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Development and Validation of the School Refusal Evaluation Scale1 for Adolescents

Objective
School refusal (SR) is considered as a clinical form of emotionally based school absenteeism related to the experience of strong negative emotions when attending school. However, there are no psychometrically sound measures specifically designed to assess SR. The aim of the present research was to develop and validate a multidimensional self-report measure of SR: the SChool REfusal EvaluatioN Scale (SCREEN) for adolescents.


Methods
Two studies were performed to develop this scale. Study 1 used content analysis on 42 semi-directed interviews to identify and organize the indicators of SR and to generate items. The item pool was then reviewed by experts to construct a pilot scale. Study 2 examined the psychometric properties of this pilot scale of the SCREEN in a community sample of 649 French adolescents (age: 10-16 years) and a clinical sample of 31 adolescents.


Results
The initial SCREEN structure was identified via exploratory factor analysis, and the resultant model was validated using confirmatory factor analysis. In its final version (an 18-item, four-factor measurement model), the SCREEN reliably measures four interrelated aspects of SR. Data suggest good reliability and validity of scores on this SR measure. Results of the receiver operating characteristic (ROC) curve analysis indicated good accuracy of the SCREEN (sensitivity = .94 and specificity = .88).


Conclusions
The SCREEN offers a new and valid measure to assess SR in research and clinical settings.