Interventions for school refusal and truancy: A case of 'old dogs in need of new tricks'?

School refusal and truancy are alike and different. Both are school attendance problems (SAPs) characterised by difficulty going to or staying in school. In school refusal the difficulty is associated with internalizing symptoms such as anxiety, mood problems, and physical complaints. The youngster - child or adolescent, male or female - is usually at home when not at school, and there is usually minimal emotional distress when attendance is not required (e.g., the weekend). Truancy, on the other hand, is an externalizing behaviour often paired with other externalizing behaviours such as fighting, stealing, and drug use. The youngster - commonly an adolescent male - may head to school but not arrive, or leave during the day, unbeknown to the parents. Difficulty attending may be associated with poor grades or the desire to fit in with truanting peers. Contextual factors (family, school, community) are also commonly discussed in relation to the development and maintenance of SAPs. Some risk factors are shared by school refusal and truancy while others are unique to one type of SAP. Because SAPs differ in form, associated risk factors, and the likely function served by non-attendance (e.g., avoiding emotional distress in school refusal; seeking more pleasurable activities in truancy), interventions for these two problems will also differ. The need for effective interventions is underscored by the strong links between non-attendance, poor academic performance, social-emotional problems, and school drop-out.