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Autism and School Avoidance

Autism and School Non-attendance

Various terms have been used to describe the frequent absences from school due to anxiety or feeling overwhelmed: e.g., school refusal, problematic absenteeism, or school avoidance. Students who miss 10% or more of school are described as having "persistent non-attendance/absence" or "problematic non-attendance." The rate of school non-attendance is notably higher for students on the autism spectrum compared with neurotypical students.

What is the rate of school absence/avoidance for autistic students?

•     Autistic students in mainstream education (no intellectual disability) had a higher rate of school refusal behavior than the general student body in Norway (43% of autistic students versus 7%) [Munkhaugen 2017]. Interestingly, parents of these autistic students noted higher levels of "school refusal behavior" (53%) than that reflected in the actual absence rate.

•     The most common reason for school absence for the autistic student is school refusal. [Adams, 2022; Totsika, 2020]

•     Kurita reported school refusal in 24% of their sample (of note: the study was in 1991 and used the former diagnostic criteria for autism and pervasive developmental disorder rather than the current criteria for ASD; therefore, their sample was more limited in scope than more recent studies).

How much school is missed by autistic students?

•     International estimates of school absence across all students (ASD and neurotypical) suggest that students miss 5-7% of school.

•     Children on the autism spectrum were found to miss 6 full days in 20 days of classes on average (4 weeks/one month, most absences were secondary to school refusal). This rate of non-attendance translates to missing 30% of school and is noticeably higher than the 1 - 1.4 days missed by the general student population [Adams 2022, Australia]

•     Regardless of the cause of non-attendance... children on the autism spectrum are missing (on average, at least) four times more school than their peers. [Adams, 2022]

•     In a UK study, 2020 [Totsika], ASD students missed an average of 5 days across 23 days (missing 22% of school).

How common is persistent non-attendance (missing 10% or more of school) in autistic students?

•     Persistent non-attendance in the Totsika study occurred among 43% of the 486 students; Other studies report rates of persistent absence for autistic students near 20% [Department for Education in England, 2019]. The department of education study included only those students with ASD listed in their educational plan as their primary need. Totsika included UK autistic students at a broader community level.

How common is truancy for the autistic student?

•     Truancy (i.e., absence without school permission and usually involving effort on the part of the student to conceal the absence from the parents) is almost non-existent in the autistic students, whereas 4-11% of the general study body miss at least one full day of school per month due to truancy [Adams, 2022 and citations; Totsika 2020]

Which autistic students show the most nonattendance?

•     Problematic non-attendance was higher in ASD students WITHOUT intellectual disability than those with ID [Totsika, 2020; Kurita, 1991]

•     School non-attendance for the autistic student has been found to increase with age [Adams, 2022; Totsika, 2020]

•     Factors identified by families and professionals as contributing to school non-attendance included late diagnosis of ASD "resulting in needs not identified and therefore not addressed," lack of understanding in schools, poor transition from primary to secondary settings, sensory issues such as noise, and more. [Preece, 2018]

Students who are anxious about and avoid school should be screened for autism characteristics. The more we know about the student's neurologic characteristics, the better able we are to support them in a school environment. Autistic individuals who find effective strategies for regulation at school may be better equipped to find comfortable ways to succeed in a workplace.

Adams D. Child and Parental Mental Health as Correlates of School Non-Attendance and School Refusal in Children on the Autism Spectrum. J Autism Dev Disord. 2022 Aug;52(8):3353-3365. doi: 10.1007/s10803-021-05211-5. Epub 2021 Jul 30. PMID: 34331173; PMCID: PMC8323746. Australia

David Preece & Marie Howley (2018) An approach to supporting young people with autism spectrum disorder and high anxiety to re-engage with formal education – the impact on young people and their families, International Journal of Adolescence and Youth, 23:4, 468-481, DOI: 10.1080/02673843.2018.1433695 United Kingdom

Kurita H. School refusal in pervasive developmental disorders. J Autism Dev Disord. 1991 Mar;21(1):1-15. doi: 10.1007/BF02206993. PMID: 2037546. Japan

Munkhaugen EK, Torske T, Gjevik E, Nærland T, Pripp AH, Diseth TH. Individual characteristics of students with autism spectrum disorders and school refusal behavior. Autism. 2019 Feb;23(2):413-423. doi: 10.1177/1362361317748619. Epub 2017 Dec 14. PMID: 29241346. Norway

Totsika V, Hastings RP, Dutton Y, Worsley A, Melvin G, Gray K, Tonge B, Heyne D. Types and correlates of school non-attendance in students with autism spectrum disorders. Autism. 2020 Oct;24(7):1639-1649. doi: 10.1177/1362361320916967. Epub 2020 May 18. PMID: 32419486; PMCID: PMC7545649. United Kingdom

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