal relationships between the behaviors and social environment categories. Although no behavior covariations extended across either child's home and school settings, contingency management procedures produced across-setting effects.     

Shared and unique predictors of antisocial and substance use behavior among a nationally representative sample of South African youth

There are well-documented high prevalence rates of violence, aggression, and substance use in South Africa. We examined theoretically salient risk factors for antisocial behavior and substance use identified in high income countries (e.g., abuse and poverty; Shaw & Gross, 2008) and whether they had predictive effects among South African youth, for whom longitudinal research examining predictors of violence is lacking. We collected data from a large, high-risk longitudinal sample of youth from two provinces in South Africa, encompassing rural and urban sites (N = 3515; 97% retained at one year; 56.7% female; M age = 13.45). We assessed antisocial behavior and substance use using an adapted version of the CBCL-YSR and items from national surveys. Finally, we assessed risk factors using previously-validated indices of risk. Antisocial behavior and substance use were reciprocally related over time. Controlling for this overlap, as well as for relevant demographic covariates, child abuse predicted increases in antisocial behavior over time, and exposure to high levels of community violence predicted increases in both antisocial behavior and substance use one year later. The findings suggest that contextual risk factors underpinning etiological models of antisocial behavior and substance in high income countries are also relevant within the South African context. In particular, both harsh home and community environments were related to the development of youth antisocial and substance use behavior outcomes. We discuss the implications of these findings for preventative interventions to reduce youth engagement in risky antisocial and/or substance use behavior in South Africa.     

工读学校学生的心理健康状况及其影响因素研究

本研究以工读学校和普通学校七～九年级学生为研究对象,研究工读学校学生的心理健康状况及其影响因素。结果表明：(1)工读学校学生的总体焦虑水平和抑郁水平显著高于普通中学生,存在更多的心理健康问题;(2)工读学校学生的心理健康水平不存在显著的年级差异,而普通中学生的心理健康水平存在显著的年级差异;(3)父母的教养方式与工读学校学生的心理健康水平存在显著的相关。工读学校学生的父母更多地采取消极的教养方式;(4)生活事件应激与工读学校学生的心理健康水平存在极其显著的负相关。工读学校学生负性生活事件所带来的应激强度显著高于普通中学生。     

From correlates to causes: can quasi-experimental studies and statistical innovations bring us closer to identifying the causes of antisocial behavior?

Longitudinal, epidemiological studies have identified robust risk factors for youth antisocial behavior, including harsh and coercive discipline, maltreatment, smoking during pregnancy, divorce, teen parenthood, peer deviance, parental psychopathology, and social disadvantage. Nevertheless, because this literature is largely based on observational studies, it remains unclear whether these risk factors have truly causal effects. Identifying causal risk factors for antisocial behavior would be informative for intervention efforts and for studies that test whether individuals are differentially susceptible to risk exposures. In this article, we identify the challenges to causal inference posed by observational studies and describe quasi-experimental methods and statistical innovations that may move researchers beyond discussions of risk factors to allow for stronger causal inference. We then review studies that used these methods, and we evaluate whether robust risk factors identified from observational studies are likely to play a causal role in the emergence and development of youth antisocial behavior. There is evidence of causal effects for most of the risk factors we review. However, these effects are typically smaller than those reported in observational studies, suggesting that familial confounding, social selection, and misidentification might also explain some of the association between risk exposures and antisocial behavior. For some risk factors (e.g., smoking during pregnancy, parent alcohol problems), the evidence is weak that they have environmentally mediated effects on youth antisocial behavior. We discuss the implications of these findings for intervention efforts to reduce antisocial behavior and for basic research on the etiology and course of antisocial behavior.     

Mental Health in the Schools

Progress is being made in the area of delivering mental health services in the schools through collaborative programs that involve combinations of schools, communities, and research-based programs. The goal of extending collaborative efforts to initiatives that prevent emotional and behavioral problems from developing or escalating is a cross-cutting theme of the National Agenda for Achieving Better Results for Children and Youth with Serious Emotional Disturbance. I discuss examples of collaborative efforts to prevent emotional behavioral problems in school children and ways by which this effort can be enhanced in schools and communities.