JOHANNE JEPPESEN LOMHOLT POSTDOC, MSC (PSYCHOLOGY), PHD TRYGFONDEN’S CENTRE FOR CHILD RESEARCH MIKAEL THASTUM PROFESSOR DEPARTMENT OF PSYCHOLOGY DEPARTMENT

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


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



RISK FACTORS FOR SCHOOL ABSENTEEISM

School absence

Child factors

Parent factors

Family factors

Peer factors

School factors

Community factors




School absence

Child factors

Parent factors

Family factors

Peer factors

School factors

Community factors


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



School absence

Child factors

Parent factors

Family factors

Peer factors

School factors

Community factors


Child factors:•Anxiety

•Depression

•Oppositional behavior

•Chronic illness

Parent factors:• Unemployme

nt

• Parental involvement in school activities

Family factors:• Language

spoken at home


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



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


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



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


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)



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



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)



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.



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


Mikael Thastum

Hvorfor er det med rødt - du præsenterer jo også andre data?


RESULTS

Preliminary data


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



Assessed for eligibility

0th-9th graden=2473

PARENTSn= 1104

(45%)

TEACHERSn= 2108(85%)


PREVALENCE


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)


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


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



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***


Note:# Only children from 4th-9th grade completed the SDQ *<.05, **<.01, ***<.001


ASSOCIATIONS WITH ABSENCE


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


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.


CHARACTERISTICS OF PROBLEMATIC ABSENCE GROUP


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


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





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



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


SUMMARY OF THE RESULTS


›Children with legal absence due to medical illness have highest level emotional problems


IMPLICATIONS


Develop and target interventions to children with problematic absence


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

Documents

JOHANNE JEPPESEN LOMHOLT POSTDOC, MSC (PSYCHOLOGY), PHD TRYGFONDEN’S CENTRE FOR CHILD RESEARCH MIKAEL THASTUM PROFESSOR DEPARTMENT OF PSYCHOLOGY DEPARTMENT