Children and youth’s participation in encounters with health services, child welfare services and schools: a scoping review
Mapping review
|Published
The aim was to investigate how schools, school owners, and collaborating agencies can facilitate student participation in the prevention, early intervention, and follow-up of school absenteeism.
Key message
According to the Norwegian Education Act, students who are absent from primary or secondary education must be followed up. Thet also have the right to participate in matters concerning themselves and be heard.
Our research question was: What systematic reviews exist regarding children and youth’s participation in encounters with schools or support services, and how is their participation described? We conducted a scoping review of systematic reviews. We searched for literature, selected reviews, assessed their methodological quality, and extracted data.
The main results were:
- We included 19 systematic reviews (one had no included studies), published 2015-2025.
- The reviews typically included qualitative studies.
- 1 review was from a school context, 5 from child welfare/social services, 5 from mental health services, and 7 from somatic health services. All reviews included studies of children/youth (0-25 years), and in 12 reviews, also parents and/or staff.
- 7 of the reviews had high methodological quality, 6 had medium, and 5 had low methodological quality.
- Almost all the studies in the reviews were from OECD countries, over 50% were from a European country, at least 12% were from a Nordic country, and at least 6% were from Norway (some overlap between the reviews).
- Some consistent findings were: Factors that promote children and young people's participation are e.g. good and stable relationships with professionals, age-appropriate information, professionals’ active listening, open-ended questions, and time for dialogue. Barriers to participation are e.g. adults' perspectives being heard and prioritized over the child's, and views of children as lacking the capacity to participate.
Even though there is limited summarized research on participation related to absenteeism, the results are considered relevant to this topic.
Summary
Introduction
The Norwegian Education Act grants all children and youth the right to public primary and secondary education. The Act requires municipalities and county authorities to take responsibility for following up with students who are absent. In accordance with the UN Convention on the Rights of the Child and the Norwegian Constitution, the Education Act specifies that students have the right to participate in all matters concerning themselves, the right to freely express themselves, and they should be listened to, with their opinions given weight according to age and maturity. Several legal provisions therefore require schools to listen to and follow up on students' opinions on matters concerning themselves, such as in situations with school absenteeism. In practice, this is not always done in a way that involves the student's real participation in their own matters. Based on the development of national recommendations in the field, the Directorate for Education and Training commissioned the Norwegian Institute of Public Health and the Knowledge Centre for Education to summarize research on children's and young people's participation in their own cases. Due to a short deadline for the assignment, we agreed with the commissioning entity to develop a knowledge base based on already summarized research.
Purpose
The aim was to investigate how schools, school owners, and collaborating agencies can facilitate student participation in the prevention, early intervention, and follow-up of school absenteeism. We did not expect sufficient coverage of summarized research where the topic was participation and school absenteeism, so in collaboration with the commissioner, we expanded possible contexts/themes to include schools, school health services, child welfare, mental health care, somatic health services, or similar. We thus had the following research question: What systematic reviews exist regarding children's and young people's participation in encounters with schools or support services, and how is participation described in the research?
Method
We conducted a scoping review in accordance with methodological principles described in international standards and guidelines. Our review maps already synthesized research in order to deliver relevant knowledge within a limited timeframe.
The scoping review was conducted according to a developed and published project plan.
We had the following inclusion criteria:
- Population: a) Children and young people aged 5-24 years receiving support from one or more services, b) the parents of these children/youth, and/or c) employees in relevant services for these children/youth.
- Intervention/Exposure: Interventions to promote and ensure participation. Various approaches to elucidate the child’s and youth’s desires, opinions, and experiences in different contexts when receiving help/interventions from services.
- Outcomes: Children and young people experience that they can freely express their opinions; that they have co-determination; that they trust the services; increased degree of participation; their opinions are carefully considered when decisions are made; better collaboration between services.
- Study design: Systematic reviews of quantitative, qualitative, or mixed-method studies.
- Publication year: 2015–2025.
- Country: All countries.
- Language: English, Norwegian, Swedish, and Danish.
We excluded, among others, reviews of studies on the participation of children and young people at group/system level; on 'shared decision-making' related to a single measure or with limited focus on the participatory process; and on children’s and youth’s participation closely linked to their experience of a (somatic) illness. A librarian developed a search strategy, and literature was systematically searched for in seven databases, including APA PsycINFO, Cochrane Library, EMBASE, and Epistemonikos. The search was concluded in June 2025. Screening was conducted in two steps. First, titles and abstracts were independently reviewed by two researchers. Then we evaluated relevant publications in full text. Any disagreements in both steps were resolved through discussion.
We assessed the methodological quality of the included systematic reviews using a standardized tool for this purpose, with some minor adjustments for reviews of qualitative studies. From each of the reviews, we extracted relevant information, including the goal of the review; definition of participation; context/theme; population and number; number of studies, study design, and country; as well as results on participation. AI-based tools were used to aid extraction. All information was then manually checked by researchers. We present the reviews with information in text, tables, and figures, along with a summary.
We sought to make a simple assessment of the transferability of the reviews' findings to a Norwegian school context. Because this is a scoping review, we chose to make an assessment based on which countries the studies (included in the reviews) were conducted in, with the premise of similarity related to, e.g., culture for children's participation.
Results
We identified a total of 10,938 references. After screening, 9,567 were automatically excluded. We read 70 full texts, including 19 systematic reviews (one review did not have any included studies). The reviews were published between 2015-2025.
- The context for the reviews was school (n=1), child welfare/social services (n=5), mental health care (n=5), and somatic healthcare (n=7). The systematic reviews covered a total of 356 studies (332 unique studies, i.e., some overlap), with an average of 20 studies (range 7-36 studies).
- All reviews included qualitative studies, and 13 also covered quantitative and/or mixed-method studies.
- All reviews included studies of children and/or young people (0-25 years, most aged 7-17 years), and in 12 reviews, parents and/or service staff were also studied.
- Over 90% of the studies in the reviews were from OECD countries, over 50% were from a European country, at least 12% were from a Nordic country, and at least 6% were from Norway (there was some overlap between the studies in the reviews).
- We assessed the methodological quality of the systematic reviews, with a modified checklist from JBI, to be high (n=7), medium (n=6), and low (n=5).
- Based on the extracted findings from the 18 systematic reviews, we can describe the following possible findings across the included systematic reviews:
- Basic principles for good participation: Children and young people want to be treated as individuals, heard, and included in decisions about their own lives. Participation is understood as a partnership with mutual information exchange, active dialogue, and real influence. Key factors are trusting relationships, openness, and power-conscious practices.
- Factors that promote participation, e.g.: good and stable relationships with professionals; continuity in contact persons; age-appropriate and transparent information; open questions, and time for dialogue; informal and safe meeting spaces; use of spokespersons for the child; multiple meetings; play-based communication for younger children; opportunity for the child to choose the degree of involvement.
- Barriers to participation: perspectives of adults, especially parents, are heard and prioritized over the child's; view of children as incapable of participating; lack of age-appropriate information; strict meetings, one-sided questioning, and little child-friendly language; little private conversation time with service personnel.
- Variations in preferences: children/youth differ in their wishes of degree for participation; older children and youth are often more involved.
Discussion and Conclusion
This scoping review provides an overview of the research on children and youths’ participation in encounters with schools or support services. It shows that there is likely limited research on students' participation in their own case specifically related to school absenteeism and/or other school-related issues. However, the review provides an overview of the research field and contributes valuable insight into key factors highlighted across service areas, and which are likely fundamental principles that also have validity and relevance in a school context. However, given this is a scoping review, we cannot draw definitive conclusions about which factors promote student participation in and around school, or how these factors work.