Case Study of a 5 Year Old with School Refusal Behaviour
Case study of a five-year old girl with school refusal behaviour
Case description
Mary, a five year old girl, had been attending her local nursery school successfully for several months. However, for the last four weeks she found it difficult to separate from her mother and refused to attend school so her case was referred to the school psychologist. Her mother and her nursery teacher agreed that her problem began when she had a disturbing dream during nap-time and became agitated when she woke up and realized her mother was not present. Everyday before going to school she began crying and requested not to attend. Subsequently, Mary was forced to attend school and when her mother dropped her to school her teacher had to hold on to her so her mother could leave the classroom. Although she was calm at times through the day she very often started crying and asked for her mother. At home, Mary did not separate from her mother and did not sleep in her own bed. Mary was described by school staff as a quiet child who liked to play alone. She lived with her mother and her eleven year old brother. Her parents had been separated for six months.
Theoretical background
When assessing treatment approaches for school refusal it is useful to consider whether the school refusal behaviour presents an acute onset or a chronic course, the degree of parental involvement, if other disorders are present as well as the number reasons behind the school refusal behaviour.
Both cognitive-behavioural and behavioural interventions have been shown to successfully treat cases of school refusal with various degrees of severity and complexity. They usually achieve treatment success within three to six weeks with maintenance of treatment improvement showed up to five years (King & Bernstein, 2001; King & Ollendick, 1989). However, behavioural interventions are usually the treatment of choice since they are not as demanding on psychologist’s time (Kearney & Beasley, 1994).
Various outcome
Case description
Mary, a five year old girl, had been attending her local nursery school successfully for several months. However, for the last four weeks she found it difficult to separate from her mother and refused to attend school so her case was referred to the school psychologist. Her mother and her nursery teacher agreed that her problem began when she had a disturbing dream during nap-time and became agitated when she woke up and realized her mother was not present. Everyday before going to school she began crying and requested not to attend. Subsequently, Mary was forced to attend school and when her mother dropped her to school her teacher had to hold on to her so her mother could leave the classroom. Although she was calm at times through the day she very often started crying and asked for her mother. At home, Mary did not separate from her mother and did not sleep in her own bed. Mary was described by school staff as a quiet child who liked to play alone. She lived with her mother and her eleven year old brother. Her parents had been separated for six months.
Theoretical background
When assessing treatment approaches for school refusal it is useful to consider whether the school refusal behaviour presents an acute onset or a chronic course, the degree of parental involvement, if other disorders are present as well as the number reasons behind the school refusal behaviour.
Both cognitive-behavioural and behavioural interventions have been shown to successfully treat cases of school refusal with various degrees of severity and complexity. They usually achieve treatment success within three to six weeks with maintenance of treatment improvement showed up to five years (King & Bernstein, 2001; King & Ollendick, 1989). However, behavioural interventions are usually the treatment of choice since they are not as demanding on psychologist’s time (Kearney & Beasley, 1994).
Various outcome
References: American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, text revision( 4th edition). Washington, DC: American Psychiatric Association Blagg, N. & Yule, Q. (1984). The behavioural treatment of school refusal: A comparative study. Behaviour, Research & Therapy, 22, 2, 119-127. Gimpel, G. & Nagle, R. (1996). Factorial validity of the Devereux behaviour rating scale-school form. Journal of Psychoeducational Assessment, 14, 4, 334-348 Gosschalk, Philip O. (2004). Behavioural treatment of acute onset school refusal in a 5-year old girl with separation anxiety disorder. Education & Treatment of Children, May2004, Vol. 27 Issue 2, p150-160, Kearney,C. & Beasley, J. (1994). The clinical treatment of school refusal behavioiur: A survey of referral and practice characteristics. Psychology in the schools, 31, 128-132. Kearney, C. A., Silverman, W.K. (1999). Behaviour Therapy. Functionally based Prescriptive and non-prescriptive treatment for children and adolescents with school refusal behaviour. Vol. 30 Issue 4, p673. King, N. & Bernstein, G. (2001). School refusal in children and adolescents: A review of the past ten years. Journal of the American academy of child and adolescent psychiatry, 40, 2, 197-205. King, N. & Ollendick, T. (1989). School refusal: Graduated and rapid behavioural treatment strategies. Australian & New Zealand Journal of Psychiatry, 23, 213-223. Last, C. G., Hansen, C., Franco, N. (1998). Cognitive behavioural treatment of school phobia. Journal of the American Academy of Child & Adolescent Psychiatry. Vol. 37 Issue 4, p404. Naglieri,J., LeBuffe, P., & Pfeiffer, S. (1993). Devereux behaviour rating scale-school form: Manual. San Antonio, Texas: The Psychological Corporation.