March 2007 

The author’s review of written texts on the subject of extended non-school attendance identifies a dominant clinical discourse with use of language such as ‘treatment’, ‘symptoms’, ‘disorder’ and ‘diagnosis’. Other discourses focus on the legal elements of school non-attendance, directing the focus on parents as the problem rather than examining systemic factors which may influence non-attendance.  

Referencing a study by Malcolm et al (2003) of parents, children and education staff on factors influencing non-attendance there were varying factors identified by each of these groups. For pupils factors included problems with lessons or teachers, the complexity of secondary schools, peer pressure, social isolation and bullying. Parents of both children with and without attendance problems believed that bullying and problems with teachers were the principal reasons for non-school attendance while school staff believed that low parental interest and low belief in the value of education were contributing factors. Pellegrini suggests that all parties need to be supported in understanding each other’s discourses and to devise interventions which address the factors influencing attendance at individual (child), group (peer/family) and systemic (school) level.  

The article discusses the importance of considering characteristics of the child and family as factors contributing to non-attendance but also highlights the need to consider school risk factors. One suggested way of doing this is using the ‘School Refusal Assessment Scale’ developed by Kearney and Silverman (1990). This assessment helps identify the needs of individual children through 4 functions of non-attendance * and is completed by the child and their parents. The limited evidence presented in the text suggests that using the SRAS assessment scale could be beneficial in improving measures of non-attendance, however it recommends being used alongside other assessments.  

Early identification of pupils at risk of non-attendance should take place, using a multi-agency approach to identifying factors which could be a cause.  

Interventions to support returning to school at individual level should not exacerbate any underlying issues, such as anxiety, by forcing a child to spend time within a school setting. Unless environmental factors which have led to the non-attendance are addressed such interventions are likely to be unsuccessful. Effective interventions at systemic level include awareness raising through staff training, ensuring a member of staff has responsibility for attendance, flexible part-time timetables, peer-mentoring, effective anti-bullying policies, identified ‘safe havens’ and whole school emotional literacy programmes. Parental interventions such as training in positive behaviour management are also cited.  

Educational Psychologists have a key role to play in supporting work with non-attending pupils, this can include assessment, intervention, parental training, social skills and behavioural support.  

* 4 functions of non-school attendance (Kearney et al 1990):  

1. avoidance of specific fear and anxiety-provoking stimuli/ settings    2. Escape from social situations which are unpleasant and/ or an element of evaluation is present       3. Attention seeking     4. Positive reinforcement (e.g opportunity to spend time with peers or parents by non-attending). 

How quickly do we take a multi-agency approach to addressing non-attendance? 

How involved are EP staff in the early stages of identifying ‘at risk’ pupils and risk factors?  

How does each setting promote and model emotional literacy across the whole school context?  

Kearney, C. A., & Albano, A. M. (2004). The functional profiles of school, refusal behaviour: Diagnostic aspects. Behavior Modification, 28(1), 147–161. 

Kearney, C.A. & Silverman, W.K. (1990). A preliminary analysis of a functional model of assessment 

and treatment for school refusal behaviour. Behavior Modification, 14(3), 340–366. 

Yoneyama, S. (2000). Student Discourse on ‘Tôkôkyohi’ (school phobia/refusal) in Japan: burnout 

or empowerment? British Journal of Sociology of Education, 21(1), 77–94. 

Current Psychiatry. 2006 December;5(12):67-83 

https://www.mdedge.com/psychiatry/article/62456/solutions-school-refusal-parents-and-kids/page/0/1 

Common long-term problems include delinquent behaviours, economic deprivation, social isolation, marital problems, and difficulty maintaining employment. Approximately 52% of adolescents with school refusal behaviour meet criteria for an anxiety, depressive, conduct-personality, or other psychiatric disorder later in life. 

The most common age of onset is 10 to 13 years. It is Imperative to ascertain the form and function of school refusal behaviour. (Click the link for an example of a School Refusal Assessment Tool https://schoolavoidance.org/school-avoidance-101/ ) 

Aside from medication psychological techniques can be applied. Once the primary reinforcers for the behaviour have been established then a tailored technique can be applied, such as-child-based interventions to manage anxiety (cognitive therapy, breath work) parent-based techniques to manage refusals such as incentives and disincentives for attendance/non-attendance and help in establishing effective parenting skills. In severe cases a multidisciplinary approach is required including psychotherapy and or medication. A multi-agency/parental inclusion approach is most often a crucial element in resolving school refusal behaviour. 

What policies and procedures are in place (both at LA and school level) to support children and families dealing with school refusal issues? 

How effectively do we identify and assess the underlying causes of absence including home, educational setting, and community factors? – Are we ascertaining the primary reinforcers and tailoring our interventions to specific needs? 

How do you effectively support those learners returning after extended absence? 

How could you facilitate an effective multi-agency approach? 

In what ways are we effectively addressing barriers to attendance? 

https://education.gov.scot/improvement/Documents/sac82-edinburgh-research.pdf 

Emotionally Based School Refusal Manual 

https://www.schoolavoidance.com/schools 

Can Informing Parents Help High School Students Show Up for School?  

This intervention used text messaging to send daily absence updates and weekly attendance summaries to guardians of students in New York City High Schools. Students were assigned randomly to receive the messages and guardians were automatically opted in to the study with the opportunity to ‘opt out’ if they chose to. The system did not replace the existing automated robo voicemails that were already being sent to guardians. Both the control group and the text message groups still received these.  

The intervention took place during the second semester of the 2015 – 16 school year. 

Text messages were sent between 6pm and 10pm on the day of absence and did not frame the information in a positive or negative way or prompt guardians to take any further action. Each message was sent in the student’s first language, to any guardian whose phone number was associated with them. The school contact information was also included within the messages.  

The evaluation found that there was no change in attendance for those students who received the text message information. Both groups had second semester attendance of about 86%. There was a pattern of attendance noted for both groups across the semester; attendance declined across the course of the semester, after a holiday and after the weekend. Attendance for both groups declined in the second semester compared to the first.  

There were no statistical differences in attendance for different sub groups e.g by grade level, those with only 1 guardian receiving messages compared to 2, or those with English as an additional language.  

Explanations for the lack of meaningful effects of the study concluded that:  

1. The study may have been too broad as it targeted all students, not specifically those with chronic absences.  

1. The intervention gave parents no further informational support to prompt them to take action on absences.  

1. The intervention may have needed to have taken place at a different time or for a longer period of time.  

1. The continued use of the original voicemail system for the text message group may have been overload for the parents receiving both types of alert.  

The report recommendations are: 

1. Target attendance interventions on students in the first year of high school.  

1. Build relationships with parents so they regard information on absence as being non-punitive.  

1. Engage parents and students together to address barriers to attendance.  

How can we best engage with parents without overloading them?  

How do we engage parents and students together to address barriers to attendance?  

What referrals and services are available to support parents in promoting attendance? How do we inform parents about these?  

Balfanz, Robert, and Vaughan Byrnes. 2014. A Report on the New York City Mayor’s Interagency Task Force on Truancy, Chronic Absenteeism, and School Engagement. Baltimore: Everyone Graduates Center, Johns Hopkins University. 

https://educationendowmentfoundation.org.uk/projects-and-evaluation/projects/developing-healthy-minds-in-teenagers 

This evaluation focused on health outcomes as measured by the Child Health Questionnaire-CF87 (CHQ-CF87) (Schmidt, Garrett and Fitzpatrick, 2002). The primary outcome measure was the single scale of self-assessed general health drawn from the CHQ-CF87. Twelve other scales were evaluated as part of this study as secondary outcomes, alongside other validated scales (the Short Mood and Feelings Questionnaire, the life satisfaction 0-10 ladder and the Child Anxiety Related Disorders (SCARED)). Outcomes were measured after both two years and four years of the programme. A second evaluation conducted by a team at NIESR includes both an impact evaluation looking at academic outcomes and an Implementation and Process Evaluation. This was published in 2020. Overall, Healthy Minds has had some positive impact on health-related outcomes without compromising academic attainment and possibly supporting reducing absenteeism and exclusions. 

The evaluation also measured pupils’ self-assessed general health after two years of the programme and found a similar impact (0.23 standard deviation difference).  

Secondary outcomes associated with physical health, behaviour and external relations were generally positive.  

Measures of internalised emotions (Emotional Difficulties, Self-Esteem, and Mental Health) were mainly close to zero and positive after four years of the programme, but in some cases were negative when collected after two years of the programme.  

Further research is ongoing to ascertain whether the optimum time for implementation is two or four years.  

The approximate cost of implementation was £23.50 per pupil per year. The programme requires 7 days of teacher training.  

It is possible to change the ‘Health Related Quality of Life’ of the treated regardless of their starting point. 

How would you implement this across your specific setting- what would the model of operation look like, who would staff it and what would the accommodation look like for this? How and to whom would you report impact? What would your criteria be for selecting the participants? 

How would you measure and demonstrate this intervention’s impact on attendance? 

Bonell, C., Fletcher, A. & McCambridge, J., (2007), Improving school ethos may reduce substance misuse and teenage pregnancy, British Medical Journal, 334:614–16. 

Attendance interventions rapid evidence assessment | EEF (educationendowmentfoundation.org.uk) 

The report documents the following limitations as compromising the validity of evidence and findings:  

• The majority of studies took place in the USA (only 3 from UK)  
• Over one third of the studies were shown to have some concern or high risk of bias in their methodologies 
• There is a lack of sufficient evidence to conclude the effectiveness of some approaches 
• The report acknowledges that some studies may have been missed due to time constraints and narrowed inclusion criteria restrictions.   

Overall, the report concludes that the overall quality of the evidence is weak. The report does highlight that there is some promising evidence, with studies showing small or very small impact on attendance, for several strategies including parental engagement approaches and responsive interventions that target the individual causes of low attendance. The report found mixed evidence for mentoring, behaviour interventions, meal provision, incentives and disincentives and extracurricular activities, with studies reporting both positive and negative impact of these interventions on attendance. There is not enough evidence to reach a conclusion for the efficacy of non-targeted interventions and whole-class interventions, such as the teaching of social and emotional skills, which had no impact overall.  

Should we delve deeper into parental engagement approaches and find examples of good practice in this area?
 

How can we ensure consistency across our schools and authorities in how we monitor and measure attendance, to gather reliable evidence to help drive sustainable, collaborative improvement in this area?
 

Due to a lack of high-quality research, do we need to spend more time gathering and sharing examples of effective interventions within and between our authorities? How could we best do this?  

See references list to access all studies included in the review.