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Training Session 2 Outline Review of 4 functions

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1 ‘Enabling children and young people with Attendance Problems to develop the four capacities’
Training Session 2 Outline Review of 4 functions Further assessment considerations Interventions Links with CfE - 4 capacities Evaluation 28/03/2017

2 A Functional Model of School Refusal Behavior
To get away from school-related situations that cause distress To get away from school-related social/performance situations that cause distress. To get attention from significant others such as parents. To get to do rewarding activities / experiences outside of school . . 28/03/2017 2 2

3 + ve Reinforcement (Rewards)
Functional Model of SR 1. SPNA Child escapes and avoids specific unpleasant things or people. 3. ASB Child is positively reinforced for school avoidance. 2. EASE Child escapes and avoids unpleasant social or evaluative situations. 4. TR Child receives tangible reinforcement for school avoidance. 28/03/2017 -ve Reinforcement + ve Reinforcement (Rewards)

4 Approaches to Functional Assessment
‘Triangulation’ multiple sources of data is more reliable. Indirect through interviews and record reviews Direct -observations in a typical day across all settings Work output/Grades SEEMIS -Discipline referrals SRAS-R ‘School Refusal Assessment Scale -Revised’ 28/03/2017

5 Assessment Unclear? Try a ‘Mini-Experiment’ - testing your theory / hypothesis
Consider allowing the pupil to stay in a base / library rather than going to class for two days Function 2 Confirmed: To get away from school-related social / performance situations that cause distress Consider allowing the parent to attend school with pupil for a day. Function 3 Confirmed: Attention from significant others. Provide a large incentive for pupil to attend for two days Function 4 Confirmed: Tangible rewards People cannot supply you with good information because they themselves are unsure what is happening A child may be out of school for such a long time that it is difficult to get information. In other cases, parents disagree with one another, or parents and children disagree about the form and function of school refusal behaviour. In these cases, you will have to consider the preponderance of evidence in one direction or another. Your own behavioural observations will become more critical in these kind of cases Carry out with caution - because this temporarily rewards the pupil for misbehaviour 28/03/2017 5 5

6 Interventions No single intervention strategy has proven to be effective Intervention should be related to the identified function of non attendance Intervention should be related to the individual’s needs A multi-stranded approach is key for success, working at levels of individual, class & school Remember all interventions should be planned through the JAT.

7 confident individuals
successful learners with enthusiasm and motivation for learning determination to reach high standards of achievement openness to new thinking and ideas and able to use literacy, communication and numeracy skills use technology for learning think creatively and independently learn independently and as part of a group make reasoned evaluations link and apply different kinds of learning in new situations confident individuals with self respect a sense of physical, mental and emotional wellbeing secure values and beliefs ambition and able to relate to others and manage themselves pursue a healthy and active lifestyle be self aware develop and communicate their own beliefs and view of the world live as independently as they can assess risk and take informed decisions achieve success in different areas of activity To enable all young people to become responsible citizens with respect for others commitment to participate responsibly in political, economic, social and cultural life and able to develop knowledge and understanding of the world and Scotland’s place in it understand different beliefs and cultures make informed choices and decisions evaluate environmental, scientific and technological issues develop informed, ethical views of complex issues effective contributors with an enterprising attitude resilience self-reliance and able to communicate in different ways and in different settings work in partnership and in teams take the initiative and lead apply critical thinking in new contexts create and develop solve problems In each case the capacity is expanded into ‘attributes’ and ‘capabilities’: it is our task to design a curriculum which will enable each child to develop these attributes and capabilities. You see here the beginning of a winnowing tool for the review of the curriculum – any activity which is not clearly directed to achieving these aims does not earn its keep and should be removed. It is easy from my view point to see where promoting social and emotional competence covers these aims under each capacity. SL – ‘openness to new thinking and ideas’ CI – ‘relate to others and manage themselves’ – surely social competence and managing your own emotions is key here. RC – ‘respect for others’ – respect self first and understand your own emotions before you can begin to respect others and recognise and emphathise with their emotions. EC – ‘communicate in different ways and in different settings’ 7

8 Interventions for Function 1 and 2: To Avoid or Escape school related stimuli
Discuss the nature of anxiety / stress with the pupil and parent Help the pupil control the physical feelings of anxiety Help the pupil develop more realistic thoughts Consider referral to a social skills group Support the pupil with a gradual and phased return back to school full-time

9 Activity: In pairs Think of a time you recently felt a bit stressed or anxious: How did you feel physically? What were you thinking? What did you do?

10 The Nature of Anxiety & Stress
A physical component Trembling, muscle tension, ‘butterflies in the stomach, nausea, or other bodily symptoms A cognitive or thinking component Such as irrational or unjustified beliefs that everyone dislikes the pupil or is judging them harshly when they perform in some way A Behavioural component Such as avoiding certain events, fleeing or escaping upsetting situations, crying, temper tantrums, or non-compliance. From your assessment you should have a good idea about what specific anxiety sequence exists for a particular child. It can be helpful to use visuals to show a child and his parents what seems to be happening in their situation. When discussing a particular anxiety sequence with a child and parents, use multiple, specific and recent examples from the child’s own experiences. Encourage the child and parents to disagree with you if their observations are radically different from your. If necessary, collect additional information from family members to modify your view of the child’s anxiety sequence. Most important, be sure all relevant family members fully undestand the sequence as this will inform the strategy you propose I.e. attend to physical, cognitive ad behavioural must be addressed if the child is to resume full-time school attendance with less distress.

11 Everyone is going to laugh
at me. I need the toilet. I feel sick. I’m out of here!

12 Anxiety & Stress Management
Breathing Breath slowly through nose (with mouth closed) and breath slowly out through mouth. Muscle Relaxation Tense-Release Method Partial muscle relaxation only on these areas that are tense.

13 Developing more Realistic Thoughts
Replacing negative thoughts with positive thoughts will NOT work. Inform pupil and parents about the different kinds of negative thoughts or mental errors commonly made in social and performance situations.

14 Identifying Types of automatic -ve Thoughts
Catastrophizing This is the worst thing that can happen to me Mind Reading She thinks I’m stupid. I know they don’t like me. All-or-None Thinking It must be perfect. I can’t do this at all. Over-generalisation I never do anything right. Negative labelling I’m such an idiot

15 Identifying Types of automatic -ve Thoughts 2
Fortune Telling I’m going to fail this test. Nobody is going to talk to me. Can’ts or Shoulds I can’t do this. I should have done better Cancelling the positive I should have done better (usually when someone gives a compliment) A potential problem when trying to get specific thoughts from teenagers is they commonly say “I don’t know”. Or they give you snippets of a thought that are not very helpful. Ask a child to keep a written diary of thoughts when in a particularly stressful situation. Ask a child to perform some anxiety provoking task before you, such as reading, & ask them to say what they are thinking periodically. Keep in mind some pupils are simply not very good at verbalising their thoughts.

16 Developing more Realistic Thoughts
Am I Scared or nervous about a certain social or performance situation? T: What Thoughts am I having in this situation? O: What Other, more realistic thoughts can I have? P: Praise myself for thinking more realistic thoughts Adapted from Silverman & Kurtines, 1996 The crucial part of the process is the O: the child must create an alternative, more realistic thought about what is happening in the situation.

17 Link with Curriculum for Excellence
Mental and Emotional Wellbeing: Experiences and Outcomes HWB 0-02a I know that we all experience a variety of thoughts and emotions that affect how we feel and behave and I am learning ways of managing them.

18 Helping Pupils develop Realistic Thoughts
Reassure pupil that their thoughts are normal & universal, even if negative or skewed Provide Dispute Handle Questions Provide STOP log sheet Role play how to engage in the STOP process. Emphasise with the pupil that: Embarrassment is a universal, temporary and manageable condition. Get the pupil to rate the chances of something happening and then test out their erroneous beliefs.

19 Dispute Handles Am I 100% sure this will happen (or is happening)?
Can I really know what this person thinks of me? What’s the worst thing that can really happen? Have I ever been in this situation before and was it really that bad? How many times has this terrible thing actually happened? Am I the only person that has ever had to deal with this situation? So what if I am not perfect in this situation? Is this really my fault?

20 STOP Log (T) (O) (P) Praise myself My Thoughts in this situation
Situations at school that bother me (S) My Thoughts in this situation (T) Other helpful thoughts I can have. (O) Praise myself (P) Walk into Gym Everyone is staring at me Only a couple of people are looking my way I’m proud for thinking differently

21 Addressing the Behavioural component: Gradual Reintegration
Make sure you, the pupil and the parents are on the ‘same page’ with respect to the pace and scope of the reintegration process Have the pupil enter school and class in the morning and stay for a limited time e.g. 1 period and then go home Gradually increase the amount of time e.g. an extra period every 3 days until full time is reached. From the start, always expect a child to attend school at whatever minimum level they can or have managed.

22 Addressing the Behavioural component: Gradual Reintegration 2
The pupil should not be allowed fun activities during school hours Suggest work sent home by teachers is completed Convey to parents that the default option in the morning should always be to send the child to school, even if minor maladies exist. Suggest pupil is only kept home if significant conditions are present Be aware that the pupil may show new behaviours to induce nonattendance Such as intense physical complaints, temper tantrums, disruptive behaviour Try to discourage a pupil with a history of school refusal behaviour being sent home for such problems Suggest in-school suspension or detentions. Children may be kept home from school if one or more of the following conditions are present: A temperature of at least 100 degrees Frequent vomiting Bleeding Head lice Sever diarrhoea Severe flu-like symptoms Another very sever medical condition such as intense pain.

23 Addressing the Behavioural component: Further tips
In time limited situations, try using anxiety management techniques - relaxation, realistic thoughts- concurrently with reintegration plan. Try to avoid some common mistakes during the process such as staff: Becoming overly stern or ‘helpful’ when a pupil is on a part-time timetable. Keep to the initially agreed plan, don’t push for more. However, allow the pupil to attend more if they ask or spontaneously do so. Assume that once the pupil is in school that they no longer have anxiety about being there. Make sure that the agreed reintegration plan is supported by SMT of school so that the pupil is not penalised for partial absence during the reintegration plan.

24 Interventions for Function 3: To get Attention from Significant others
The foundation for intervention for this function is to re-establish parent control through: Routines, rules, commands, rewards, and sanctions. Establish a set morning routine. Attend to Appropriate behaviours and Ignore Inappropriate behaviours Restructuring Parent Commands Address Excessive Reassurance Seeking and Clingy behaviour Establish formal rewards and sanctions for school attendance / nonattendance. As a last resort, Force School Attendance

25 Helping to Establish a set morning routine
Design a morning routine with parents that is regular and predictable The child should be required to rise from bed minutes before entry into school This provides sufficient flexibility to absorb behaviours such as dawdling, crying, and complaints of physical symptoms Divide the morning routine into individual components based on what a child must do to get ready for school Washing, dressing, accessorizing, eating breakfast, brushing teeth and hair, making final preparations such as getting their bag ready. Ask the parent how long each activity should take, then give extra time to allow the child to do so.

26 Helping to Establish a set morning routine: part 2
Tailor the morning routine to the demands and constraints of an individual family Try out the routine for a few days to see what needs tweaking Emphasise to parents the importance of remaining consistent and persistent in the routine Encourage parents to focus on positive child behaviours, especially getting up and sticking to the routine. Encourage parents to engage in the same tasks at the same time e.g. eating breakfast, brushing teeth Encourage parents to build the expectation that their child is to attend school without discussion

27 Restructuring Parent Commands
Tell a child exactly what to do. Instead of ‘clean your room’ say ‘pick up all of your clothes off the floor right now’ Give short, direct commands that only involve one step. Make a command a command and not an option or a question (not a ‘should’ or ‘can you’). Reduce speech, don’t ‘lecture’. Make sure the child can physically carry it out. Make direct eye contact with a child when making a command so you know you have their full attention. Ensure nothing competes with their child’s attention (e.g. watching television, texting etc) Do a task with a child after giving a command to increase attention and supervision

28 Restructuring Parent Commands 2
Encourage parents to be as matter-of-fact and neutral in tone as possible. Eliminate sarcasm of negative statements. Praise good listening and compliance, and discourage poor listening or noncompliance Finally, tell parents to say to their child: “You’re going to school, end of story.”

29 Establishing formal rewards for school attendance
The most effective kinds of rewards and sanctions will be attention based. Rewards for appropriate school attendance, or attendance without major problems such as temper tantrums could include: Doing fun activities with a parent i Reading stories together Running errands together, going for a walk Also, set aside a short period of time for successfully completing the morning routine Brief activity with parent Watching some TV.

30 Establishing formal sanctions for school nonattendance
Help parents identify two or three behaviour problems in the morning and link specific sanctions to these behaviours. A good rule of thumb is that the sanction should be twice the number of minutes a child actively refused school E.g. a temper tantrum for 20 minutes should result in 40 minutes of sanction time in the evening. Losing a fun activity with the parent Losing computer or TV time Discourage parent from threatening extreme punishments If a child does remain home from school, attention toward the child should be minimized

31 Addressing Excessive Reassurance- Seeking and Clingy behaviour
In respond to persistent ‘nagging’ by child, the parent should ignore questions or statements about refusing school for at least one hour, then extending this to 2-3 hours. To avoid ‘clingy’ behaviour a parent should: Ensure, the bag is packed the night before Minimise conversation with the child and ignore minor complaints on the way to school. Arrive with the child at school at the same time each school day (ideally 10 minutes before bell rings) Should say a final goodbye & leave quickly. You should meet the parent and child on the playground and courteously but quickly escort the child to class

32 Forced School Attendance
SHOULD ONLY BE CONSIDERED AS A LAST RESORT AND ONLY IF ALL OF THE FOLLOWING CONDITIONS APPLY The child is younger than 10 years The child has no distress at all about attending school The child is refusing school only for attention The child fully understands what will happen if he refuses school The child is missing more days than not Two adults can take the child to school Parents have the energy and no reservation about taking the child to school You or another school official know what is planned to happen and meets the parents to escort the child to class quickly. Forced school attendance begins during the morning routine when a child refuses to attend school. Parents first issue a warning that the child must attend school or he will be physically taken to school. School refusal behaviours such as tantrums or crying are ignored. Parents then bring the child to a waiting school official and leave quickly after depositing him at school. Parents and school officials can then speak during the morning session to assess what happened and what may need to change. A severe downside is that if the parents give up on the procedure, reintegrating a child to school in future days will be very difficult. The child has essentially ‘survived’ the strongest intervention possible and will be more emboldened to resist other methods to increase school attendence.

33 Interventions for Function 4: Refusing school for tangible rewards outside of school requires:
A concerted effort between school officials, parents, and the adolescent. Increasing supervision Developing written contracts to boost incentives for school attendance Escorting a child from class to class Teaching a child to refuse offers from others to miss school Given we are generally talking about adolescents within this function, it will necessarily involve some negotiation with the young person. You should attempt to have all the family members, including the adolescent, commit to the long term goal of full time school attendance. You may also wish to commit to certain support services that will help a child succeed in school, make school less boring for him, or give him hope that the school year is not lost e.g. creating opportunities for the young person to salvage some academic credit for the year, rearranging classes and lunch time, providing some tutoring, easing deadlines for makeup work.

34 Increasing supervision
Identifying and proactively short-circuiting high-risk times during the school day when a child is most likely to leave the school campus. Having a child visit you during times he is most likely to be missing school. Using attendance sheet/card a child must have each teacher sign. Knowing exactly where a young person is when he is out of school during school hours and returning him to school when found Establishing immediate communication between you and a parent when a child is out of school

35 Constructing a Contract
Contracts must be written to eliminate problems remembering what all parties must do. Contracts must be time limited and preferably no longer than one week in length Everyone must completely agree with all contract provisions or the contract is invalid Contract provisions must be within a family’s value system and within their resources, so extravagant provisions must be avoided. Contract provisions must be very clearly defined. Contracts should be as simple and short as possible.

36 Sample Contract Privileges Responsibilities
For the privilege of seeing her friends on the weekend Alex agrees to have no more than zero marked absences this week For the privilege of being paid £7 for tidying her room on Saturday Alex agrees to have no more than one marked class absence this week For the privilege of being paid £3 for tidying her room on Saturday Alex agrees to have no more than two marked class absences this week

37 Sample Contract: General Statements
A marked absence is equal to one missed class and is determined by the school ‘Tidy your room’ means putting all your clothes away in the wardrobe or chest of drawers, dirty washing in the wash basket, making your bed, putting things away lying on the floor or in the bin and vacuuming the floor. If Alex had one or more marked absence this week, she may not see her friends this weekend. If Alex has two or more marked absences this week, she must tidy her room for free. If she does not tidy her room, then she loses her mobile phone and computer. The contract is good only for this week (Monday - Friday) Everyone who signs this contract agrees to the conditions of this contract and to read and initial the contract every day Young Person’s signature: Parent’s signature: Date:

38 Helping Young People Refuse Offers to Miss School
Encourage them to avoid certain people and places Help a young person to use specific statements: My parents and guidance teacher are give me a hard time about going to school They’re all watching me closely and I don’t want detention I have to stay in school this week if I want to hang with you guys Friday night. A young person can also talk about wanting to finish certain school projects or attend an extra-curricular activity Alternatively they can be encouraged to say nothing and walk away.

39 Difficult Parents Combative Parents:
Hostile, defiant, sceptical, suspicious, evasive and pessimistic about change. Appear determined to challenge you every step of the way. Dismissive Parents: Lackadaisical about discipline, fail to respond to your suggestions, don’t show up for appointments, don’t return calls Confused Parents: May be tangential in their thinking or bring in irrelevant stories or unrelated information.

40 Problematic family dynamics
Conflictive family members: Argue and fight with one another. Poor problem solving and communication skills Enmeshed family members: Over-involved with each other’s lives and may have trouble separating from one another Isolated family members: Rarely interact with people outside the family unit, including school officials Detached family members: Relatively uninterested in each other’s lives, which may lead to lax discipline and poor supervision Mixed dynamics: some combination of above

41 Suggested Approaches:
REMEMBER: Not all young people who refuse school have difficult parents or problematic family dynamics Increase collaborative contact Parents are generally more receptive if they know a child’ absenteeism is tracked at school and if school officials let them know immediately about unexcused absences. When speaking to parents, emphasise a non-defensive collaborative approach. Be neutral and matter of fact in your tone and listen carefully to what a parent says Try to steer conversation away from past events to what can be done in the next few days Work closely with professionals from other agencies, social work, health, psychological services that a family is involved with.

42 Link with Curriculum for Excellence
Mental and Emotional Wellbeing: Experiences and Outcomes HWB 0-03a I understand that there are people I can talk to and that there are a number of ways in which I can gain access to practical & emotional support to help me & others in a range of circumstances Responsibilities of All

43 Activity in Groups of 4: Briefly share a case of a pupil who has had attendance problems? What do you think was the dominant reason / function? Share what strategies you think may also have been useful in light of today’s training? Reference: Kearney, C.A (2008) Helping School Refusing Children & their Parent. A Guide for School Based Professionals. Oxford University Press

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