Four Reinforcers Predict School Refusal Behavior

ST. LOUIS – Problematic family functioning merges with children's perceptions of positive and negative reinforcements to produce school refusal behavior, according to research presented at the annual conference of the Anxiety Disorders Association of America.

“It's important that we be aware of the relationship between family environment and school refusal behavior,” said Gillian Chapman, of the University of Nevada, Las Vegas.

“This awareness is an essential step toward our ability to structure appropriate clinical assessment criteria and, ultimately, devise applied and appropriate therapy for children and families with school refusal behavior,” she said.

Ms. Chapman is part of a team of UNLV researchers, led by Christopher A. Kearney, Ph.D., that is investigating the often complicated circumstances that lead to a child's desire to avoid school.

School refusal behavior is an umbrella term that covers many hypothesized subtypes of youths with problematic absenteeism, including truancy, school phobia, and anxiety-based school refusal, explained Dr. Kearney, professor of psychology and director of clinical training at the university.

“Refusal to attend school is a common and urgent problem, and it would benefit clinicians if they had a cookbook reference to help them identify and treat the various forms of this behavior,” he said in an interview.

Through his previous research, Dr. Kearney has concluded that there are four primary functions, or reinforcements, that are the best predictors of absenteeism:

▸ Avoidance of school-related stimuli that provoke negative affectivity. Differential diagnoses or problems include panic disorder and agoraphobia; generalized anxiety disorder; specific phobia; and depression and suicidal behavior.

▸ Desire to escape aversive social and/or evaluative situations. Differential diagnoses or problems include social anxiety disorder, depression, and suicidal behavior.

▸ Pursuit of attention from significant others, usually the parents. Differential diagnoses or problems include separation anxiety disorder, oppositional defiant disorder, and noncompliance in response to most parental commands.

▸ Seeking of tangible reinforcers outside of school (or, it's “more fun” to be outside of school). Differential diagnoses or problems include conduct-disordered behavior such as stealing, setting fires, or aggression; substance abuse; and lack of motivation in many situations.

These reinforcers maintain or reward school refusal behavior. The first two are negative reinforcements (avoidance behavior), and the second two constitute positive reinforcement, Dr. Kearney noted.

The goal of Ms. Chapman's research was to clarify the clinical distinctions among these four functions. She examined the roles of such contributing factors as family cohesion, communication, expressiveness, independence, enmeshment, achievement, and control.

It turned out that family conflict was significantly more common in children who sought reinforcements outside of school and that family enmeshment was more common in attention-seeking children.

Children in well-adjusted, healthy families may exhibit school refusal behavior merely because they're anxious, added Dr. Kearney. “They have good problem-solving and communication skills, but they just don't know how to solve the high anxiety.”

Ms. Chapman also found that children who refuse school to get attention come from more dependent families than do those who refuse school for positive tangible reinforcement, and children who refuse school to avoid stimuli-provoked negative affectivity come from more cohesive families than do those who refuse school for positive tangible reinforcement.

As a group, the 182 families in the study scored below average for independence (that is, they had higher parent-child dependence and overindulgence), she said.

Mean family scores on the cohesion, achievement, intellectual-cultural orientation, active-recreational orientation, and organization subscales were also below normative levels.

Avoidance of school-related stimuli that provoke negative affectivity is just one reinforcer. DR. KEARNEY

ST. LOUIS – Problematic family functioning merges with children's perceptions of positive and negative reinforcements to produce school refusal behavior, according to research presented at the annual conference of the Anxiety Disorders Association of America.

“It's important that we be aware of the relationship between family environment and school refusal behavior,” said Gillian Chapman, of the University of Nevada, Las Vegas.

“This awareness is an essential step toward our ability to structure appropriate clinical assessment criteria and, ultimately, devise applied and appropriate therapy for children and families with school refusal behavior,” she said.

Ms. Chapman is part of a team of UNLV researchers, led by Christopher A. Kearney, Ph.D., that is investigating the often complicated circumstances that lead to a child's desire to avoid school.

School refusal behavior is an umbrella term that covers many hypothesized subtypes of youths with problematic absenteeism, including truancy, school phobia, and anxiety-based school refusal, explained Dr. Kearney, professor of psychology and director of clinical training at the university.

“Refusal to attend school is a common and urgent problem, and it would benefit clinicians if they had a cookbook reference to help them identify and treat the various forms of this behavior,” he said in an interview.

Through his previous research, Dr. Kearney has concluded that there are four primary functions, or reinforcements, that are the best predictors of absenteeism:

▸ Avoidance of school-related stimuli that provoke negative affectivity. Differential diagnoses or problems include panic disorder and agoraphobia; generalized anxiety disorder; specific phobia; and depression and suicidal behavior.

▸ Desire to escape aversive social and/or evaluative situations. Differential diagnoses or problems include social anxiety disorder, depression, and suicidal behavior.

▸ Pursuit of attention from significant others, usually the parents. Differential diagnoses or problems include separation anxiety disorder, oppositional defiant disorder, and noncompliance in response to most parental commands.

▸ Seeking of tangible reinforcers outside of school (or, it's “more fun” to be outside of school). Differential diagnoses or problems include conduct-disordered behavior such as stealing, setting fires, or aggression; substance abuse; and lack of motivation in many situations.

These reinforcers maintain or reward school refusal behavior. The first two are negative reinforcements (avoidance behavior), and the second two constitute positive reinforcement, Dr. Kearney noted.

The goal of Ms. Chapman's research was to clarify the clinical distinctions among these four functions. She examined the roles of such contributing factors as family cohesion, communication, expressiveness, independence, enmeshment, achievement, and control.

It turned out that family conflict was significantly more common in children who sought reinforcements outside of school and that family enmeshment was more common in attention-seeking children.

Children in well-adjusted, healthy families may exhibit school refusal behavior merely because they're anxious, added Dr. Kearney. “They have good problem-solving and communication skills, but they just don't know how to solve the high anxiety.”

Ms. Chapman also found that children who refuse school to get attention come from more dependent families than do those who refuse school for positive tangible reinforcement, and children who refuse school to avoid stimuli-provoked negative affectivity come from more cohesive families than do those who refuse school for positive tangible reinforcement.

As a group, the 182 families in the study scored below average for independence (that is, they had higher parent-child dependence and overindulgence), she said.

Mean family scores on the cohesion, achievement, intellectual-cultural orientation, active-recreational orientation, and organization subscales were also below normative levels.

Avoidance of school-related stimuli that provoke negative affectivity is just one reinforcer. DR. KEARNEY

ST. LOUIS – Problematic family functioning merges with children's perceptions of positive and negative reinforcements to produce school refusal behavior, according to research presented at the annual conference of the Anxiety Disorders Association of America.

“It's important that we be aware of the relationship between family environment and school refusal behavior,” said Gillian Chapman, of the University of Nevada, Las Vegas.

“This awareness is an essential step toward our ability to structure appropriate clinical assessment criteria and, ultimately, devise applied and appropriate therapy for children and families with school refusal behavior,” she said.

Ms. Chapman is part of a team of UNLV researchers, led by Christopher A. Kearney, Ph.D., that is investigating the often complicated circumstances that lead to a child's desire to avoid school.

School refusal behavior is an umbrella term that covers many hypothesized subtypes of youths with problematic absenteeism, including truancy, school phobia, and anxiety-based school refusal, explained Dr. Kearney, professor of psychology and director of clinical training at the university.

“Refusal to attend school is a common and urgent problem, and it would benefit clinicians if they had a cookbook reference to help them identify and treat the various forms of this behavior,” he said in an interview.

Through his previous research, Dr. Kearney has concluded that there are four primary functions, or reinforcements, that are the best predictors of absenteeism:

▸ Avoidance of school-related stimuli that provoke negative affectivity. Differential diagnoses or problems include panic disorder and agoraphobia; generalized anxiety disorder; specific phobia; and depression and suicidal behavior.

▸ Desire to escape aversive social and/or evaluative situations. Differential diagnoses or problems include social anxiety disorder, depression, and suicidal behavior.

▸ Pursuit of attention from significant others, usually the parents. Differential diagnoses or problems include separation anxiety disorder, oppositional defiant disorder, and noncompliance in response to most parental commands.

▸ Seeking of tangible reinforcers outside of school (or, it's “more fun” to be outside of school). Differential diagnoses or problems include conduct-disordered behavior such as stealing, setting fires, or aggression; substance abuse; and lack of motivation in many situations.

These reinforcers maintain or reward school refusal behavior. The first two are negative reinforcements (avoidance behavior), and the second two constitute positive reinforcement, Dr. Kearney noted.

The goal of Ms. Chapman's research was to clarify the clinical distinctions among these four functions. She examined the roles of such contributing factors as family cohesion, communication, expressiveness, independence, enmeshment, achievement, and control.

It turned out that family conflict was significantly more common in children who sought reinforcements outside of school and that family enmeshment was more common in attention-seeking children.

Children in well-adjusted, healthy families may exhibit school refusal behavior merely because they're anxious, added Dr. Kearney. “They have good problem-solving and communication skills, but they just don't know how to solve the high anxiety.”

Ms. Chapman also found that children who refuse school to get attention come from more dependent families than do those who refuse school for positive tangible reinforcement, and children who refuse school to avoid stimuli-provoked negative affectivity come from more cohesive families than do those who refuse school for positive tangible reinforcement.

As a group, the 182 families in the study scored below average for independence (that is, they had higher parent-child dependence and overindulgence), she said.

Mean family scores on the cohesion, achievement, intellectual-cultural orientation, active-recreational orientation, and organization subscales were also below normative levels.

Avoidance of school-related stimuli that provoke negative affectivity is just one reinforcer. DR. KEARNEY