Improvements In School Attendance Research Articles

The Effectiveness of Modular Transdiagnostic Cognitive Behavioral Therapy Versus Treatment as Usual for Youths Displaying School Attendance Problems: A Randomized Controlled Trial.

School attendance problems (SAPs) are associated with negative short- and long-term outcomes. Despite high prevalence of SAPs, there is a shortage of evidence-based interventions. Existing approaches often target either school refusal or truancy, leaving a gap in effective interventions addressing both types of SAPs. This randomized controlled trial (RCT) assessed the effectiveness of Back2School (B2S), a modular transdiagnostic cognitive behavioral therapy (CBT) for SAPs, compared to treatment as usual (TAU). Outcomes included youths' school attendance and mental health. A group (B2S, TAU) × time (Pre, Post, 3-Month Follow-Up) design involving 152 youths (B2S; n = 74, TAU; n = 78) with SAPs (i.e., ≥ 10% absence in the past three months), aged 6-16 years (M = 12.2, SD = 2.2, males = 60%) were used. B2S comprised three months of CBT with youths, parents, and school involvement, while TAU comprised public and/or private intervention services. On average, youths in B2S received 15.0, (SD = 3.9) hours of intervention, while those in TAU received 13.4, (SD = 21.6). Intervention effects were investigated using mixed linear models. Both B2S and TAU exhibited significant within-group improvements in school attendance, with no significant differences between them. However, the B2S group significantly outperformed TAU in reducing youths' emotional problems, conduct problems, problems with peers, the overall impact of problems, and increasing youths self-efficacy for attending school and parent self-efficacy for dealing with a SAP. This RCT represents the first evaluation of a modular transdiagnostic CBT for youths displaying SAPs, showing significant mental health and self-efficacy benefits. (Clinical trial registration: ClinicalTrials.gov: NCT03459677).

Case report: Co-occurring autism spectrum disorder (Level One) and obsessive-compulsive disorder in a gender-diverse adolescent.

This fictionalized case report captures the common themes and considerations during the diagnostic assessment and behavioral treatment of adolescents demonstrating symptoms of autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD), as well as gender-diversity concerns. Our patient was a white, non-Hispanic 17-year-old individual who identified as gender-neutral but had been assigned female at birth. Symptoms presented were social withdrawal, rigid rule-following behavior, unusual repetitive behavior, impairments in social communication skills, sensory sensitivity, body dissatisfaction, self-injury, and anxiety related to contamination, perfectionism, and social interactions. These symptoms contributed to functional impairment with school attendance, school achievement, family relationships, and the activities of daily living. This case report summarizes instruments employed for differential diagnosis concerning cognitive functioning, ASD, OCD, ADHD, depression, anxiety, and commonly co-occurring repetitive behavior. This patient was ultimately diagnosed with ASD, level one for both social communication and restricted, repetitive behaviors, without accompanying intellectual or language impairment; OCD with panic attacks; gender dysphoria; major depressive disorder (single episode and moderate); and ADHD. The subsequent 40-session course of cognitive-behavioral therapy with exposure and response prevention (CBT/ERP) to treat OCD tailored to an individual with ASD and gender diversity concerns is described in detail. Components of family involvement are highlighted. As a result, significant improvements in school attendance, OCD symptoms, depression, social relationships, and adaptive functioning were measured. Lastly, recommendations for clinicians are summarized.

Implementation and Outcomes of a National School-Based Mental Health Program for Middle School Students in Chile.

BackgroundChile’s national school-based mental health program, Skills for Life (SFL), has demonstrated effectiveness in improving behavioral and academic outcomes in first- through third-grade students. The current study assessed the feasibility and outcomes of SFL’s program for sixth- through eighth-grade students.MethodsWe assessed the percentage of students who participated in the program and longitudinal changes on teacher-reported Teacher Observation of Classroom Adaptation Re-Revised (TOCA-RR) scores, youth-reported Pediatric Symptom Checklist-Chile (PSC-Y-CL) scores, grade-point average, and school attendance from sixth to eighth grade (2016–2018) for SFL’s workshop intervention. Linear mixed effects models analyzed the association between outcome variables and workshop attendance.ResultsOf the 30,649 sixth graders who attended the 754 participating schools in 2016, 28,204 (92.0%) were screened with the TOCA-RR. Of the 1829 students who screened at risk, 1344 had available workshop data for seventh grade, with 86.9% of them participating in most (≥ 7) workshop sessions. Workshop attendance was significantly associated with improvements in school attendance and peer relationships (a TOCA-RR subscale) in eighth grade.ConclusionsWith high rates of behavioral health screening and workshop attendance, this study demonstrated the feasibility of implementing SFL’s middle school program on a national scale. Higher workshop attendance by at-risk students was associated with better school attendance and peer relationships in eighth grade, as well as better but not significantly different outcomes on other measures (e.g., teacher-rated school performance and aggressive behavior in the classroom). Overall, these findings provide preliminary evidence of the feasibility and benefits of SFL’s middle school program.

Evaluation of an Intensive Program for Children With Co-occurring Medical and Emotional Disorders.

The study objective was to assess clinical outcomes and cost avoidance of an intensive day treatment program for children with co-occurring chronic medical disease and emotional problems. Intensive day treatment programs for this population are uncommon, and their effectiveness has not been previously reported. A total of 175 children were enrolled during the 3-year study period. Children had more than 30 medical diagnoses including chronic pain, dysautonomia, neurologic disorders, and diabetes. Complete utilization data were available for 118 patients, and demonstrated decreased hospitalizations and increased behavioral health visits during the 12 months post program compared with 12 months prior. Private insurance and female sex were associated with reduced utilization costs after program participation. Estimated avoided cost for the 118 children was $1 111 485. Patients reported significant improvements in somatic symptoms, sleep problems, inattention, depression, anger, and anxiety. Limited data indicated improvements in school attendance. Additional research addressing other outcomes, such as school-related symptoms, would be helpful.

Coordinating the Mesosystem: An Ecological Approach to Addressing Chronic Absenteeism

ABSTRACT To reduce the number of chronically absent students in schools annually, cities and municipalities across the United States have implemented programs, initiatives, and invested resources into educational reforms that would lead to improvement in school attendance. Drawing on ecological systems theory and interview data, we examined how organizations within Pittsburgh, Pennsylvania directly worked with students, collaborated with each other, and facilitated opportunities to reduce the impact of chronic absenteeism in the local school district. Interview data revealed how organizations leveraged resources to train key personnel, communicate the importance of daily school attendance, and work directly with students on improving school attendance. Our findings highlight how community approaches to absenteeism require various levels of support from organizations.

Child fostering and the educational outcomes of Jamaican children

The practice of informal fostering is prevalent in many developing regions of the world. Our paper investigates the effects of this practice on school attendance in Jamaica using a rotating panel data set of children constructed from the 2004, 2006, 2007, 2008, 2009, and 2010 rounds of the Jamaican Survey of Living Conditions. Using panel data allows us to deal more effectively with the problem of endogeneity by being able to control for household and child fixed effects. Our findings indicate that the effect of fostering on school attendance depends on whether the household is a beneficiary of PATH, a conditional cash transfer programme instituted by the Government of Jamaica in 2001. We find that a foster child that lives within a non-PATH household is associated with being less likely to be absent from school than a foster child who lives in a household that benefits from PATH. This is true especially for foster girls. Although the PATH programme generally appears to be linked to the improvement in school attendance of Jamaican children, the benefits of the programme may be skewed towards biological children.

Medical and psychosocial outcomes of youth with psychogenic nonepileptic seizures: An observational study

BackgroundFew studies have examined both medical and psychosocial outcomes of youth with psychogenic nonepileptic seizures (PNES). The current observational study aimed to fill this gap by examining changes in seizure frequency, school absences, emergency department (ED) visits, psychological functioning, and health-related quality of life (HRQoL) in youth attending a clinic for brief treatment of PNES. MethodsNineteen youth with PNES and their families presented to an integrated clinic and received psychoeducation and recommendations by medical and mental health professionals. Patients returned to the clinic, on average six months later, for follow-up. Parent proxy-report and self-report measures of psychological functioning and HRQoL were collected at each visit, and medical data were extracted from patient charts. ResultsForty-six percent of youth in the study experienced a reduction in seizure frequency, and 58% reported improvements in school attendance. Emergency department visits decreased by over 50%, and significant improvements in parent proxy-report of depression and HRQoL were observed. ConclusionsResults provide valuable information regarding the clinical profiles of youth with PNES and demonstrate the possibility for improved medical and psychosocial prognoses in response to psychoeducation and treatment guidance. Information obtained in this study may aid in the design of future clinical trials and research, assisting in the development of appropriate interventions.

Does public infrastructure affect human capital? The effect of improved transport connectivity on children's education in the Philippines

While the literature acknowledges the importance of transport infrastructure and improved connectivity to economic growth, a less explored aspect is how these investments impact human capital. This paper seeks to address this gap by evaluating the impact of the Roll-on/Roll-off (Ro-Ro) policy -a policy that allowed for a more efficient mode of inter-island transfer within the country -on school attendance in the Philippines. Using a difference-in-differences strategy, we compare the school attendance of children in municipalities near the Ro-Ro and the non-Ro-Ro ports over the span of ten years. Our results show consistent improvements in school attendance of males and females in the primary, secondary and tertiary level of education in areas near the Ro-Ro ports. We also observe a reduction in child employment, especially in males. Additional tests reveal that the Ro-Ro policy was able to affect children's education through increased household income in areas near the Ro-Ro ports.

Can Solar Lanterns Improve Youth Academic Performance? Experimental Evidence from Bangladesh

Abstract We conducted an experimental intervention in unelectrified areas of northern Bangladesh to investigate the effectiveness of solar products in improving children’s educational achievement. We found that treated households substituted solar lanterns for kerosene-based lighting products, helping to decrease total household expenditure. Solar lanterns increased the children’s home-study hours, particularly at night and before exams. The solar lanterns initially led to an increase in school attendance, but this effect diminished over time. However, the increased study hours and initial improvement in school attendance did not translate into improved academic performance. Varying the number of solar products within the treated households did not alter these results. Analyses that exploited the school grade treatment intensity also provided no evidence suggesting that spillover effects explained the “no academic performance effects.” These findings suggest that improving the home-study environment solely through the provision of solar products may have a limited impact on children’s educational achievement.

Impact of mental disorders on attendance at school

Mental disorders are among the most common and disabling conditions affecting children and adolescents. Patterns of school attendance among students with and without mental disorders were examined using data from the 2013–2014 Australian Child and Adolescent Survey of Mental Health and Wellbeing. One in seven school students had a mental disorder in the previous 12 months, with attention-deficit/hyperactivity disorder and anxiety being the most common. Students with a mental disorder had lower school attendance – being absent for 11.8 days per year in Years 1–6, 23.1 days per year in Years 7–10 and 25.8 days per year in Years 11–12, on average. In comparison, students without mental disorders were absent an average of 8.3 days (Years 1–6), 10.6 days (Years 7–10) and 12.0 days (Years 11–12) per year. Among students with a mental disorder, absences due to the disorder accounted for 13.4% of all days absent from school. This increased across years in school from 8.9% in Years 1–6 to 16.6% in Years 11–12. Improving prevention, early intervention, treatment and management of mental disorders may lead to significant improvements in school attendance.

The Long-Term Effects of Group-Based Psychological Interventions for Children With Tourette Syndrome: A Randomized Controlled Trial

This randomized controlled trial examined the long-term effects of group-based psychological interventions on measures of tic severity, self-reported quality of life (QOL), and school attendance. Children (n = 28) with Tourette syndrome (TS) were assessed 12 months after completing a course of either group-based Habit Reversal Training (HRT) or Education.Both groups demonstrated long-term improvement in tic severity and QOL, which included significant continued improvement during the follow-up (FU) period. Both groups also showed significant posttreatment improvement in school attendance. Further research is required to explore potential therapeutic mechanisms, independent or mutual, which may underlie long-term symptom improvements.

Re-analysis of health and educational impacts of a school-based deworming programme in western Kenya: a statistical replication of a cluster quasi-randomized stepped-wedge trial.

Introduction: Helminth (worm) infections cause morbidity among poor communities worldwide. An influential study conducted in Kenya in 1998–99 reported that a school-based drug-and-educational intervention had benefits for worm infections and school attendance.Methods: In this statistical replication, we re-analysed data from this cluster quasi-randomized stepped-wedge trial, specifying two co-primary outcomes: school attendance and examination performance. We estimated intention-to-treat effects using year-stratified cluster-summary analysis and observation-level random-effects regression, and combined both years with a random-effects model accounting for year. The participants were not blinded to allocation status, and other interventions were concurrently conducted in a sub-set of schools. A protocol guiding outcome data collection was not available.Results: Quasi-randomization resulted in three similar groups of 25 schools. There was a substantial amount of missing data. In year-stratified cluster-summary analysis, there was no clear evidence for improvement in either school attendance or examination performance. In year-stratified regression models, there was some evidence of improvement in school attendance [adjusted odds ratios (aOR): year 1: 1.48, 95% confidence interval (CI) 0.88–2.52, P = 0.147; year 2: 1.23, 95% CI 1.01–1.51, P = 0.044], but not examination performance (adjusted differences: year 1: −0.135, 95% CI −0.323–0.054, P = 0.161; year 2: −0.017, 95% CI −0.201–0.166, P = 0.854). When both years were combined, there was strong evidence of an effect on attendance (aOR 1.82, 95% CI 1.74–1.91, P < 0.001), but not examination performance (adjusted difference −0.121, 95% CI −0.293–0.052, P = 0.169).Conclusions: The evidence supporting an improvement in school attendance differed by analysis method. This, and various other important limitations of the data, caution against over-interpretation of the results. We find that the study provides some evidence, but with high risk of bias, that a school-based drug-treatment and health-education intervention improved school attendance and no evidence of effect on examination performance.

Green &amp; Healthy Homes Initiative: Improving Health, Economic, and Social Outcomes Through Integrated Housing Intervention

Poor quality housing is an ongoing environmental injustice placing a significant burden on low-income and minority families. The Green & Healthy Homes Initiative (GHHI) in Baltimore, MD, grew out of the historical healthy homes work of the Coalition to End Childhood Lead Poisoning, an organization dedicated to using housing as a platform for health to ensure environmental and social justice for families and children in low-income communities. GHHI's Healthy Homes Demonstration Project utilized the standards and practices created by GHHI: A Holistic Housing Assessment coupled with environmental health education and combined as an integrated environmental health and energy housing intervention for children with asthma, ages 2–14. The project braids resources from healthy homes, lead hazard reduction, weatherization, and energy efficiency projects to form a single multi-component, multi-factorial intervention. Findings from the health surveys at intake and six months after the intervention provide evidence of the impact on the reduction of asthma symptomatic episodes, emergency room visits, and hospitalizations, while showing improvements in school attendance and parents' work attendance. Findings will provide evidence that improved health outcomes and more stable and productive homes in primarily African American, low-income neighborhoods are related to the mitigation of asthma triggers and home-based environmental health hazards. Upstream integrated housing interventions are an effective means to improve health, economic, and social outcomes for children diagnosed with asthma.

Cost-Effectiveness of the School-Based Asthma Therapy (SBAT) Program

Impoverished urban children suffer disproportionately from asthma and underuse preventive asthma medications. The objective of this study was to examine cost-effectiveness (CE) of the School-Based Asthma Therapy (SBAT) program compared with usual care (UC). The analysis was based on the SBAT trial, including 525 children aged 3 to 10 years attending urban preschool or elementary school who were randomized to either UC or administration of 1 dose of preventive asthma medication at school by the school nurse each school day. The primary outcome was the mean number of symptom-free days (SFDs). The impact of the intervention on medical costs was estimated by using parent-reported child health services utilization data and average national reimbursement rates. We estimated the cost of running the program using wages for program staff. Productivity costs were estimated by using value of parent lost time due to child illness. CE of the SBAT program compared with UC was evaluated based on the incremental CE ratio. The health benefit of the intervention was equal to ∼158 SFD gained per each 30-day period (P < .05) per 100 children. The programmatic expenses summed to an extra $4822 per 100 children per month. The net saving due to the intervention (reduction in medical costs and parental productivity, and improvement in school attendance) was $3240, resulting in the incremental cost-savings difference of $1583 and CE of $10 per 1 extra SFD gained. The SBAT was effective and cost-effective in reducing symptoms in urban children with asthma compared with other existing programs.

Youth Outcomes Following Implementation of Universal SW-PBIS Strategies in a Texas Secure Juvenile Facility

School-wide positive behavior interventions and supports (SW-PBIS) is a framework for creating safe and effective learning environments and cultivating a positive educational climate. Researchers show that SW-PBIS can improve behavioral outcomes, while demonstrations of a causal relationship between improvements in students' academic achievement and implementation of SW-PBIS remain equivocal. We provide evidence of reductions in behavioral incident reports, improvements in school attendance, and increases in career and technical industry certifications following SW-PBIS implementation in one Texas secure male juvenile correction facility. We argue that these improvements could only be due to SW-PBIS implementation and not alternative explanations (e.g., agency policy/procedure changes, changes in facility or agency leadership, other treatment/rehabilitation programs, validity of measures). We also offer an explanation for these improved gains based on the academic characteristics of incarcerated youth.

Attrition rates in primary schools in Delta State of Nigeria

This study investigated attrition rates in selected primary schools in Delta State, Nigeria, involving 5,545 pupils comprising 3,014 boys and 2,531 girls using the 2003 cohort. A checklist collected data on the flow of pupils from all available school records from the start of cohort to graduation. Percentage and mean were used for data analysis. Average attrition rate found was 19.24%, highest was 36.60% for a public/rural/small school, lowest was 7.24% for a private/urban/large school, 15.60% for boys and 23.59% for girls. Generally, attrition rates were higher in girls than in boys, and in public than private, rural than urban, and small than large schools. These rates were all lower than the fifty percent and above found in earlier studies in Nigeria, indicating improvement in school attendance, reduction in wastages, and improvement in girl-child education. Although these rates did not meet the UNESCO’s one percent minimum, they did not exceed its fifty percent maximum, and were not as alarming as older studies indicated. The index of wastage provided by these rates would help government in strategizing and projecting targets for achieving the EFA and MDG goals by 2015. There is however room for greater improvement if public primary schools were better equipped and greater campaign pursued for formal girl-child education. Key words: Primary school, attrition rates, Delta State, Nigeria.

Psychosocial Interventions for School Refusal Behavior in Children and Adolescents

This article reviews empirical evidence for the efficacy of psychosocial interventions for school refusal behavior. Data corresponding to eight experimental single-case and seven group-design studies are presented. Across studies, behavioral and cognitive-behavioral treatments emerged as promising lines of intervention. These interventions produced improvements in school attendance and youths'symptom levels (e.g., anxiety, fear, depression, anger) based on this study's examination of effect sizes. The article concludes with suggestions for interventionists, researchers, and policymakers attempting to deal with the problem of school refusal.

Gender discrimination and education in West Africa: strategies for maintaining girls in school

Girls’ enrolment in primary schools has achieved significant increase and parity with male enrolment in many countries in Africa since the 1960s. Some of these countries include Botswana, Namibia and Tanzania. However, in most Sub‐Saharan African countries, female enrolment still lags behind male enrolment. This paper examines some of the reasons for the persistent gender gap between females and males in the three African countries of Ghana, Nigeria and Togo within the West Africa sub‐region. It discusses gender relations, cultural practices such as early marriage, child slavery, and child fostering/trafficking, poverty and multiple household duties for girls as some of the contributing factors. It is argued that unless these cultural beliefs and attitudes are changed and mandatory measures such as holding parents accountable and responsible are put in place, gender parity and quality education for all, especially for females, will not be achieved in Africa. A number of additional strategies for improvement in school attendance and retention for females are also discussed.

The Efficacy of Asthma Case Management in an Urban School District in Reducing School Absences and Hospitalizations for Asthma

Pediatric asthma rates are reaching epidemic proportions, adversely affecting children's quality of life, educational potential, and health care costs, especially those in the inner city. This study evaluated the effectiveness of a school-based asthma case management (CM) approach with medically underserved inner-city children attending Memphis City schools. Fourteen elementary schools with high rates of asthma-related hospital utilization were grouped according to school size, percentage of children with asthma enrolled, and percentage of children eligible for free or reduced-price lunch. Schools were randomized to either a nurse CM intervention or a usual care (UC) condition. The CM group included 115 students; 128 students were in the UC group. A longitudinal design was used to follow students' progress. Students were primarily African-American children diagnosed with asthma. In CM schools, nurse case managers conducted weekly group sessions incorporating the Open Airways curriculum, followed up on students' school absences, and coordinated students' asthma care with families, school personnel, and medical providers. In UC schools, students received routine school nursing services. CM students had fewer school absences than their counterparts in UC schools (mean 4.38 vs 8.18 days, respectively) and experienced significantly fewer emergency department visits (p < .0001) and fewer hospital days (p < .05) than UC students. No such differences existed before program initiation. Replication and follow-up in year 2 showed continued significant improvements. School-based nurse CM can achieve significant improvements in school attendance and medical utilization.

BIOFEEDBACK TREATMENT OF PARADOXICAL VOCAL FOLD MOTION AND RESPIRATORY DISTRESS IN AN ADOLESCENT GIRL

In this investigation, we evaluated the effectiveness of surface electromyography (EMG) biofeedback to treat paradoxical vocal fold motion in a 16-year-old girl. EMG biofeedback training occurred once per week over the course of 10 weeks. In a changing criterion design, muscle tension showed systematic changes that corresponded with changes in the criterion. Overall, baseline muscle tension levels were reduced over 60%, with corresponding reductions in episodes of respiratory distress and chest pain. Subjective reports by the patient and the patient's mother indicated improvements in school attendance and overall adaptive functioning.