Abstract
Background: Autistic students face a range of challenges that can make regularly attending school difficult. Extant literature is sparse but indicates autistic students have lower school attendance compared to the general population. However, these studies are often limited by small samples and parent reported data.
Aims: Use whole-of-population data to examine school attendance among autistic students compared to non-autistic students and explore type of non-attendance.
Methods: National retrospective cohort study using population-level data on students aged 5 to 16 years in 2018. Autism identified using diagnostic information contained within multiple health datasets. Regular attendance defined as attending 90% or more of school half days. Association between autism and attendance estimated using complete-case 2-level random intercept modified Poisson regression. Adjusted models controlled for age, sex, ethnicity, deprivation level, rurality and accounted for the correlation structure of the data with students nested within schools.
Results: Among 654,438 enrolled students, 8,427 (1.3%) were autistic. In adjusted analyses, autism was associated with significantly decreased likelihood of regular attendance (incident rate ratio 0.88; 95% confidence interval, 0.86-0.90). The driver for lower attendance among autistic students was justified absence (8.2% of recorded attendance hours for autistic students vs. 5.0% for non-autistic students), in particular medical absence (5.7% vs 4.1%).
Discussion/Conclusion: The findings of this study raise a number of concerns around inclusionary practices and unmet need for autistic students. To improve attendance of autistic students, comprehensive and targeted supports are required to help the student, whānau, and school.