Types and correlates of school non-attendance in students with autism spectrum disorders

Abstract

School non-attendance in autism spectrum disorders has received very little attention to date. The study aimed to provide a comprehensive description of school non-attendance in students with autism spectrum disorders. Through an online survey, parents of 486 children (mean age: 11 years) reported on school attendance over 1 month and reasons for instances of non-attendance. On average, students missed 5 days of school of a possible 23 days. Persistent non-attendance (absent on 10%+ of available sessions) occurred among 43% of students. School non-attendance was associated with child older age, not living in a two-parent household, parental unemployment and, especially, attending a mainstream school. School refusal accounted for 43% of non-attendance. School exclusion and school withdrawal each accounted for 9% of absences. Truancy was almost non-existent. Non-problematic absenteeism (mostly related to medical appointments and illness) accounted for 32% of absences. Non-problematic absenteeism was more likely among those with intellectual disability, school refusal was more likely among older students and school exclusion was more likely among students from single-parent, unemployed and well-educated households. Findings suggest that school non-attendance in autism spectrum disorders is a significant issue, and that it is important to capture detail about attendance patterns and reasons for school non-attendance. Lay abstract Our study aimed to describe school non-attendance in students with autism. We conducted an online survey. Parents of 486 students (mean age: 11 years) indicated which days their child had missed school (over a period of 1 month). If the child had missed a day, the parent was asked to select a reason from a list of 15 possible reasons (this is a measure of types of school non-attendance called SNACK (School Non-Attendance ChecKlist; Heyne et al., 2019)). On average, students missed 5 days of school of a possible 23 days. Missing over 10% of school is known as persistent absence, and in our study, 43% of students experienced persistent absence. Older students, who attended mainstream schools, who did not live in a two-parent household and whose caregiver was unemployed were more likely to miss school. Looking at the reasons for absence, school refusal was the most frequent reason, accounting for 43% of absences. Nine percent of absence was due to school exclusion. Nine percent of absence was due to school withdrawal. Truancy was almost non-existent. A final reason describes non-problematic absence that is mostly due to medical appointments and illness. This type of absence accounted for 32% of absences in our study, and it was more likely in student with intellectual disability. School refusal was more likely among older students. School exclusion was more likely among students from single-parent, unemployed and well-educated households. Findings from this study help us to understand better the difficulties students with autism experience attending school.

Child and Parental Mental Health as Correlates of School Non-Attendance and School Refusal in Children on the Autism Spectrum

“…This asks parents to report on the number of days of school missed in the last four weeks across 14 possible reasons. Through using the SNACK, Totsika et al (2020) identified that the most frequent cause of school non-attendance in students on the autism spectrum was school reluctance/refusal, accounting for 43% of absences. "Non-problematic" absences (e.g., medical appointments) were also common, accounting for 32% of all absences.…”

“…Only one study to data has looked at multiple forms of school non-attendance in autism specifically. That one study (Totsika et al, 2020) plus the small number of studies focusing upon school refusal and school exclusion all highlight the importance of considering child, family, and school factors from across the KiTeS framework as predictors of school non-attendance, and of exploring the possibility of differing factors predicting different types of school non-attendance. There is therefore a clear and pressing need for research which explores a broad range of both "problematic" and "non-problematic" forms of school non-attendance and builds upon the range of child, family, and school factors identified as predictors.…”

“…Parents were also prompted to check that the combined number of full and half days recorded on the SNACK items matched the number of missed full/half days given in the opening question, and that the number of reasons given for absences did not exceed 20. Item 15 of the SNACK is an "other" reason, where parents are able to enter a written description of the reason for the absence; using the guide developed for previous studies (e.g., Totsika et al, 2020), these were analysed to see if they could be recoded into any of the other SNACK reasons.…”

“…International estimates of school non-attendance rates across all students suggest that students miss 5-7% of school (Australian Institute of Health & Welfare, 2020; Department for Education, 2019). In the only paper to date to look at a broad range of both "problematic" and "non-problematic" forms of school non-attendance in children on the autism spectrum, Totsika et al (2020) reported that students on the autism spectrum miss 22% of school.…”

“…Despite this high prevalence of school non-attendance and its potentially long-lasting impacts on the lives of people on the autism spectrum, research into school non-attendance in autism is scant. After reporting upon the prevalence of school non-attendance in children on the autism spectrum, Totsika et al (2020) used the Kids and Teens at School framework (KiTeS; Melvin et al, 2019), which is based upon an ecological systems perspective, to explore potential factors and correlates of school non-attendance in their sample of 486 children on the autism spectrum. Regardless of how they explored school non-attendance (number of days missed, whether the student missed more than 10% of days, school absence on any given day), the same four variables were associated with increased risk of non-attendance: attending a mainstream school, parental unemployment, increasing child age, and not living in a two-parent household.…”