Chronic absenteeism associated with poor adult health outcomes. Therefore American Academy of Pediatrics (AAP) has issued a policy statement aimed at addressing chronic school absenteeism with students and their caregivers. The recommendations for clinicians have been published in Paediatrics.
More than 6.5 million children in the United States, approximately 13% of all students, miss 15 or more days of school each year. Chronic absenteeism broadly refers to missing too much school for any reason, including excused and unexcused absences as well as suspensions. The US Department of Education’s Office of Civil Rights has used a definition of missing 15 or more days over the course of a school year. Chronic absence is different than truancy. The definition of truancy also varies but usually refers to when a student willfully misses school, and the absence is “unexcused.
Paediatricians could address school attendance in their office-based practices and communities and/or states or nationally as advocates using a tiered approach.
Main recommendations are:
- Routinely ask at preventive care visits and sick visits about the number of absences a student has experienced. Consider adding questions about the number of missed school days in the previous month and the name of the school each patient is currently attending in templates in the paper or electronic medical record;
- Regularly ask how many school days students have missed at office visits; praise those who miss school rarely (on average, 1 day per month or less).
- Discuss with patients and parents how school absenteeism potentially affects academic performance and future health. For example, chronic absenteeism is associated with lower educational attainment, which in turn is tied to risky health behaviours such as smoking.
- For children with chronic conditions, help caregivers complete school action plans so they feel safe sending their child to school.
- Be clear about when a student should — and should not — stay home because of illness.
- Encourage parents of students with excessive absences to seek a formal school team meeting (often termed a school study team) to discuss how the school and family can cooperate to address the issue. Specifically, parents can request that their student be considered for participation in their school’s behavioural intervention system
The AAP cites evidence suggesting that 10% of kindergartners and first-graders miss at least a month of school per year, and nearly 20% of high school students are chronically absent. Absenteeism attributable to physical health conditions can be compounded by the presence of mental or behavioural health conditions and socioeconomic factors.
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