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Cited by 72Youth Substance Use and School AttendanceAutism Spectrum Disorder ResearchChild and Adolescent Psychosocial and Emotional Development

School distress and the school attendance crisis: a story dominated by neurodivergence and unmet need

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Connolly, Sophie E., Constable, Hannah L., Mullally, Sinéad L.·2023·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2023.1237052PMC PMC10556686

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Abstract

Background: The Covid-19 pandemic has brought into sharp focus a school attendance crisis in many countries, although this likely pre-dates the pandemic. Children and young people (CYP) struggling to attend school often display extreme emotional distress before/during/after school. We term this School Distress. Here we sought to elucidate the characteristics of the CYP struggling to attend school in the United Kingdom. Methods: Using a case–control, concurrent embedded mixed-method research design, 947 parents of CYP with experience of School Distress completed a bespoke online questionnaire (February/March 2022), alongside an age-matched control group ( n = 149) and a smaller group of parents who electively home-educate ( n = 25). Results: In 94.3% of cases, school attendance problems were underpinned by significant emotional distress, with often harrowing accounts of this distress provided by parents. While the mean age of the CYP in this sample was 11.6 years (StDev 3.1 years), their School Distress was evident to parents from a much younger age (7.9 years). Notably, 92.1% of CYP currently experiencing School Distress were described as neurodivergent (ND) and 83.4% as autistic. The Odds Ratio of autistic CYP experiencing School Distress was 46.61 [95% CI (24.67, 88.07)]. Autistic CYP displayed School Distress at a significantly earlier age, and it was significantly more enduring. Multi-modal sensory processing difficulties and ADHD (among other neurodivergent conditions) were also commonly associated with School Distress; with School Distress CYP having an average of 3.62 NDs (StDev 2.68). In addition, clinically significant anxiety symptomology (92.5%) and elevated demand avoidance were also pervasive. Mental health difficulties in the absence of a neurodivergent profile were, however, relatively rare (6.17%). Concerningly, despite the striking levels of emotional distress and disability reported by parents, parents also reported a dearth of meaningful support for their CYP at school. Conclusion: While not a story of exclusivity relating solely to autism, School Distress is a story dominated by complex neurodivergence and a seemingly systemic failure to meet the needs of these CYP. Given the disproportionate number of disabled CYP impacted, we ask whether the United Kingdom is upholding its responsibility to ensure the “right to an education” for all CYP (Human Rights Act 1998).

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  • Attendance is a meaningful proxy for pupil engagement and wellbeing, particularly in cases of emotionally based school avoidance or long-term disconnection.

    “Attendance has long been recognised as a meaningful proxy for pupil engagement and wellbeing, particularly in cases of emotionally based school avoidance or long-term disconnection”

    From Beyond the Classroom: Strengthening Pupil Engagement, Attendance and Belonging through Alternative Education and Community Partnerships (2025) · cites this paper as Connolly et al., 2023

    The Methods (Data analysis; page unavailable) use attendance rates as a proxy marker of school distress, and the Results (Child health and neurodivergences; page unavailable) link lower attendance with higher anxiety. But the paper does not establish attendance as a proxy for pupil engagement, and the Discussion cautions that pupils can experience considerable distress while maintaining attendance. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

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Authors
Connolly, S. E., Constable, H. L., & Mullally, S. L.
Affiliations
Newcastle University (GB)
Corresponding author
Mullally, Sinéad L.
ORCID
Mullally, Sinéad L.
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2023-09-22
Volume
14
Pages
1237052-1237052
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2023.1237052
PMC
PMC10556686
OpenAlex
W4386958092
Cited by
72
References
13
Citations by year
2026: 37 · 2025: 29 · 2024: 5 · 2023: 1
FWCI
32.15
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • medRxiv (acceptedVersion)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Newcastle University ePrints (Newcastle Univesity) (cc-by)
Funders
International Seafood Sustainability Foundation
Topics
  • Social Sciences › Education › Youth Substance Use and School Attendance
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
neurodivergence, autism spectrum disorder, children and young people, emotional distress, sensory processing difficulties, attention deficit hyperactivity disorder, anxiety, unmet needs, right to education, parental attitudes, school support

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