Bowden Nicholas, Anns Francesca, Vu Hien, Dacombe Joanne, Muir Colette, Russell Jin, van der Meer Larah, Williams John, Clendon Sally
Women's and Children's Health, University of Otago, Dunedin, New Zealand.
COMPASS Research Centre, University of Auckland, Auckland, New Zealand.
J Paediatr Child Health. 2025 Apr;61(4):609-616. doi: 10.1111/jpc.16795. Epub 2025 Jan 28.
Extant literature indicates autistic students have lower school attendance compared to the general population. However, there remains considerable heterogeneity between studies, a lack of large population-based studies beyond the UK and US, and insufficient consideration of age and sex differences in attendance rates. The aim of this study was to examine school attendance among autistic compared with non-autistic students including stratification by age and sex.
This was a national retrospective cohort study using population-level data on students aged 5 to 16 years in 2018. Autism was identified using diagnostic information contained within multiple health datasets. Regular attendance was defined as attending 90% or more of school half days. The association between autism and attendance was estimated using complete-case 2-level random intercept modified Poisson regression.
Among 654 438 students, 8427 (1.3%) were autistic. In adjusted analyses, autism was associated with significantly decreased likelihood of regular attendance (incident rate ratio [IRR] 0.88; 95% CI, 0.86-0.90). Age and sex stratification revealed significant age differences with likelihood of regular school attendance lower for younger autistic students (5-11 years) (IRR 0.85; 95% CI, 0.83-0.87) while sex differences were marginal. The most frequent type of non-attendance among autistic students was justified (including medical) absence (8.2% of recorded attendance hours for autistic students vs. 5.0% for non-autistic students).
This study provides further, whole-population evidence of the significant disparities experienced by Autistic students. To improve attendance of autistic students, comprehensive and targeted supports are required to help the student, family and school.
现有文献表明，与普通人群相比，自闭症学生的上学出勤率较低。然而，研究之间仍存在相当大的异质性，除英美之外缺乏基于大量人群的研究，并且在出勤率方面对年龄和性别差异的考虑不足。本研究的目的是比较自闭症学生与非自闭症学生的上学出勤率，包括按年龄和性别分层。
这是一项全国性回顾性队列研究，使用了2018年5至16岁学生的人群水平数据。利用多个健康数据集中包含的诊断信息来识别自闭症。正常出勤定义为出勤天数达到学校半日制天数的90%或更多。使用完全病例2级随机截距修正泊松回归估计自闭症与出勤率之间的关联。
在654438名学生中，8427名（1.3%）为自闭症学生。在调整分析中，自闭症与正常出勤的可能性显著降低相关（发病率比[IRR]为0.88；95%置信区间，0.86 - 0.90）。年龄和性别分层显示出显著的年龄差异，年龄较小的自闭症学生（5至11岁）正常上学出勤率较低（IRR为0.85；95%置信区间，0.83 - 0.87），而性别差异不明显。自闭症学生最常见的缺勤类型是合理（包括因病）缺勤（自闭症学生记录出勤小时数的8.2%，而非自闭症学生为5.0%）。
本研究进一步提供了全人群证据，证明自闭症学生存在显著差异。为提高自闭症学生的出勤率，需要全面且有针对性的支持来帮助学生、家庭和学校。
