JOHANNE JEPPESEN LOMHOLTPOSTDOC, MSC (PSYCHOLOGY), PHDTRYGFONDEN’S CENTRE FOR CHILD RESEARCH
MIKAEL THASTUMPROFESSORDEPARTMENT OF PSYCHOLOGY
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
AU network of public mental child health 12 DECEMBER 2014
Danish schoolchildren with low attendance
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
WHY FOCUSING ON SCHOOL ABSENTEEISM?›A serious public mental health issue
›Associated with school dropout
›Key factor for:› violence› injury› substance use› psychiatric disorder› economic deprivation
BACKGROUND Aim Methods Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
RISK FACTORS FOR SCHOOL ABSENTEEISM
School absence
Child factors
Parent factors
Family factors
Peer factors
School factors
Community factors
BACKGROUND Aim Methods Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
RISK FACTORS FOR SCHOOL ABSENTEEISM
School absence
Child factors
Parent factors
Family factors
Peer factors
School factors
Community factors
BACKGROUND Aim Methods Results Conclusion
Parent and family factors• Family structure• Education level• Income• Chronic illness/disability
• Parents• Siblings
• Emotional disorders• Parental involvement in
the school
Child factors• Gender• Age• Anxiety• Depression• Oppositional behavior• Chronic illness• Pain• Sleep problems/fatigue• Extreme obesity
School factors• Teacher-student
relationship• Teacher-parent relationship• Students feeling of being:
• Safe• Accepted• Respected
Peer factors• Bullying• Early peer rejection
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
RISK FACTORS FOR SCHOOL ABSENTEEISM
School absence
Child factors
Parent factors
Family factors
Peer factors
School factors
Community factors
BACKGROUND Aim Methods Results Conclusion
Child factors:•Anxiety
•Depression
•Oppositional behavior
•Chronic illness
Parent factors:• Unemployme
nt
• Parental involvement in school activities
Family factors:• Language
spoken at home
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
HOW TO CATEGORIZE SCHOOL ABSENTEEISM?Danish primary and lower secondary school:
Legal1. Due to medical illness or other accepted causes 2. Absence with permission from the head master
Illegal3. E.g. truancy
BACKGROUND Aim Methods Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
OVERALL AIMIn a sample of children from 0 th - to 9 th grade in 5 schools in the municipality of Aarhus, with children, parents, and teachers as informants the primary aim is to investigate the individual and relative importance of several domains of risk factors (individual, parental, family, peer, and school) for school absenteeism
Background AIM Methods Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
AIM OF THIS PRESENTATIONTo investigate:
1. Associations between school absence and individual and contextual factors
2. The psychological characteristics of children with problematic school absence
Background AIM Methods Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
DESIGNCross-sectional study
I. Survey with students, parents, and teachers as informants
II. Absence data from the municipalityIII. Register data (not obtained yet)
Data collected in winter/spring 2014
Background Aim METHODS Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
SCHOOL ABSENCE DATARegistered on a daily basis by the teachers for each student and are monthly reported to the municipality of Aarhus.
The school absence data are linked to the child’s civil registration number
In this presentation: overall absence from August 2013 to April 2014 (164 school days)
Background Aim METHODS Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
PROCEDURE- TEACHERS
›The class teacher completes the questionnaires during their working hours
1. A questionnaire for each student in the classa) Strength and difficulties questionnaire (SDQ)b) Questions about parental involvement
2. A questionnaire about the classa) Wellbeing in the classb) How the teacher managed absence
Background Aim METHODS Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
PROCEDURE- PARENTS
One parent invited to complete questionnaire at home. Distributed: intranet
Questionnaire:I. Strength and difficulties questionnaire (SDQ)I. Parental involvementII. UpbringingIII. Child healthIV. AnxietyV. Reason for absence (school refusal assessment scale)
Background Aim METHODS Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
PROCEDURE- STUDENTSCompleted survey in class using IPads/ schools laptop
Research assistants administered the data collection
Children from 0th to 1st grade did not receive a questionnaire.
Background Aim METHODS Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
DATA COLLECTION-STUDENTS• WHO-5 (wellbeing)• Anxiety• Wellbeing in school (teachers, friends,
bullying)• Upbringing • Spare time• Health and pain• Strength and difficulties questionnaire
(SDQ)• Reason for absence
Background Aim METHODS Results Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
RESULTS
Preliminary data
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
Background Aim Methods RESULTS Conclusion
STUDENTSAssessed for eligibility
2nd-9th grade
n= 2021
Final student samplen= 1731 (86%)Age: 11.66 ±2.37
♂= 877 (50.7%) ♀=854 (49.3%)
Non-participants
• Changed school
• Disagreed to participate
• No contact to parents
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
Background Aim Methods RESULTS Conclusion
Assessed for eligibility
0th-9th graden=2473
PARENTSn= 1104
(45%)
TEACHERSn= 2108(85%)
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
PREVALENCE
Background Aim Methods RESULTS Conclusion
Total Legal (illness) Legal (other) Illegal0123456789
10
Average number of days with absence from school(5% of school days)
(3%of school days )
(1% of school
days)
(1% of school
days)
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
SDQ-LEVELS AND MEAN DAYS OF ABSENCESDQ Total Normal
RangeM (SD)
Above 80% percentile
M (SD)
Difference
TEACHER REPORTED n=1643 n=462 Cohens d
Total absence 7.7 (7.4) 11.7 (11.8) 0.41***
Legal absence (illness) 4.3 (5.2) 6.2 (7.2) 0.30***
Legal absence (other) 2.1(3.6) 2.3 (4.2) 0.05
Illegal absence 1.2 (3.8) 3.2 (7.9) 0.32***
PARENT REPORTED n=825 n=267
Total absence 6.8 (6.4) 9.3 (10.5) 0.29***
Legal absence (illness) 3.8 (4.5) 5.3 (6.5) 0.27**
Legal absence (other) 2.3 (3.8) 2.2 (4.3) d=0.03
Illegal absence 0.7 (1.8) 1.7 (6.5) d=0.21*
Note: *<.05, **<.01, ***<.001c
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
SDQ-LEVELS AND MEAN DAYS OF ABSENCE
SDQ Total NormalRangeM (SD)
Above 80% percentile
M (SD)
Difference
STUDENT REPORTED n=879 n=239 Cohens d
Total absence 8.2 (8.4) 10.2 (9.9) 0.22**
Legal absence (illness) 4.6 (5.6) 5.2 (6.4) 0.10
Legal absence (other) 2.1 (3.6) 2.0 (3.2) 0.03
Illegal absence 1.5 (4.2) 2.9 (6.8) 0.25**
Note: *<.05, **<.01, ***<.001
Background Aim Methods RESULTS Conclusion
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
ASSOCIATIONS WITH ABSENCE
Total absence
Children(n=1118#/
1731)
Parents(n=1104)
Teachers(n=2108)
Internalizing (SDQ) .06* .20*** .24***
Externalizing (SDQ) .08* .09* .16***
Prosocial behavior (SDQ) -.04 .02 -.15***
Wellbeing (WHO-5) -.12*** - -
Home/school cooperation
- -.04 -.17***
Background Aim Methods RESULTS Conclusion
Note:# Only children from 4th-9th grade completed the SDQ *<.05, **<.01, ***<.001
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
ASSOCIATIONS WITH ABSENCE
Background Aim Methods RESULTS Conclusion
Legal (illness) Legal (other) Illegal
C P T C P T C P T
Internalizing (SDQ) .06* .21*** .20*** -.02 -.02 .01 .06 .12*** .18***
Externalizing (SDQ) .05 .07* .08*** -.03 -.002 .01 -.10** .10** .17***
Prosocial behavior (SDQ) -.02 -.03 -.03 -.002 .09* .02 -.05 -.02 -.16***
Wellbeing (WHO-5) -.08** .002 -.12***
Home/school cooperation
-.09** -.10*** .04 .05* .-12*** .003 -.22***
Note: *<.05, **<.01, ***<.001c
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
PROBLEMATIC ABSENCEOur definition:
More than 10% absence from school in the period August 2013- April 2014 (164 school days).
Only absence classified as either due to illness or illegal absence are included.
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
CHARACTERISTICS OF PROBLEMATIC ABSENCE GROUP
Background Aim Methods RESULTS Conclusion
Problematic absence
n=213
Remaining samplen=2260
Cohens d / phi
Age 12.8 (2.4) 11.6 (2.4) .50***
Gender 57% males 51 % males .03
Divorced parents 53% 31% .12***
Chronic illness 45% 22% .11**
Pain 64% 47% .08**
Obesity 16% 4% .12**
Wellbeing (WHO-5) 16.0 (4.9) 18.4 (4.1) .53***
Note: *<.05, **<.01, ***<.001.Cohen’s d: 0.2=small, 0.5= medium, 0.8= largephi: 0.1= small, 0.3=medium, 0.5= large
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
Problematic absencen=213
Remainingn=2260
Cohens d
Home/school cooperation:Parent-ratedTeacher-rated
3.1 (0.6)3.0 (0.8)
3.3 (0.5)3.3 (0.6)
.36*.50***
Internalizing(SDQ):Child-ratedParent-ratedTeacher-rated
5.4 (3.4)5.8 (3.3)4.8 (3.8)
4.4 (3.2)2.8 (3.0)2.0 (3.0)
.30***
.95***
.82***
Externalizing (SDQ):Child-ratedParent-ratedTeacher-rated
5.9 (3.8)4.6 (3.4)5.7 (5.2)
4.6 (3.4)2.8 (3.0)3.2 (4.1)
.36***
.56***
.53***
Note: *<.05, **<.01, ***<.001.Cohen’s d: 0.2=small, 0.5= medium, 0.8= large
Background Aim Methods RESULTS Conclusion
CHARACTERISTICS OF PROBLEMATIC ABSENCE GROUP
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
Background Aim Methods RESULTS Conclusion
Problematic absencen=213
Remaining n=2260
phi
Close friend 78% 84% .04
Bullying 19% 20% .002
Low academic performance 51% 23% .18***
Special education need 33% 14% .15***
Current contact to school psychologist (PPR)
36% 11% .21***
Note: *<.05, **<.01, ***<.001.phi: 0.1= small, 0.3=medium, 0.5= large
CHARACTERISTICS OF PROBLEMATIC ABSENCE GROUP
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
SUMMARY OF THE RESULTS
Background Aim Methods Results CONCLUSION
Children with problematic absence have more emotional and behavioral problems (in the subclinical range)
Associations between absence and wellbeing and emotional and behavioral problems.
Children with legal absence due to medical illness have highest level of emotional problems
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
SUMMARY OF THE RESULTS
Background Aim Methods Results CONCLUSION
›Children with legal absence due to medical illness have highest level emotional problems
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
IMPLICATIONS
Background Aim Methods Results CONCLUSION
Develop and target interventions to children with problematic absence
DEPARTMENT OF PSYCHOLOGY AND BEHAVIOURAL SCIENCESBUSINESS AND SOCIAL SCIENCESAARHUS UNIVERSITY
RESEARCH GROUPI. Lead researcher: Mikael Thastum, professor,
Department of Psychology, Aarhus University
II. Johanne Jeppesen Lomholt, postdoc, Trygfonden’s Centre for Child Research, Aarhus University
III. Jacob Arendt Nielsen, professor, KORA
IV. Jill Mehlby, senior researcher, KORA
›Municipality of Aarhus
This project is a part of Trygfonden’s Centre for Child
Research
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