Estimating the prevalence of school refusal and associated psychopathology in an Arab community sample of children in the United Arab Emirates

Objective: To study the prevalence of 'school refusal in the United Arab Emirates. Methods: A community survey of a stratified sample (N=1100) of 6-12 year old primary school children was carried out in Al Ain city, United Arab Emirates using the Parents' and Teachers' versions of the Rutter Questionnaire for children's psychological health. Results: Completed reports about 911 children were obtained. Of them, 4.1% had school refusal (refusal to go to, or getting distressed when they arrive at school). The prevalence rate was higher in boys than girls. Those with school refusal were compared to non-refusers matched for school, age and gender. The results showed that refusers showed higher rates of psychopathology (46% vs. 20% according to teachers' reports and 27% vs. 3% according to parents' reports). However, contrary to expectations, refusers were mostly showing behavior problems (14%-35%) rather than emotional problems (8%-14%), particularly in older children. Conclusion: School refusal is infrequent in Arab children in the United Arab Emirates, but is more likely to be associated with symptoms of behavioral disorders. Possible explanations for these findings are discussed.