exclusion from school

J . Child Psychol. Psychiat., Vol. 13, 1972, pp. 259 to 266. Pergamon Press. Printed in Great Britain.

EXCLUSION FROM SCHOOL

ROLAND YORK

Edinburgh Corporation Department of Special Educational Servicesand

JUDITH M . HERON and SULA WOLFF

Department of Psychological Medicine, Royal Hospital for Sick Children, Edinburgh

INTRODUCTION

THIS study arose from the observation of one of us (R.Y.) that many children ex-cluded from school were seriously educationally retarded and psyehiatricallydisturbed, and that it was often very difficult indeed to make alternative educationalarrangements for them. Little attention has so far been given in the literature tochildren whose behaviour eannot be tolerated by their teaehers. Robins (1966),in her follow-up study of child guidance clinic attenders in America, found that 36per cent of ehildren excluded or suspended from school were soeiopathic in adultlife. However, the act of exclusion did not itself eontribute to the genesis of per-sistent, antisocial behaviour in ehildren, nor was there any evidence that it led toimproved behaviour. Exclusion from school was merely a pointer to other factorsinvolved in the etiology of soeiopathy. In an investigation of a home treatmentprogramme for low income multiproblem families with severely disturbed children,Levine (1964) assumed that ehildren excluded from school would be suitable indexcases. The families of seven New York boys excluded from school were studied butnot described in any detail.

In Edinburgh exclusion follows a decision by the head teacher, after consultingwith the Director of Education, that a child's behaviour is sueh that he can nolonger be tolerated within the school.

AIMS

The aims of the present study were; (1) to establish the size of the problem;(2) to examine the factors leading up to a child's exclusion from school, especiallyto discover whether this tends to be an arbitrary act on the part of a teaeher or apointer to serious pathology in the child; (3) to describe the children involved,their family and social background; and (4) to determine what alternative schoolarrangements were made for the children and whether the educational and psy-chiatric provisions available were adequate to meet their needs.

METHOD

During the two school years between August 1967 and July 1969, 31 children(including two pairs of siblings) were excluded from their schools. This group didnot include children suspended from school for only a few days. Ten other children

Accepted manuscript received 1 April 1972

2 5 9

260 ROLAND YORK, JUDITH M. HERON AND SULA WOLFF

were attending the Edinburgh Educational Child Guidance Centre or the Depart-ment of Psychological Medicine, Royal Hospital for Sick Children because of aprevious exclusion from school. These 41 children form the subjects of this study.

All 41 children were known to the Educational Child Guidance Centre; 39had also been referred to the hospital department, but only 35 attended for inter-view and the records of one child could not be traced.

The records of both clinics were scrutinised. Information was systematicallyextracted about each child and his family. All symptoms recorded anywhere werelisted and categorised by two psychiatrists independently (J.M.H. and S.W.) interms of "neurotic", "conduct" and "mixed" behaviour disorders. Agreement wascomplete except in three cases who were classified as "mixed" by one psychiatristand as "conduct" disorder by the other. Using Rutter's classification (Rutter, 1965),a diagnosis based on the psychiatric case histories was also made, again by twopsychiatrists, one of whom knew the majority of the children. Agreement, basedon independent classification, was reached in only half the cases. The final diag-nostic categories assigned were arrived at after discussion.

In October 1970, that is between one and three years following their exclusion,all children still at school were traced to find out in what type of setting they werethen being educated.

RESULTS

The .size of the problem in primary and secondary schoolsThirty-one children were excluded fi-om school in two years. During the sessions

studied the average number of children in Edinburgh Corporation Schools was67,500 (to the nearest hundred). The problem is thus numerically very small. Ofthe whole group of 41 children, 16 were excluded from primary schools out of atotal average population of 43,800; 25 were excluded from secondary schools outof a total average population of 20,600. Exclusions were thus about three times ascommon in children of secondary as in those of primary school age.

Age and sexThe mean age of the children at the time of exclusion was 12-0 years; range

5-15 years (Fig. 1). Of the 41 children, 34 were boys and seven girls.There is a suggestion that the numbers of exclusions of boys rise in the years

before transfer to secondary school and, of boys and girls, in the year prior to leavingschool.

Type of schoolOf the primary school children, 6 were at a day school and 1 at a residential

school for maladjusted children, 5 attended a day school for the mentally handi-capped, and 1 a school for the physically handicapped. (In Edinburgh there arcat present no day schools for maladjusted children of secondary school age, anduntil 1971 the only secondary residential school for the maladjusted catered only forchildren of above average intelligence.)

In all, 13 of the 41 children excluded from school were already attending sometype of special school, out of a total special school population averaging 858 for the

EXCLUSION FROM SCHOOL 261

BoysGirls

FIG.

Age, yr

1. Distribution of age for boys and girls at exclusion from school.

relevant school years. This is more than thirty times the proportion of childrenexcluded from ordinary schools.

Sex ratioAmong the 41 children, 34 were boys and seven were girls. This exeess of boys

far exceeds the usual excess of three boys to two girls among child psychiatric clinicattenders (Rutter, 1966).

The exclusionThe child's contribution. An act of aggressive or disruptive behaviour on the part

of the child always precipitated the exclusion. The child's behaviour was oftendangerous. In every case it was the culmination of a series of incidents. Frequentlyteachers gave multiple reasons for deciding that the child could no longer betolerated in school. Eleven children had physically attacked another child (theattack was usually described as "vicious"); one child threw a lighted firework intothe classroom; another threw a glass tumbler across the room; one child, a psychoticboy, was described as "not with you". The rest were described as aggressive, dis-ruptive, unco-operativc and subject to intolerable outbursts of temper. Althoughmany children also stole, thefts did not precipitate exclusion.

Other factors. It was thought possible that children might be more difSeult atschool during the winter months when the short evenings curtail outdoor play.The dates of exclusion were known for 40 of the total group of 41 children studied.Fourteen were excluded during the five and a half months of schooling (mid-March to mid-October) when day-light hours are long; 26 during the remainingfour and a half months of schooling at times of relative darkness. Thus over twiceas many ehildren were excluded during the time of year when opportunities foroutdoor play are restricted.


II was also thought that more exclusions might occur towards the end of aschool term when teachers and children are likely to be fatigued. In fact, wheneach term was divided into three equal periods, it was found that more exclusionstook place in the middle thirds of the school terms (23 compared with eight in thefirst, and 13 in the last thirds). The mid-term peak may reflect the time lag involvedfor a child's behaviour to become intolerable for the teacher. Towards the end ofterm teachers may be able to put up with difficulties more readily, knowing that aholiday break is near.

The childrenIntelligence. Results of intelligence tests were available for 40 children. The

Wechsler Intelligence Scale for Children (Full Scale I.Q..) was used in 34 cases,the Terman-Merrill L-M Scale in six. One child was incompletely tested but wasbelow average on Raven's Matrices. In Table 1, the distribution of intelligence ofchildren excluded from school is compared with that expected in the generalpopulation of Scottish school children. The excluded children were intellectuallyfar inferior to the general population of Scottish school children. Twenty-six excludedchildren had an intelligence score of less than 90, compared with an expected numberof 10.

TABLE I. DISTRIBUTION OF INTELLIGENCE IN EXCLUDED

CHILDREN COMPARED WITH THAT EXPECTED IN THE GENERAL

POPULATION OF SCOTTISH SCHOOL CHILDREN

I.Q.. < 70 70-89 90-109 110 +

No. of excluded 6 20 13 1children *

Expected no. ofScottish school 0-88 9-12 20 10

* Unknown In one case.

Educational attainments. Attainment test results were available for 38 children (onechild was too young to be tested; two were incompletely assessed). Using as anarbitrary index of backwardness in reading a reading age of two and a half yearsbelow the child's chronological age, 25 of the 38 children were backward readers.In addition five children were backward in reading by between two and two anda half years, and only six children had a reading age equivalent to their chrono-logical age.

Behaviour. Between them the children had a recorded repertoire of 39 symptoms.Thirty-four children had five or more symptoms. Aggressive, and anti-social symp-toms predominated. Thirty-eight children were described as aggressive, 21 hadtemper tantrums, 19 stole, 17 were disobedient, 15 a distracting infiuence in theclassroom, 14 attention-seeking in the classroom, 13 wandered, 12 were restless,12 were described as "abusive", 11 truanted and 11 could not get on with otherchildren. Two children had taken overdoses.


Fifteen ehildren had appeared in eourt; eleven on a charge of theft or shoplifting(one of these also committed a breach of the peace, another was found guilty ofvandalism, and a third of using threatening behaviour); three children werecharged with assault and aggression; and one with contravening the road trafficaet by driving the family ear.

As a group the ehildren were extraordinarily delinquent and aggressive, 'lhisis reflected in the symptom categories to which their behaviour was assigned. Thebehaviour of 33 children was classified as of "conduct" disorder type; that of eightchildren as of "mixed" type; no ehild displayed behaviour of a "neurotic" type.

Psychiatric diagnosis. The primary psychiatric diagnosis assigned to ihe 34 childrenfor whom psychiatrie records were available were as follows:

Conduct disorder 17Mixed behaviour disorder 7Mental subnormality 4Hyperkinetic syndrome 3Depressive illness 2Childhood psychosis 1

The following criteria for possible cerebral dysfunction were used: a definitehistory of obstetric damage or severe prematurity (under 4 | lb); a history of con-vulsions; an abnormal E.E.G.; abnormal neurological signs; a clinieal diagnosis ofhyperkinetic syndrome. By these eriteria, eight of the 34 children for whom hospitalrecords were available had evidence of possible cerebral dysfunction and three werediagnosed as hyperkinetic compared with 3 out of 103 primary school childrenattending the same ehild psychiatric department (Wolff, 1967).

Physical health. In the absence of a control population it was not possible todetermine the relative state of phsyical health of the children. Neurological diseasecontributed to the psychiatric disorder of four children (one had had a cerebralabscess in the second year of life; one had had a serious head injury; one childwas epileptic; and one had a mild spastic paraplegia). Twelve children had beenin hospital more than once; one boy had a late circumcision; one an operation forundescended testicles. Four children had minor physical handicaps (two had de-fective vision; one a mild speech defect; one had eczema). On the whole however,the children seemed in good physical health at the time of examination.

The social backgroundThe occupation of the father was known in 37 cases and was classified according

to the Registrar General's Classification of Occupations (1966). Table 2 shows thedistribution of the social class of the fathers of excluded children compared withthat of economically active men in the Edinburgh City Census (1966). Only onechild had a father of social class II and this man's second job fell into categoryIII. There was a marked excess of families in social classes IV and V.


TABLE 2. SOCIAL CLASS DISTRIBUTION OF FATHERS OF

EXCLUDED CHILDREN COMPARED WITH ECONOMICALLY

ACTIVE MEN IN EDINBURGH, 1966

Social class I + II III IV + V

No. of fathers of 1 20 16excluded children *

Expected no. ofeconomically active 7-8 20 9-2men in Edinburgh

* Unknown in four cases.

The familiesFamily disruption. The family composition was known in 37 cases. In only 22 of

these were the children actually living with both natural parents. These 22 childrenincluded two pairs of siblings, so that only 20 out of 35 families were in fact complete.One child had been adopted. Among the 20 complete families, parental discordwas noted in 16. In addition one father spent much time at sea. Out of 37 children,therefore, only 5 lived consistently at home with both natural parents who were inaccord.

Parental ill health and delinquency. Three parents were seriously ill physically; onefather had had several abdominal operations and a coronary thrombosis; one fatherwas dying of a carcinoma of the throat; one mother had lost both legs and the useof one arm as a result of vascular disease. Three other parents were mildly disabledby physical illhealth.

More striking was the frequency of psychiatric disorder, especially sociopathy,among the parents. In the 34 psychiatric records three mothers were described ashaving a current depressive illness; five mothers as being "intellectually dull";and 22 (10 mothers and 12 fathers) as having a personality disorder. In addition, 2mothers and 4 fathers had drinking problems; 1 step-father had committed murderand 1 theft. Only 7 of the 34 children seen in the hospital department had parentswithout psyehiatric disability or evidence of personality disorder.

Six fathers of the total group of 41 children were known to have been in prison(for murder, assault, stealing and drunkenness); one mother had been imprisonedfor child neglect.

Delinquency among siblings. Three children had brothers in Approved Schools ora Detention Centre.

Follow-upBy October, 1970, 16 children had either left school or the district and were

not traced. Of the remaining 25 children, seven were in Approved Schools; 6 inresidential schools for the maladjusted; 4 in psychiatric or mental deficiency hos-pitals; 2 in children's homes and attending an ordinary school; 2 in day schoolsfor mentally handicapped children but living at home; and only 4 children wereboth living at home and attending ordinary schools.


Tluis, of" the 25 children still at school one to three years after exclusion, onlyfour were both living at home and attending ordinary schools. None of the childrenwere however, at the time of follow-up, giving rise to any particular managementproblems in the setting in which they found themselves.

DISCUSSIONLittle attention has so far been given to the numerically very small, but for

cducaton and psychiatrists extremely difficult, group of children who each yearare excluded from school. The problem is greater in boys than girls, and in olderthan in younger children. There are hints that opportunities for outdoor play mayreduce classroom difficulties, and that teachers' tolerance for children's disruptiveand aggressive behaviour is lowest at mid-term. The present study however, showsconclusively that children excluded from school are severely disturbed psychiatricallyand have serious educational handicaps. Exclusion from school is not an arbitraryact on the part of a teacher and headmaster. It results from the inability of sociallydeprived, dull children, usually boys, and often from disrupted families with socio-pathic parents, to meet the demands of school life.

Although a third of the children were already attending small classes In specialschools, this had not succeeded in preventing exclusion: on the contrary, pro-portionally more children were excluded from special than from ordinary schools.It must be pointed out that in Edinburgh, day schools for the maladjusted and thementally handicapped have only female teaching staff, and that aggressive behaviourof big boys in these schools is difficult to channel and control.

The children studied were extraordinarily aggressive and delinquent and ineight minimal cerebral dysfunction probably contributed to both their intellectualdeficits and behaviour disorders.

Not only were the children intellectually dull and seriously backward education-ally, they also came from family environments characterised by low socio-economicstatus. Moreover, the occurrence of family disruption, marital discord, personalitydisorder and delinquency among parents was very high. Forty-one per cent ofchildren were not living with both their own parents, compared with 28 per centof consecutive primary school children referred to and seen at the same departmentwith behaviour disorders, and 29-1 per cent in Rutter's (1966) somewhat olderdisturbed children. In the 32 families of the 34 hospital attenders twelve mothers(37-5 per cent) and eighteen fathers (56 per cent) in all showed evidence of per-sonahty disorder, compared with 41 per cent of mothers and 29 per cent of fathersof primary school children attending the same department with behaviour dis-orders (Wolff c/ al., 1968). The excess of personality disordered fathers in this ratherolder group of children presenting almost exclusively with conduct disorders isparticularly striking.

The limited follow-up information available for the 25 children still at schoolone to three years after their exclusion, indicates that their behaviour disorders inthe school setting were by no means transient. While at the time of exclusion onlyone child was not living at home, at the time of follow-up 21 children were inresidential care of some kind. In a more structured environment away from family


stresses, these children were now contained at school. It must be said, however, thatto find a residential school, psychiatric in-patient unit or children's home willingto accept these severely disturbed children at very short notice was often difficult.In many cases alternative, sometimes part-time, day schooling had to be arrangedas an interim measure.

As a group, these aggressive and educationally backward children excludedfrom school were characterised by many features of psychiatrically disturbedchildren known to be of poor prognostic significance. They tended to be poorlyendowed intellectually, often had evidence of cerebral dysfunction, came from soci-ally deprived backgrounds and frequently disrupted homes in which marital discordand parental sociopathy prevailed. The ultimate outcome in the present group isunknown. It is not surprising that Robins (1966) found over a third of childrenexcluded from school to be sociopathic in adult life.

SUMMARY

(1) Exclusion from school is numerically a small problem. Forty-one childrenexcluded from Edinburgh schools are described. (2) Exclusion from school occurredmore often in secondary schools and much more often in boys. While commonerwhen opportunities for outdoor play are reduced in the winter months and com-monest at mid-term, it is by no means the result of an arbitrary decision by a teacher,but the culmination of a series of aggressive acts by a seriously disturbed child whois usually poorly endowed intellectually, backward educalionally, socially deprivedand with a family background characterised by disruption, marital disharmony,and sociopathy and delinquency on the part of the parents. A high proportion ofexcluded children were already attending special schools. (3) One to three yearslater only 4 out of 25 children still at school were living at home and attendingordinary schools; 19 were in psychiatric hospitals, residential schools or children'shomes.

REFERENCESGENERAL REGISTER OFFICE (1966) Classifications of Occupations, H.M.S.O., London.GENERAL REGISTER OFFICE (1966) Sample Census—Scotland., Edinburgh.LEVINE, R . A. (1964) Treatment in the home: an experiment with low income multi-problem

families. In Mental Heallh of the Poor (Edited by RIESSMAN, F. , COHEN, J. and PEARL, A.), FreePress of Glencoe, Collier-Macmillan, London.

ROBINS, L . N . (1966) Deviant Children Grown-up. Williams & Wilkins, Baltimore.RuTTF.R, M. (1965) Classification and categori.sation in child psychiatry. J. Child Pshcyol, Psychiat.

6, 71-78.RUTTER, M . (1966) Children of Sick Parents. Maudsley Monograph \ o . II, Oxford University Press,

London.SCOTTISH COUNCIL FOR RESEARCH IN EDUCATION (1967) Scottish Standardization of Wechslcr Intelligence

Scale for Children. Edinburgh.WOLFF, S. (1966) Behavioural characteristics of primary school children referred to a psychiatric

department. Br. J. Psychiat. 113, 885-893.WOLFF, S. and ACION, W . P. (1968) Characteristics of parents of disturbed children. Br. J. Psychiat.

114, 593-601

exclusion from school

Documents