School Refusal Assessment Scale Revised (SRAS-R)

The School Refusal Assessment Scale (SRAS) was first constructed by Kearney and Silverman (1993) and then revised in 2002 (Kearney). The scale was created to overcome shortcomings from previous classification systems including an over reliance on clinical judgement rather than empirical evidence leading to a lack of rater reliability, issues with validity and lack of utility in treatment (Kearney & Silverman, 1993). The SRAS was designed to assess the function, rather than the form, of school refusal behaviour and has been used on children aged 6-17 years. The SRAS was constructed based on the authors clinical observations as well as research studies looking at successful treatment targeting specific behaviours relating to school refusal. The revised scale identified four functions of school refusal which included: (a) avoidance of school-related stimuli provoking negative affectivity (e.g., teacher, test), (b) escaping from aversive social or evaluative situations, (c) to get attention from others and (d) to pursue positive tangible reinforcement outside of school (e.g., television, play). The first two are centred around negative reinforcement and the other two around positive reinforcement of school refusal behaviour.

The SRAS-R is a 24-item measure with six items devoted to each function. Each item is presented on a Likert scale ranging from 0-6 with 0 being never and 6 being always. A mean score is calculated for each function and are ranked from highest to lowest. The condition that scores the highest is interpreted as the primary maintaining function of school refusal however the scores on the other conditions are also taken into account when developing a treatment plan. This gives the questionnaire both typological and dimensional properties (Kearney & Silverman, 1993). If two functions are within .25 of one another they are ranked as equal. The SRAS-R consists of a child and parent questionnaire with the wording on items altered slightly for each target audience. This allows scores to be combined from each respondent to create a more complete picture of school refusing. It also allows a clinician to examine differences between respondents and use this information in designing and targeting treatment.

The SRAS was revised to improve psychometric properties, increase score range and to modify the functional model (Kearney, 2002). All items on the parent and child questionnaire had significant test-retest reliability over a 7 to 14-day period. Mean correlations for each function subscale on the parental questionnaire ranged from .61- .78 and from .56- .78 on the child version. All but two items had significant inter-rater reliability on the parent questionnaire with mean correlations for each subscale ranging from .46 to .57.

Factor analysis has identified three main constructs of the scale which include a combination of the first two negative reinforcement functions, attention seeking and tangible reinforcement. The revised version of the scale was shown to have good concurrent validity for each function subscale with the original version of the scale (r range from .65 to .77). The SRAS-R also shows good concurrent validity with the Fear Survey Schedule for Children-Revised and the State-Trait Anxiety Inventory for Children for the negative reinforcement functions. Furthermore, diagnosed internalising disorders tend to be more common with negatively reinforced school refusers, separation anxiety disorders are generally more common for attention based school refusal and oppositional defiant and conduct disorder are generally more common for school refusing based on tangible reinforcement (Kearney, 2002). However, comparisons between other measures of internalising and externalising symptoms and the SRAS have shown nonsignificant associations although they were in the direction expected.

Further work needs to see if it is possible to distinguish between function one and two or if they need to be subsumed under a function of negative reinforcement. However, youth normally do score higher in one function or the other. Nevertheless, the SRAS-R is useful for understanding the function of school refusal, help the design of treatment interventions and to see any changes in function over the course of treatment.

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