Being absent from school too often, excused or not, can put a child’s academic achievement—and future health—at risk. A new policy statement from the American Academy of Pediatrics (AAP) in the February 2019 Pediatrics, “The Link Between School Attendance and Good Health” (published online Jan. 28), recommends health care providers promote good school attendance as preventive medicine. Defined as missing too much school for any reason, chronic absenteeism starting as early as preschool and kindergarten has been linked to poor educational and health outcomes, according to the AAP.
More than 6.5 million U.S. children, about 13 percent of all students, miss 15 or more days of school each year, a benchmark for chronic absenteeism that’s been used by the U.S. Department of Education. Common, preventable causes of school absences range from infections such as influenza to poorly controlled chronic conditions like asthma. Socioeconomic factors tied to absenteeism include unstable housing conditions, transportation difficulties, a history of maltreatment, exposure to domestic violence, and being called on to care for younger family members. The AAP encourages pediatricians and their colleagues caring for children to promote school attendance. Among the AAP recommendations:
• Stress the value of developing strong school attendance habits as early as preschool. Ask about the number of school days missed in the past month at every visit, when appropriate.
• Document children’s medical needs for an Individualized Education Program or 504 Plan when needed for access to services that optimize learning opportunities.
• Encourage families to share health concerns with their school nurse.
• Provide firm guidance on when a child should stay home sick and when a child can attend school. Lice, for example, is not a reason to stay home from school.
• Avoid writing excuses for school absences when the absence was not appropriate. Encourage patients who are well enough to return to school immediately after their medical appointments.
• Advocate for policies known to promote school attendance. These include programs that avoid suspension and expulsion and promote a positive school climate.
