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Functional analysis of school refusal: An exploratory study in the Indian context.
Arun Singh Yadav1, Kiragasur Madegowda Rajendra2, Lakshmi Sravanti2
1Department of Psychiatry, 174 Military Hospital, Bathinda Cantt., Bathinda, Punjab, India.
Industrial Psychiatry Journal
|February 3, 2025
Summary
School refusal behavior, often linked to anxiety and home rewards, impacts children and families. Functional assessment is key for effective, individualized treatment plans in child psychiatry.
Area of Science:
- Child and Adolescent Psychiatry
- Clinical Psychology
- Developmental Psychology
Background:
- School refusal behavior (SRB) is a complex issue encompassing truancy, school phobia, and school refusal.
- It is influenced by psychological and psychosocial factors, causing significant distress to children and families.
- Understanding SRB is crucial for effective intervention in child mental health.
Purpose of the Study:
- To evaluate the clinical and functional characteristics of school refusal behavior in Indian children and adolescents.
- To identify primary reasons and associated factors contributing to SRB in a tertiary care setting.
- To explore the relationship between SRB and sociodemographic, clinical, and family variables.
Main Methods:
- A study involving 36 subjects (ages 6-17) with SRB at a Child and Adolescent Psychiatry service.
- Utilized MINI-KID 6.0 and School Refusal Assessment Scale-Revised (SRAS-R) for evaluation.
- Analyzed sociodemographic and clinical data using frequency analysis and Cramer's V coefficient.
Main Results:
- Anxiety in social/evaluative situations with home rewards was the primary driver of SRB.
- Significant associations found between SRB functions, academic performance, psychiatric diagnoses, and family stressors.
- Children's Global Assessment Scale (CGAS) scores ranged widely, indicating diverse functional impairments.
Conclusions:
- SRB is a multifactorial issue with individual and psychosocial components.
- A functional perspective is essential for developing tailored treatment strategies.
- Individualized treatment plans based on functional assessment can improve outcomes for children with SRB.
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