A Description of School Refusal Behavior in Adolescents Prior to Acute Care Admission

Abstract

This study uses a novel measure to describe school refusal (SR) behavior among 91 U.S. adolescents ages 13 to 18 years old in the month leading up to a partial hospitalization program (PHP) admission. Youth exhibit a range of SR behaviors. Three fourths (77%) reported missing at least two full days of school and nearly one third (29%) reported being absent from school the entire month before PHP admission. Among youth who reported attending school, 36% reported leaving school early, 55% reported leaving the classroom, and 59% reported arriving late to school at least “a little” or 2 days in the month prior to PHP admission. Youth rarely shared that they spend time with friends or doing homework while absent from school. In addition, agreement between caregivers and youth on the extent to which youth are struggling with school attendance and how youth spend their time while out of school was low to moderate (r = .14–.52). Results suggest that the School Interference Questionnaire (SIQ) can complement existing SR instruments to offer descriptive information about the frequency and type of SR behavior, perceived impact, and targets of intervention by identifying potential positive and negative reinforcers.