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In this chapter I outline the features of common neurodevelopmental disorders (NDD), the link between NDD and special educational needs and disability, and types of school attendance problems that occur for young people with NDD. I discuss common contributing factors to problems with school attendance for young people with NDD at the individual and school levels. Suggestions for promoting attendance and understanding attendance problems for young people with NDD are discussed throughout. Young people with NDD are at higher risk than their peers of having many of the risk factors for poor school attendance: low academic achievement, sensory difficulties, physical health problems, poor social or academic skills, co-occurring conditions, difficulty verbally communicating anxiety or frustration, being bullied, having difficulties with relationships, and low self-esteem. School absences in these young people may be due to a multitude of reasons, embedded in complex social conditions including family and school factors. Adaptations to the school environment and individually focussed cognitive and behavioural approaches adapted to the needs of young people with NDD are most likely to help in addressing problems with school attendance. Effective management, support and treatment of symptoms due to NDD is likely to improve the school attendance of these young people.
The occurrence of early childhood adversity is strongly linked to later self-harm, but there is poor understanding of how this distal risk factor might influence later behaviours. One possible mechanism is through an earlier onset of puberty in children exposed to adversity, since early puberty is associated with an increased risk of adolescent self-harm. We investigated whether early pubertal timing mediates the association between childhood adversity and later self-harm.
Participants were 6698 young people from a UK population-based birth cohort (ALSPAC). We measured exposure to nine types of adversity from 0 to 9 years old, and self-harm when participants were aged 16 and 21 years. Pubertal timing measures were age at peak height velocity (aPHV – males and females) and age at menarche (AAM). We used generalised structural equation modelling for analyses.
For every additional type of adversity; participants had an average 12–14% increased risk of self-harm by 16. Relative risk (RR) estimates were stronger for direct effects when outcomes were self-harm with suicidal intent. There was no evidence that earlier pubertal timing mediated the association between adversity and self-harm [indirect effect RR 1.00, 95% confidence interval (CI) 1.00–1.00 for aPHV and RR 1.00, 95% CI 1.00–1.01 for AAM].
A cumulative measure of exposure to multiple types of adversity does not confer an increased risk of self-harm via early pubertal timing, however both childhood adversity and early puberty are risk factors for later self-harm. Research identifying mechanisms underlying the link between childhood adversity and later self-harm is needed to inform interventions.
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