Remote Education/Homeschooling During the COVID-19 Pandemic, School Attendance Problems, and School Return–Teachers’ Experiences and Reflections

According to Norway’s Educational Act (§2-1), all children and youths from age 6 to 16 have a right and an obligation to attend free and inclusive education, and most of them attend public schools. Attending school is important for students’ social and academic development and learning; however, some children do not attend school caused by a myriad of possible reasons. Interventions for students with school attendance problems (SAPs) must be individually adopted for each student based on a careful assessment of the difficulties and strengths of individuals and in the student’s environment. Homeschooling might be one intervention for students with SAPs; however, researchers and stakeholders do not agree that this is an optimal intervention. Schools that were closed from the middle of March 2020 due to the COVID-19 pandemic provided an opportunity to investigate remote education more closely. An explorative study was conducted that analyzed 248 teachers’ in-depth perspectives on how to use and integrate experiences from the period of remote education for students with SAPs when schools reopen. Moreover, teachers’ perspectives on whether school return would be harder or easier for SAP students following remote education were investigated. The teachers’ experiences might be useful when planning school return for students who have been absent for prolonged periods.publishedVersio

Does homeschooling fit students with school attendance problems? Exploring teachers’ experiences during COVID-19

Attending school on a regular basis and completing school is usually seen as a precondition for students’ academic, emotional, and social learning and development. However, some students struggle with school attendance problems (SAPs) for a myriad of reasons. Homeschooling is a topic of concern in long-term or problematic SAP cases. Some scholars claim that school absenteeism might increase and be maintained, while others argue that homeschooling may reduce students’ anxiety associated with school attendance. Regardless, homeschooling is often an intervention for academic learning and/or as a part of gradual reintegration to school for SAP students. Moreover, homeschooling/home education/home tuition is not a new phenomenon and is an intervention for students with long-term sickness. When schools in many countries closed from the middle of March 2020 caused by the COVID-19 pandemic, all students were homeschooled. This gave us the opportunity to investigate homeschooling more closely. In the current study, teachers’ thoughts and experiences of homeschooling for students with SAPs prior to the pandemic are investigated. The main aim was to gain more insight into and knowledge about homeschooling: does it work for SAP students? Practical implications of homeschooling for SAP students are discussed.publishedVersio

Familieambulatoriet - en vellykket modellfor identifisering av sped- og småbarn i risiko?

Studien undersøkte om en pilot-implementering av Familieambulatoriet i Norge har lyktes med å rekruttere og identifisere sped- og småbarn og deres familier med forhøyet risiko basert på dokumentasjon i sykehusjournal. Familieambulatoriet er en modell for å støtte gravide/småbarnsforeldre med rus- og psykiske problemer og tilbyr oppfølging fram til barnets skolestart. Resultatene viste signifikante forskjeller mellom brukere av Familieambulatoriet og den generelle befolkningen, og at Familieambulatoriet langt på vei rekrutterer og identifiserer gravide kvinner, sped- og småbarn i risiko for psykisk skjevutvikling, men at modellen trenger økt kvalitetssikring slik at risikofaktorer systematisk blir dokumentert

Divergent decennial trends in mental health according to age reveal poorer mental health for young people: Repeated cross-sectional population-based surveys from the HUNT Study, Norway

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School children’s mental health during the COVID-19 pandemic

Introduction: The COVID-19 pandemic significantly impacted the daily routines of children, with social distancing and quarantine leading to reduced social interactions and potential increased conflicts within families. These factors can increase the risk for anxiety and depression while reducing overall quality of life. Methods: Our study included 1843 school children aged 8 to 12 from 56 schools over a 2.5-year period before and during the pandemic. This multi-wave cross-sectional study utilized baseline data from an optimization trial of an indicated preventive intervention. The main outcomes were self-reported symptoms of anxiety and depression, and quality of life was the secondary outcome measure. Furthermore, responses to COVID-relevant questions were measured using a self-composed scale. Our objectives were to compare anxiety and depression symptom levels between cohorts of children who participated in the study before and during the pandemic, to examine if anxiety or depression predicted the COVID response, and whether anxiety and depression and subtypes of anxiety had an impact on quality of life during the pandemic. Linear regression and interaction models were used to examine relevant associations. Results: Levels of anxiety and depression were higher in all waves compared to pre-pandemic levels. Quality of life was lower during the pandemic than before the pandemic, particularly among children with generalized anxiety symptoms. Quality of life was negatively associated with loneliness. Discussion: Our study revealed that children reported higher anxious and depressive symptoms during the pandemic compared to pre-pandemic levels, as well as reduced quality of life. Lockdowns and restrictions may have contributed to this burden. Additionally, self-reported loneliness was a significant possible consequence of the restrictive measures imposed on children during the pandemic. Additional research is needed to investigate the long-term effects of the pandemic on children, particularly regarding the stability of elevated levels of anxiety and depression. Such studies could examine whether these conditions are indicative of a trajectory toward more severe internalizing disorders.School children’s mental health during the COVID-19 pandemicpublishedVersio

Inside the clockwork of the ECHO factorial trial: A conceptual model with proposed mediators for prevention of emotional problems in children

Having interventions that are not only evidence-based and effective but also cost-effective and efficient is important for the prevention and treatment of child and adolescent emotional problems. A randomized clinical trial (RCT) tests the totalinterventions effect but does not address specific components of the intervention. In this article the hypothesis and a conceptual model of the ECHO study are presented and discussed. The ECHO intervention consists of three different components each containing two levels of intervention. By using a cluster randomized factorial design, children aged 8–12 at 40 schools across Norway will be randomized to eight different experimental conditions investigating the optimal balance between effect, cost-effectiveness, and efficiency. The article presents the design and the different components being tested and discusses how optimalization can be reached through this innovative design. The article also discusses how interventions can be improved by investigating and understanding the mechanisms of change within psychological interventions. For each of the three components in the study we consider the mediators that could be active within the intervention and how the study investigates such mediation. The results will contribute to a better understanding of how psychological interventions work and how we intend to optimize the EMOTION intervention

Study Protocol of a factorial trial ECHO: Optimizing a group-based school intervention for children with emotional problems

Background - Youth mental health problems are a major public health concern. Anxiety and depression are among the most common psychological difficulties. The aim of this study is to evaluate an optimized version of a promising indicated group intervention for emotional problems. The program (EMOTION Coping Kids Managing Anxiety and Depression) targets school children 8–12 years with anxious and depressive symptoms and examines three factors. Factor 1 compares the standard EMOTION intervention delivered in 16 group-based sessions (Group), versus a partially-digital EMOTION intervention (DIGGI) delivered as eight group sessions and eight digital sessions. Both versions use virtual reality technology (VR) to improve behavioral experiments. Factor 2 compares parent participation in a 5-session parent group (high involvement) versus sharing information with parents via a brochure (low involvement). Factor 3 compares the use of a measurement and feedback system (MFS) designed to help group leaders tailor the intervention using feedback from children with no MFS. Methods - Using a cluster-randomized factorial design, 40 schools across Norway will be randomized to eight different experimental conditions based on three, two-level factors. To assess internalizing symptoms in children, children and their parents will be given self-report questionnaires pre-, post-, and one year after intervention. Parents also report on demographics, user satisfaction, personal symptoms and perception of family related factors. Teachers report on child symptoms and school functioning. Group leaders and the head of the municipal services report on implementation issues. The primary outcomes are changes in depressive and anxious symptoms. Some secondary outcomes are changes in self-esteem, quality of life, and user satisfaction. Questions regarding the consequences of the COVID-19 pandemic are included. Treatment fidelity is based on checklists from group leaders, and on user data from the participating children. Discussion - This study is a collaboration between three regional centers for child and adolescent mental health in Norway. It will provide knowledge about: (1) the effect of school-based preventive interventions on anxiety and depression in children; (2) the effect of feedback informed health systems, (3) the effect and cost of digital health interventions for children, and (4) the effect of parental involvement

Optimizing indicated cognitive behavioral therapy to prevent child anxiety and depression: A cluster-randomized factorial trial

Identifying effective components can lead to interventions that are less resource-intensive and better suited for real-world needs. In this 2×2×2 cluster-randomized factorial trial (clinicaltrials.gov NCT04263558), we investigated the effects of three components of an indicated, transdiagnostic CBT intervention for children: 1) Intervention Delivery Format (child group format versus a blended format with group sessions and automated web-based sessions), 2) Parental Involvement in the intervention (group-based versus psychoeducational brochure), and 3) a Measurement Feedback System (MFS; on versus off). The intervention was delivered at schools in a group-based format. The participants (N = 701 children) were school children (age 8–12 years) with elevated symptoms of anxiety or depression, and their parents. The main outcomes were self-reported (N = 633) and parent-reported (N = 725) symptoms of child anxiety and depression post-intervention. The secondary outcome was children's user satisfaction with the intervention. We did not find significant main or interaction effects of Delivery Format, Parental Involvement, or MFS on children's symptom levels. There were no significant effects on children's user satisfaction. Results were compatible with retaining the least resource intensive combination (i.e., blended format, parental brochure, no MFS) in an optimized intervention.Optimizing indicated cognitive behavioral therapy to prevent child anxiety and depression: A cluster-randomized factorial trialpublishedVersio

Inside the Clockwork of the ECHO Factorial Trial: A Conceptual Model With Proposed Mediators for Prevention of Emotional Problems in Children

Having interventions that are not only evidence-based and effective but also cost-effective and efficient is important for the prevention and treatment of child and adolescent emotional problems. A randomized clinical trial (RCT) tests the total interventions effect but does not address specific components of the intervention. In this article the hypothesis and a conceptual model of the ECHO study are presented and discussed. The ECHO intervention consists of three different components each containing two levels of intervention. By using a cluster randomized factorial design, children aged 8–12 at 40 schools across Norway will be randomized to eight different experimental conditions investigating the optimal balance between effect, cost-effectiveness, and efficiency. The article presents the design and the different components being tested and discusses how optimalization can be reached through this innovative design. The article also discusses how interventions can be improved by investigating and understanding the mechanisms of change within psychological interventions. For each of the three components in the study we consider the mediators that could be active within the intervention and how the study investigates such mediation. The results will contribute to a better understanding of how psychological interventions work and how we intend to optimize the EMOTION intervention