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Acad Pediatr. 2017 Nov - Dec;17(8):837-843. doi: 10.1016/j.acap.2017.09.013. Epub 2017 Sep 18.

Chronic School Absenteeism and the Role of Adverse Childhood Experiences.

Author information

1
University of Colorado at Denver-Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, Colo; Department of Pediatrics, Children's Hospital Colorado, Aurora, Colo. Electronic address: hilary.stempel@ucdenver.edu.
2
University of Colorado at Denver-Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, Colo.
3
University of Colorado at Denver-Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, Colo; Department of Family Medicine, University of Colorado Denver, Aurora, Colo.
4
University of Colorado at Denver-Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, Colo; Department of Pediatrics, Children's Hospital Colorado, Aurora, Colo.

Abstract

OBJECTIVE:

To examine the association between chronic school absenteeism and adverse childhood experiences (ACEs) among school-age children.

METHODS:

We conducted a secondary analysis of data from the 2011-2012 National Survey of Children's Health including children 6 to 17 years old. The primary outcome variable was chronic school absenteeism (≥15 days absent in the past year). We examined the association between chronic school absenteeism and ACEs by logistic regression with weighting for individual ACEs, summed ACE score, and latent class analysis of ACEs.

RESULTS:

Among the 58,765 school-age children in the study sample, 2416 (4.1%) experienced chronic school absenteeism. Witnessing or experiencing neighborhood violence was the only individual ACE significantly associated with chronic absenteeism (adjusted odds ratio [aOR] 1.55, 95% confidence interval [CI] 1.20-2.01). Having 1 or more ACE was significantly associated with chronic absenteeism: 1 ACE (aOR 1.35, 95% CI 1.02-1.79), 2 to 3 ACEs (aOR 1.81, 95% CI 1.39-2.36), and ≥4 ACEs (aOR 1.79, 95% CI 1.32-2.43). Three of the latent classes were also associated with chronic absenteeism, and children in these classes had a high probability of endorsing neighborhood violence, family substance use, or having multiple ACEs.

CONCLUSIONS:

ACE exposure was associated with chronic school absenteeism in school-age children. To improve school attendance, along with future graduation rates and long-term health, these findings highlight the need for an interdisciplinary approach to address child adversity that involves pediatricians, mental health providers, schools, and public health partners.

KEYWORDS:

adverse childhood experiences; child development; school absenteeism

PMID:
28927940
DOI:
10.1016/j.acap.2017.09.013
[Indexed for MEDLINE]

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