(PS4-B43) School Absenteeism in Autistic and ADHD Youth During COVID-19

Chronic school absenteeism is associated with dropout, risk behaviors, poor social relationships, and increased mental health problems (Ingul et al., 2019; Kearney, 2019). Students with developmental disabilities have higher rates of school absenteeism than their non-disabled peers, and autistic youth appear to be at especially high risk (Black & Zablotsky, 2018; Gottfried et al., 2019). Recent studies on autistic youth before the COVID-19 pandemic estimated 21.5-31.5% of school missed, with school refusal accounting for around half of absences (43% and 52% of absences, respectively; Adams 2021, Totsika et al. 2020). ADHD, which commonly co-occurs with autism, has also been identified as a predictor of more frequent school absences (Niemi, et al. 2022). Little research has explored the reasons for higher absenteeism in these groups, and no research to date has reported on absenteeism since the onset of the COVID-19 pandemic.

N=74 parents of youth aged 11-20 who were diagnosed with autism and/or ADHD filled out online surveys relating to their child’s experiences with school and peer relationships. Parents were asked to report the number of days in the last four weeks (up to 20 school days) that their child missed due to 16 potential reasons using the School NonAttendance Checklist (SNACK; Heyne et al., 2019). They also completed the Social Responsiveness Scale (SRS-2) and the Behavior Assessment Scale for Children (BASC-3).

Youth missed an average of 3.34 days (SD=4.88) during the 4-week period, or 16.7% of school. The most frequently cited reason for missed days was school reluctance/refusal, explaining 31.6% of missed days across the sample.

The number of missed days differed significantly by diagnostic group (F(71,2) = 4.535, p = .014). Bonferroni post hoc comparisons indicated that Autistic-only participants (N=15) missed significantly more school days (M=5.8, SD=6.7) than the ADHD-only group (N=25; M=1.6, SD=2.1, p = .011).  Number of missed days for the Autistic + ADHD group (N=34; M=3.0, SD=4.2) did not significantly differ from the Autistic only group  (p = .107) or the ADHD only group (p = .700). Reasons for absences also differed by group (see Table 1).

A regression analysis was conducted to examine youth characteristics as predictors of school absenteeism. Youth age and internalizing symptoms were significantly related to the number of days missed (Table 2) when also controlling for gender, social skills, externalizing symptoms, executive functioning, and adaptive skills.

Overall frequency and reasons for school absenteeism in this sample were consistent with pre-COVID samples, suggesting that pre-existing barriers to attendance remain relevant above and beyond COVID-specific factors. School refusal was the most frequent reason for missed school for Autistic youth, both with and without ADHD. School exclusion was only reported in the Autistic and Autistic+ADHD groups, and was not reported in the ADHD-only group. Age and internalizing symptoms were related to missed school above and beyond other child characteristics, and therefore may be important factors in identifying youth in need of support to prevent or mitigate chronic absenteeism.
Table 1
Table 2