The “Supporting Kids, Avoiding Problems” (SKIP) study: relationships between school exclusion, psychopathology, development and attainment – a case control study

Publication Date20 June 2016
Date20 June 2016
AuthorClaire Parker,Ruth Marlow,Marc Kastner,Felix May,Oana Mitrofan,William Henley,Tamsin Ford
SubjectHealth & social care,Vulnerable groups,Children's services
The Supporting Kids, Avoiding Problems
(SKIP) study: relationships between
school exclusion, psychopathology,
development and attainment a case
control study
Claire Parker, Ruth Marlow, Marc Kastner, Felix May, Oana Mitrofan, William Henley and
Tamsin Ford
The authorsaffiliations can be
found at the end of this article.
Purpose The purpose of this paper is to explore the association between children who are at risk of being
or who have been excludedfrom school between the ages of 4 and 12 yearsand the role of psychopathology,
development and atta inment.
Design/methodology/approach A case-control approachwas conducted. Cases were children who had
been excluded from school compared to those who had no reported exclusions and normative data where
possible. A range of measures were used to collect information from the parent, child and teacher on areas
covering the childs mental health and well-being.
Findings The findings showed the number of difficulties faced by children who are at risk of being or who
have been excluded from school compared to gender- and age-matched controls and normative data
increased. Behavioural difficulties were apparent in the majority of the cases and an alarming number of
children reported self-harm. Interestingly nearly all the cases had recognised needs, but not all of them were
accessing appropriate services.
Practical implications There have been a number of changes regarding the identification and support of
childrens mental health and well-being. This study highlights gaps in resources and provision, particularly
around behavioural difficulties for children who are presenting as not coping in school.
Originality/value The findings from the SKIP study indicate the complexities and compounded difficulties
faced by children who are experiencing exclusion from school. By implementing a systematic group of
assessments the study was able to identify these complexities of need across a vulnerable group of children.
Keywords Development, Mental health, Primary school, Psychopathology, Attainment,
Primary school children, School exclusion, School suspension, Primary school age
Paper type Research paper
Schools have a recognised role in identifying and meeting childrens social, emotional and
behavioural needs (NICE, 2008; Department for Education, 2014a; Department of Health, 2015).
Persistent disruptive behaviour is the most common reason given by headteachers for excluding
a child from school (Department for Education, 2015b). The breakdown or potential breakdown
Received 12 March 2015
Revised 12 December 2015
Accepted 9 February 2016
The authors would like to thank all
the children, their families and the
schools for taking part in the
study. The authors are grateful for
all the support that has been
provided by a number of services
and individuals across the county.
The authors are grateful to the
Peninsula CLAHRC for funding
Claire Parkers doctoral
studentship. This paper presents
independent research funded by
the National Institute for Health
Research (NIHR) Collaboration for
Leadership in Applied Health
Research and Care (CLAHRC) for
the South West Peninsula. The
views expressed in this publication
are those of the authors and not
necessarily those of the NHS, the
NIHR or the Department of Health
in England.
DOI 10.1108/JCS-03-2015-0014 VOL. 11 NO. 2 2016, pp. 91-110, © Emerald Group Publishing Limited, ISSN 1746-6660
PAG E 9 1
of a childs school placement, particularly during primary school, should prompt a thorough
assessment to explore tractable contributing factors related to learning, mental health and the
relationships between school, child and family.
Research suggests that children may be excluded from school with unidentified, unsupported or
poorly managed Attention Deficit Hyperactivity Disorder (ADHD; ORegan, 2010). Similarly, a small
case-control study identified undetected autistic behavioural traits among children reported to be at
risk of exclusion due to persistent disruptive behaviour (Donno et al., 2010). Failure to recognise or
accurately identify a childs additional needs could be a significant problem. Further school placements
may rupture, with potential adverse educational, social and health consequences for the child and his
or her family, and with an inevitable economic burden to society. School exclusion predicts many
adverse outcomes including offending, substance misuse and poor educational attainment (Daniels
et al., 2003; Hayden and Dunne, 2001; Hemphill et al.,2010;Parsonset al., 2001).
Childhood psychopathology places a heavy burden on schools. The government and NHS
England have recently confirmed the launch of The Mental Health Services and Schools Link
Pilots(Department for Education, 2015a). In a large nationally representative study of childrens
mental health, the most commonly consulted professionals regarding childrens mental health
were teachers (Ford et al., 2007). The proportion of children with psychiatric disorder in contact
with special educational professionals equalled the proportion (25 per cent) in contact with child
and adolescent mental health services (Ford et al., 2007). These mental health-related contacts
with the education system incur costs that dwarf those to other public sector services (schools
£799.2 million, specialist educational services £508.8 million, £162.8 million for health and welfare
combined; 2007-2008 prices; Snell et al., 2013).
Government statistics report a continuing overall downward trend in exclusions from school in
England (Department for Education, 2015b).The rate of permanent exclusions (expulsions)
reportedly decreased from 12 exclusions per 10,000 pupils enroled in 2006/2007, to
6 per 10,000 pupils enroled in 2013/2014 (Department for Education, 2015b). A similar longer
term downward trend has been reported for pupils receiving a fixed-term exclusion (suspension),
however the number of fixed-term exclusions from primary schools has increased, accounting for
0.02 per cent of pupil enrolment (Department for Education, 2015b). Some groups of children are
disproportionately represented in the exclusion figures. Boys are over three times more likely to
receive a permanent exclusion from school than girls and are more likely to be excluded at a
younger age. Similarly, children from certain ethnic groups, namely, Gypsy/Roma and Traveller of
Irish Heritage, black Caribbean and white and black Caribbean dual heritage, all have a higher
rate of exclusion, as do children eligible for Free School Meals. It is particularly concerning that
seven in ten of all permanent exclusions are of children with a statement of special educational
needs (SEN), as are six in ten for fixed-term exclusion. Similarly, children with SEN without a
statement are nine times more likely to be excluded than their peers without SEN (Department for
Education, 2015b). This last point would seem to suggest that inadequate support and resources
may contribute to the exclusion of vulnerable children.
It is however likely that the decline in overall rate of exclusions presented by government statistics
are misrepresentative for a number of reasons. Managed moves, where children are formally
moved between schools to avoid exclusions, are thought to be becoming more common and are
not included in statutory returns to government (Abdelnoor, 2007). More worryingly, it has been
suggested that pressures on schools to remain inclusive have led to higher levels of hidden
exclusions; the Childrens Commissioner for England reported there to be a number of illegal
exclusions from school where, for example, the headteacher would send pupils home to cool
off(Childrens Commissioner, 2012, 2013).
Few recent studies have explored the relationship between exclusion from school and childrens
psychopathology (Parker et al., 2015; Whear et al., 2013). This case-control study aimed to
explore the level of psychopathology and learning difficulties and the extent to which they were
recognised and supported among children who had been excluded from school or were at risk of
exclusion (cases), compared to peers of the same age and gender who were coping well with
school (controls). Based on government statistics and literature regarding the potential
vulnerabilities of this group, we predicted that there would be higher levels of psychopathology,
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VOL. 11 NO. 2 2016

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