School absenteeism in autistic children and adolescents: A scoping review.
Viviann Nordin, Maud Palmgren, Anna Lindbladh and 2 others
PMID 38159071WHAT IT FOUND
Autistic children miss school more often than peers, especially those with co-occurring mental health conditions.
Current interventions are small, uncontrolled, and lack evidence of efficacy. Schools should focus on individualized accommodations and early detection rather than relying on proven treatment programs.
Key findings
01Population-based studies show autistic children have significantly higher rates of chronic absenteeism and school exclusion compared to non-autistic peers, with risk increasing substantially when co-occurring conditions like ADHD or depression are present.
02Intervention evidence is very weak: the identified studies were small (1 to 31 participants), had no comparison groups, and did not test efficacy, meaning no treatment is currently proven to improve attendance in this population.
03Contextual factors such as bullying, lack of staff competence in autism, and insufficient environmental adaptations are frequently linked to absenteeism, suggesting a need for school-level changes rather than just student-focused therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review did not assess the quality or risk of bias of the included studies. There was significant heterogeneity in how absenteeism was defined and measured across studies. Most studies were conducted in high-income countries (US, UK, Australia), limiting generalizability. Intervention studies were very small and lacked control groups, so no conclusions about efficacy could be drawn. The review excluded gray literature and studies where autism data were not reported separately from other disabilities.
Declared interests
One author (S.B.) has acted as a consultant or lecturer for Medice and Roche, receives royalties from Hogrefe and Liber, and is a partner in NeuroSupportSolutions International AB. The work was funded by Region Stockholm.
The easy way to misread this
Do not interpret the small, uncontrolled intervention studies as evidence that any specific therapy works for school absenteeism in autism. The review found no robust evidence of efficacy, so clinical decisions should be based on individualized assessment and accommodation rather than adopting a specific treatment protocol as proven.