The Attention-Seeking Elementary School Child

Chapter 4 focuses on elementary school children who refuse school primarily due to attention-seeking behavior. Many of these children are not necessarily anxious about school, though separation anxiety could be present, but instead desire to remain home from school to be with a parent or primary caregiver. This chapter includes detailed recommendations for psychoeducation, contingency management, and reintroduction to school, with a focus on parents. Recommendations are made for encouraging parents to supervise attendance more closely, refrain from keeping a child home from school, maintain a regular morning routine for school preparation behaviors, and implement consequences for attendance and nonattendance as appropriate. Core intervention components and procedures to expand the effectiveness of these core components are covered.

Rapid Assessment, Consultation, and Immediate First Steps

Chapter 2 first offers an overview of methods to assess youths with school attendance problems. These methods target youth who are just beginning to refuse school and/or have scattered absences, a few skipped classes, recurrent tardiness, premature departures from school during the day, excessive crying or resistance going to school, and noncompliance regarding school attendance, in addition to more subtle behaviors such as frequent requests to leave class, visits to the school nurse, or escalating distress about attending school. An emphasis is placed on time-sensitive and highly efficient ways to gather substantial information about a youth’s school attendance problems and related variables. Focus is on the crucial interview questions and topics to cover in a short period of time. The discussion also covers consultation and immediate first intervention steps, which co-occur with evaluation in one session in many of these cases.

Introduction to School Attendance Problems in Youth

Chapter 1 initially offers the reader a detailed definition and description of the concept of school attendance problems in children and adolescents. The chapter briefly focuses on definitions of key terms, epidemiology, common behaviors and symptoms associated with problematic absenteeism, and short- and long-term outcomes of problematic absenteeism. However, the main focus is on how these characteristics pertain to, and illustrate, the real-life cases seen by the reader. Chapter 1 also includes an overview of the book’s approach and its theoretical basis and mechanisms of action, such as (1) a proactive focus and immediate, effective intervention, (2) frequent progress monitoring, (3) functional behavioral assessment, (4) empirically supported treatment procedures, and (5) a team-based cooperative approach among clinicians, school officials, and family members, especially parents, for implementation.

Chronic and Severe School Attendance Problems

Chapter 7 covers approaches to address enduring and severe cases of problematic school absenteeism. These interventions refer to those directed toward students with complex or longstanding problems who require a broader approach and progress monitoring across various areas. This includes alternative educational programs, legal strategies, and accommodation plans. Chapter 7 also offers ideas about working with youths who have already departed the school system. In addition, guidelines are presented to address challenging scenarios and examples of various pathways to graduation that do not necessarily involve full-time attendance in a regular classroom setting.

The Anxious Middle/High School Adolescent

Chapter 5 focuses on middle and high school youth who refuse school primarily due to anxiety. School attendance problems in middle and high school students are usually much more complicated than in younger students. Part of this is due to the different structure of the school experience, including open campuses, multiple classes and teachers, larger and more chaotic settings, and new and challenging social and academic tasks. As such, school-based anxiety and school disengagement are key threats to attendance in middle and high school. This chapter gives detailed recommendations for psychoeducation, cognitive restructuring, mindfulness, and gradual reintegration into school. Circumstances most characteristic of older children with school attendance problems include difficulty with increased academic challenges, social and performance anxiety, and peer pressure. Core intervention components and procedures to expand the effectiveness of these core components are covered.

The Disengaged Middle/High School Adolescent

Chapter 6 focuses on middle and high school youth who are increasingly disengaged from school and who may be pursuing activities outside of school during school hours. Chapter 6 includes detailed recommendations for psychoeducation, family work that can include agreements for problem-solving and enhanced communication, and work with school officials to modify academic requirements in line with a particular youth’s attendance status and potential alternative pathway toward graduation. In addition, frequent consultations between school-based personnel, mental health professionals, and parents are recommended regarding a student’s attendance status, grades, required past and present academic work, and legal and other policies regarding absenteeism. Core intervention components and procedures to expand the effectiveness of these core components are covered.

The Anxious Elementary School Child

Chapter 3 is the first of several chapters devoted to the specific treatment guidelines for school attendance problems, with an emphasis on the most common scenarios evident in this population. This chapter focuses on elementary school children who are anxious about school and thus have attendance problems. Chapter 3 includes detailed recommendations for psychoeducation, somatic management techniques, and gradual reintegration into school. The recommendations are tailored to this younger age group and include those circumstances most characteristic of younger children with school attendance problems, such as difficulty with a new school or teacher, increased academic work, transitions between areas of the school, and the school bus. The specific mechanics of each treatment technique are explained at length. Core intervention components and procedures to expand the effectiveness of these core components are covered.