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Trajectories of school refusal: sequence analysis using retrospective parent reports.
Laelia Benoit1,2,3,4, Edith Chan Sock Peng5, Julien Flouriot5
1Université Paris-Saclay, UVSQ, Inserm U1018, CESP, 94807, Villejuif, France. laelia.benoit@yale.edu.
European Child & Adolescent Psychiatry
|April 11, 2024
Summary
This study identified five distinct patterns of school refusal (SR) over three years in children and adolescents. Understanding these trajectories can aid in early identification and intervention for school attendance problems.
Area of Science:
- Child and Adolescent Psychiatry
- Developmental Psychology
- Educational Psychology
Background:
- School refusal (SR) is a significant school attendance problem (SAP) requiring specialized mental health care.
- The longitudinal course of SR remains incompletely understood despite advancements in SAP definitions.
Purpose of the Study:
- To characterize three-year patterns of school refusal (SR) trajectories in children and adolescents.
- To identify distinct courses of SR based on parental reports of school attendance and emotional distress.
Main Methods:
- Anonymous web-based survey administered to parents reporting on their child's school attendance over three academic years.
- Sequence analysis employed to define standard SR trajectories based on retrospective recall.
- SR onset defined as absence from school for ≥2 weeks with emotional distress in a single academic year.
Main Results:
- Five prototypical SR trajectories were identified: 'beaded absences' and 'rapid recovery' for children; 'prolonged recovery', 'gradual decline', and 'rapid decline' for adolescents.
- The study analyzed data from 1328 parents meeting SR criteria, with 729 providing three years of school attendance data.
- Distinct patterns of SR course were observed, varying between children and adolescents.
Conclusions:
- The identified typology of SR trajectories offers a framework for timely identification of school refusal.
- Pattern recognition of these trajectories can facilitate the implementation of evidence-based interventions to improve outcomes for students with SR.
- Further prospective research and field application are recommended to validate and utilize these findings.
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