The school guidance counselor refers a family with an 8-year-old child to mental health clinic because of child’s frequent fighting in school and truancy. Which of following data would be a priority to nurse doing initial family assessment?

Correct Answer: C. The family’s perception of the current problem

The family’s perception of the problem is essential because change in any one part of a family system affects all other parts and the system as a whole. Each member of the family has been affected by the current problems related to the school system and the nurse would be interested in the data. Research indicates at-risk youth are more likely to experience emotional and psychological problems. Young people who are often truant from school represent a group of at-risk youth, but one for which mental health issues are understudied.

• Option A: The child’s performance in school and the teacher’s attempts to solve the problem are relevant and may be assessed; however, priority would be given to the family’s perception of the problem. Truancy is a serious problem that affects most school districts in the U.S. Research on truancy can be challenging because there is not a uniform definition of truancy and statistics on truancy rates are lacking and/or inconsistently reported across school districts. Psychological research reports a high prevalence of mental health problems among youths characterized as school refusers. School refusers demonstrate symptoms of mood disorders such as depression and dysthymia, anxiety disorders such as generalized anxiety, separation anxiety, and panic disorder, and disruptive behavior disorders such as oppositional defiant, attention deficit hyperactivity disorder (ADHD) and conduct disorders.
• Option B: The family education and work history may be relevant, but are not a priority. Generally, truancy is defined as unauthorized, intentional absence from compulsory schooling. It is estimated that thousands of youth in the U.S. are absent from school each day. For example, recent statistics on truancy in Los Angeles County and Colorado indicate truancy rates greater than 10 percent, with the highest rates in urban high schools. Comparable statistics corroborating high rates of truancy can also be found in other jurisdictions.
• Option D: Truancy appears to be a risk factor for a life-course trajectory toward more negative behaviors. As Garry observed, truancy may be the beginning of a lifetime of problems among students who routinely skip school, including poor standardized test performance, high school dropout, a stressed family life, difficulties in emotional/psychological functioning, drug use, and progression to both juvenile delinquency and adult criminal offending. Related research has also documented a link between truancy and later problems with employment, adult crime and incarceration.