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School Refusal: Evidence-Based Practices

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Joanna Wexler

on 13 April 2014

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Transcript of School Refusal: Evidence-Based Practices

Student Attendance : Evidence-Based Policies and Interventions
Non-Emotionally Based Attendance Issues
Somatic Complaints/Medical
Refusal to Move
Child - Family-School
Temperament/medical difficulties/anxiety
Transition between elementary and secondary
Bereavement in the family
Parent/Caregiver wellbeing
Taking on additional care role of siblings
Changes in friendship
Size of school
Prolonged illness or school holiday
Emotionally-Based Attendance Issues
General and Social Anxiety
Temper Tantrums
Sleep Problems
Psycho-Somatic Complaints
TIER I: All School Approach
Annual notices regarding importance of attendance
Attendance awareness and reward systems
Posting policy/reminders
Review of attendance reports within Achievement Team
Letter 1 : HSV/SSW or Counselor call home to family

TIER II: Individualized
Tier III: Central Office Support
Letter 5
Notify Alex Seherlis
Referral to outside agencies
OCY if under 13 years old
District Court if 13-17 years old
Continued home visits if authorized by Supervisor of Student Services or other central office administrator


Letter 2 (Doctor's excuse)
Nurse Initiates releases to speak with health providers
Home Visits (5+ absences)
Gather Information regarding FUNCTION
School Refusal Assessment Scale-Revised

(SRAS-R; Kearney, 2002)
Encourage structure and routine
Reinforce attendance policy
Letters 3 and 4
HSV/SSW leads the design of the Truancy Elimination Plan (TEP) with counselor, LEA, & family using SRAS data
**Differentiating strategies based on function
Parent/guardian MUST sign the document
SRAS-R & FUNCTIONS: Why is this happening, what is nature of problem, how do we solve it?
1. Avoidance of negative affectivity
2. Escaping aversive social or evaluative situations (social or peformance anxiety)
3. Gaining attention from a significant other (separation anxiety)
4. Pursuing tangible rewards outside school
Good Practice: Re-Integration Planning
Identifying key "check-in" person
More gradual transition approach needed for severe emotionally-based issues and middle/high school students
Informing staff of difficulties and re-integration plan
Identify safe place or home base
Stay connected with family during re-integration
Expect setbacks; be patient
HSV/SSW maintains close contact with family and county-based supports

County-Based Supports
Family Focused Solutions Based Services (FFSBS)
Case Management
Family Based Services (FBS)
Multi-Systemic Therapy (MST)

Resiliency: Seven Ingredients
Reaching Out
Realistic Optimism

Resiliency : Seven Ingredients

Emotional Awareness
Impulse Control
Flexible Thinking
"Give it Time"...
Collaboration with Private Providers
Therapists & Psychiatrists
Medical Specialists

“Solving” the Problem Through Functional Assessment/Sample TEP/Intervention Menu
Anxiety-based: Child-focus on strengths & resiliency (emotional regulation, self-efficacy) and reduction of irrational thoughts; gradual re-integration
Attention seeking from parent or caregiver: Contingency management (reward system) with high expectations for re-integration
Tangible reinforcement outside school: Contingency contracting, increased supervision, agency supports; high expectations for re-integration
Full transcript