1607: Factors associated with school refusal and outcome in Sri Lankan children

Conference: 
Author(s): 
K.C. Jeewanara1, H. Perera2
1 Department of Family Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka; 2 Department of Psychological Medicine, University of Colombo, Colombo, Sri Lanka
Text: 
Background: School refusal occurs in 1–5% of all school children and has major social, emotional and educational implications for the child. It can cause serious disruption of the child’s well-being and associated with significant short- and long-term sequelae. Children with school refusal may suffer from significant emotional distress, especially anxiety and depression.
Objectives: To study the clinical features, social, familial, and environmental and temperamental factors associated with children presenting with school refusal and the outcome of school refusal
Method: All children between 5 to 12 years of age, seen at child mental health clinic during January 2009 to July 2010 were included in the study. An interviewer administered semi-structured questionnaire used for collection of bio-data and features associated with school refusal.
Results: 71 children aged 5 to 12 years(mean age 9.08 years) participated in the study. 59.2%(42) were male. Commonest associated features were Somatic complaints 98.6%(70), fearfulness 46.5%(33), anxiety 29.6%(21), difficulty in separation 28.2%(20).Commonest precipitants were difficulty with peers 25.4%(18), difficulty with teacher 18.3%(13), change of school 14.1%(10). 50.7%(36) had an “easily upset” temperament. 32.4%(23) of these children were temperamentally timid. Majority of the children 45.1%(32) did not carry a specific diagnosis while others had phobic anxiety disorder 16.9%(12), Asperger syndrome 14.1%(10) and depression 11.3%(8).Learning disability was represented only in 1.4%(1). 84.5%(60) children were managed as out patients.36.6%(26) required medication. 57.7 %( 41) returned to school consistently and 22.5%(16)returned to school inconsistently.
Conclusions: Children with school refusal may suffer from significant emotional distress, especially anxiety and depression.

Disclosure: No conflict of interest declared