登校拒否症は共同研究班参加5施設で216例が経験され, その発症推定誘因, 患児の家庭環境, 患児の性格, 母親の育児態度を検討した結果, 現代の子どもたち自身がひ弱になつている面がある上に, 現在の日本の社会には子どもたちの健康な成長を歪める要因が数多く存在していることが実証された.
登校拒否症の発症を防ぐためには子どもたちの基本的権利を保障し, 健やかに成長できるような社会にしていくことが最も肝要なことであるが, 当面は親や教師を啓蒙し, 登校拒否症の前兆をできるだけ早く発見し, 適切に対応し適応障害に陥らないように努めることである.

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通院による精神療法的アプローチが困難な7名(中学2年生3名, 3年生4名)に入院治療を行つた.
教育的接近, 集団療法により, 無力性, 成績の低さを改善し, 生活習慣のみだれを調整し, 協調性を養成することで自我機能の薄弱性を強化し, 復学させることを目標とした.
マラソン, バレーボール, 英語学習などを治療の手段とした.
入院期間は5～21ヵ月で, 退院後, 登校している者が4名, 病院から原籍校に通学している者が1名, 再入院1名, 不登校状態の者が1名である.
復学した者は教育的接近のいずれか, あるいは, いくつかの効果があがり, 自我機能が強化されたために登校が可能になつたものと考えられる.

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国立療養所小児慢性疾患病棟に受け入れるべき登校拒否について明らかにするために, 平成2年度より4年度に入院した登校拒否263名を斎藤の4タイプ分類で分類し, 治療内容, 退院後の進路および社会適応, 入院中の問題行動について検討した. 治療内容はタイプによる差異はなかったが, 退院後の進路は全日制高校への進学が過剰適応タイプで多く, 他のタイプでは定時制高校への進学が比較的多くみられた. しかし, 家庭引き取りも各タイプ15%前後にみられた. 退院後の社会適応では, 過剰適応, 受動タイプで78%, 75%に良好な社会適応を認めたが, これに比べ衝動統制未熟タイプは65%, 分類不能は55%でやや低率だった. 入院中の問題行動は, 衝動統制未熟タイプの70%に認められた. 以上より, 現在の病棟構造, スタッフにおいて受け入れるべき登校拒否のタイプは, 過剰適応および受動タイプであると考える.

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Broadwin first made psychological researches into truancy in the 1930's. Since Johnson (1941) defined the term of "school phobia" discriminated from truancy, non-attendance at school has been known as the childhood neurosis. In our country, this term is used for neurotic disability of attending school.
In this communication, we h ave reported our psychotherapeutic procedures used with a 14-year-old girl who had been unable to attend school when transferring to another school. Neither her personality nor home environment were so distorted as expected. Just after admitting new class, she had quarreled with one of the classmates. Because of that, she was left alone from most of them, and she became unable to attend school. Though she had repeatedly tried to go to school over and over again. At every attempt to atttend school, she had been suffered from “IJIME (ill-treatment)”. After a few weeks, she visited our hospital together with her mother for the first time.
The authors have described the psychotherapeu tic procedures used in her treatment, and discussed about some aspects of her good school adjustment newly obtained through psychotherapy.

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北海道の情緒障害学級の実態について、郵送質問紙法による調査を行った。学級設置地域の人口規模別に分析した結果、次のような特徴が見いだされた。札幌市(人口150万人)は障害の重い自閉児の割合が高く、1学級当たりの人数が多い。担任の年齢は20〜30歳代が多く、指導形態は固定制である。人口10〜40万人の中都市では障害の重い自閉児は情緒障害学級に少なく、通級制の指導形態を含んでいる地域が半数あり、担任の年齢分布に強い偏りはない。人口4万人未満の小規模地域では、在籍児が1〜3人の小規模学級が多く、障害の重いものと軽いものが混じっている。担任の年齢は50歳代が多い。人口4〜10万人の小都市では、中都市と小規模地域の中間的な傾向がみられた。学級開設は中大都市から小規模地域へと広がっている。中学校で指導の体制をとっている情緒障害学級が中大都市9地域のうち3地域にあり、さらに増設される可能性が示唆された。

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In regard to a kind of neurosis which is called School Refusal (socalled “school-phobia”), it is said that there is a tendency to increase in recent days.
The factor in that outbreak is not simple. Interpersonal relationship in a family, as well as the moment of outbreak and the specific character of the sick child, is one of the important factors.
The environment in which the child in question is brought up, and the inclination of the attitude in the family show phenomenal tendencies to over-protection and overinterference.
The emotional entanglement between the parents, which is the motive of those tendencies (sometimes between the parents and grandfather-and-mother) and between the parents and the child (or, between the grandfather-and-mother and the child), especially the disposition and the role relation between the parents have a much influence on the formation of personality in addition to the disposition of the child.
Consequently, the child fails to take in the images of their parents which should be the psychological support over again. As a result, enlarging their sever wound, the child is driven to bay and isolated gradually. On the other hand, his parents grow increasingly uneasy, and regard the child as wilfulness on account of his rejection. In spite of this attitude, the parents are at a loss how to bring up their child, and reveal their immature disposition. These attitudes of the parents produce the vicious circle that they are drawn about by their child against their will.
On the occasion of treatment, if a case is serious, it is necessary to separate the child from his home (take to hospital) and to make him reconstruct his own self.
Moreover, the members of the family is required the efforts to recognize the role with one another, to understand their own disposition and to admit the others' situation.
In our hospital, we have the situation for the group guidance as well as the individual guidance for the family with the child in question.
Through the interaction between the members of several families, they accomplished the following aims: improvement of the immature disposition of the parents, the reduction and rmmovement of the conflict in their home, the conquest of anxiety, finding out their own roles, and adjustment of the relation to the children.
The treatment of the family with the child rejecting the school attendance is not accomplished by itself alone, It becomes meaningful when it keeps the close and imseparable connection with the treatment of the child, Besides, the effect of such a treatment can not be expected till we keep the connection with the school.

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This study examined the differences in perception among adolescents, adults and teachers towards school refusals. A questionnaire was administered to 510 adolescents, 291 adults and 152 teachers. The results were as follows: (1) The results commonly showed a rather low sympathetic and a relatively high estimative attitude towards school refusals, although teachers showed more sympathetic and less estimative than others; (2) Teachers explained the main cause of school refusals in terms of a developmental trouble in the reorganization of personality, while adolescents and adults explained them in terms of a defensive reaction of pupils against school administration and an individual pathology resulting from a poor family environment, respectively; and (3) More frequent contacts with school refusals led to an increase in sympathetic attitude towards them and a decrease in the estimative one for adolescents and adults, together with an increase in their explanation concerning the developmental perspective for adolescents. However, these tendencies did not show at all among teachers while very little in adolescents and adults. Therefore, the importance of mediative variables such as receiving a support was considered.

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