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Attendance Matters: Chronic Absenteeism

A day or two here, leaving early there, and just like that, more than 16% of the student population, nationally, is chronically absent each school year.  In the wake of the COVID-19 pandemic, chronic school absenteeism, defined as missing 10% (or around 15 days) of school in a school year, has more than doubled.  Absenteeism cannot be avoided altogether, for reasons including isolating in the case of infectious disease, but with recent research indicating profound learning loss caused by the pandemic, the negative effects resulting from chronic absenteeism have the potential to cause irreparable setbacks and detrimental consequences.  At the start of this new year, prioritizing school attendance and reducing chronic school absenteeism should be a primary focus of every school.

The National Association of School Nurses (NASN) promotes combating chronic absenteeism by “addressing the physical, mental, and social needs of the student.”  Students from vulnerable populations facing the most significant challenges and generally in the most need of the educational supports offered at school are often those that tend to have the most absences. While acute health conditions are the leading cause of school absences, students with chronic illnesses including asthma and type 1 diabetes, frequently miss school when symptoms are present or not well controlled.  Exacerbating the school absenteeism crisis is the rise in mental health absences, with up to 5% of students experiencing school-related anxiety and regularly refusing to attend school.

Chronic absence is different from truancy which normally refers to absences that are “unexcused.”  In the past federal law required states to track truancy but the number of unexcused absences it takes for a student to be considered “truant” has always varied by state–find your state’s laws and regulations here.  In 2015, the Every Student Succeeds Act (ESSA), a reauthorization of the No Child Left Behind Act, for the first time included chronic absenteeism (both unexcused and excused absences) as an accountability metric for schools to measure, report, and address.  The inclusion of all absences signified the adverse consequences resulting from too many missed days, regardless of reason or compliance with absence policies.

Chronic school absenteeism is associated with poor school performance, school dropout, and the development of unhealthy behaviors in adolescents and young adults, leading to poor health outcomes as adults.  Additionally, students’ experiences of violence, unintentional injury, teenage pregnancy, and suicide attempts are all associated with chronic absenteeism.  The pattern of frequent absences begins early, with rates of chronic absenteeism higher in kindergarten than any other elementary school grade, and the effects compounding, as indicated by lower reading and math scores by third grade in students missing more than 10% of school days in their first two years of school.

Reducing chronic absenteeism requires a multi-tiered approach that supports students and families and addresses the various reasons for student absences.  The impact that the presence of a school nurse has on improving student attendance has been well documented, and lower nurse-to-student ratios have long been associated with improved school-level attendance rates, but school nurses are not always equipped with specific interventions to target absenteeism concerns.  Strategies to address the issue should begin with detailed collection, interpretation, and monitoring of chronic absenteeism data in your school.  Armed with the “why” behind absences, school nurses can then work to engage and educate students and parents on physical and emotional health needs and appropriate case management.  Finally, collaboration with school administration and faculty to build protective measures to establish a positive school climate and reduce and mitigate any potential barriers to essential resources.

Reducing chronic absenteeism is critical for students to achieve academic success and optimal health.  Perhaps no other issue validates the need for school nurses more than the vital role they play in improving school attendance and thus laying the foundation for robust and healthy futures for students everywhere.

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