Children's Absenteeism Research Articles

School Absenteeism in Children with Physical Disabilities：Three Cases Studies

特別支援学校または学級に所属する肢体不自由の児童・生徒は3万6,000人以上に上るが，このうち不登校の児童・生徒の正確な統計は明らかではない．肢体不自由児の中には知的・発達・認知などの障害を合併することも多く，合併障害が不登校の原因となっていることも少なくない．しかし，他者によって移送されることの多い肢体不自由児にあっては，とにかく登校はしてくる（あるいはさせられる）ことも多い．本稿では，学校を含めた「通い続けることが望まれる機会や場（作業所）」への参加を拒否した中学生から成人の3事例（外傷後脊髄損傷，脳性麻痺）について検討した．その結果，本人の発達段階に応じた個別的対応を要すると考えられた．

Coordination of Health Care for Complex Kids (CHECK) and Chicago Public Schools (CPS): A Partnership to Reduce Absenteeism in Children with Chronic Disease

Program Goals: 1. Describe a program that links a large, urban, academic medical center with a large public school system to decrease absenteeism in children with chronic disease 2. Describe Community Health Workers’ (CHWs) roles in connecting families to health and school systems 3. Discuss use of school attendance as a health marker Program Description: A child’s ability to succeed in school is linked directly to health. Children with chronic diseases suffer elevated risks for low school attendance …

Coordination of Health Care for Complex Kids (CHECK) and Chicago Public Schools (CPS): A Partnership to Reduce Absenteeism in Children with Chronic Disease

Coordination of Health Care for Complex Kids (CHECK) and Chicago Public Schools (CPS): A Partnership to Reduce Absenteeism in Children with Chronic Disease

Impact of home remediation and household education on indoor air quality, respiratory visits and symptoms in Alaska Native children

ABSTRACTAlaska Native children experience high rates of lower respiratory tract infections (LRTIs) and lung conditions, which are associated with substandard indoor air quality (IAQ). We conducted an intervention of home remediation and education to assess the impact on IAQ, respiratory symptoms and LRTI visits. We enrolled households of children 1–12 years of age with lung conditions. Home remediation included improving ventilation and replacing leaky woodstoves. We provided education about IAQ and respiratory health. We monitored indoor airborne particles (PM2.5), CO2, relative humidity and volatile organic compounds (VOCs), and interviewed caregivers about children’s symptoms before, and for 1 year after intervention. We evaluated the association between children’s respiratory visits, symptoms and IAQ indicators using multiple logistic regression. A total of 60 of 63 homes completed the study. VOCs decreased (coefficient = −0.20; p < 0.001); however, PM2.5 (coeff. = −0.010; p = 0.89) did not decrease. Burning wood for heat, VOCs and PM2.5 were associated with respiratory symptoms. After remediation, parents reported decreases in runny nose, cough between colds, wet cough, wheezing with colds, wheezing between colds and school absences. Children had an age-adjusted decrease in LRTI visits (coefficient = −0.33; p = 0.028). Home remediation and education reduced respiratory symptoms, LRTI visits and school absenteeism in children with lung conditions.

Validation of a Definition for K-12 Student Absenteeism Due to Influenza-like Illness (ILI) for School-based Influenza Activity Monitoring in Oregon School District, Wisconsin—ORCHARDS (Oregon Child Absenteeism and Respiratory Disease Study)

Validation of a Definition for K-12 Student Absenteeism Due to Influenza-like Illness (ILI) for School-based Influenza Activity Monitoring in Oregon School District, Wisconsin—ORCHARDS (Oregon Child Absenteeism and Respiratory Disease Study)

Strategy of Making Hand Washing a Routine Habit: Principles of 5Es and 3Rs

Regular hand washing habit has potential to reduce morbidity and mortality due to diseases and improves child development and reduces absenteeism of children, teachers and workforce. Improving hand washing behavior is more cost effective than improving clean water and sanitation infrastructure. There are numbers of initiatives and interventions in place, which have gained momentum with key messages of a call to action with increasing investment in schools, engaging policy makers and demonstration them with evidence. However, change in behavior as a routine habit has not reached to an optimum level and requires institutionalizing hand washing practices in schools, from schools and by schools and develop it as a curriculum. Therefore, we are purposing principles of 5Es and 3Rs - a strategy to make hand washing a routine habit. These 5E principles are: i) Embedding in a system, ii) Enabling Environment, iii) Eliminating Friction, iv) Encouraging all, and v) Establishing intervention and 3Rs are practicing them Religiously, Routinely and Repeatedly. Numbers of interventions have well demonstrated that hand hygiene educational interventions can help maintaining good practices. Finally, if schools and community start doing today, we can observe behavioral change practices for hand washing as a routine habit by at least 10 years after.

Quality of Life and School Absenteeism in Children With Chronic Illness.

Children and adolescents with a chronic illness (CI) tend to demonstrate diminished physical and social functioning, which contribute to school attendance issues. We investigated the role of social and physical functioning in reducing school absenteeism in children participating in Mastering Each New Direction (MEND), a family-based psychosocial intervention for youths with CI. Forty-eight children and adolescents with a CI (70.8% female, M age = 14.922, SD = 2.143) and their parent(s) completed a health-related quality of life (HRQOL) measure pre- and postintervention. Using multiple mediation, we examined whether parent- and child-rated physical and social HRQOL mediated the relationship between school attendance before and after MEND. Once the mediational model was not supported, we investigated whether HRQOL moderated the relationship between missed school days pre- and postintervention. Neither physical nor social functioning mediated or moderated the relationship between missed school days pre- and postintervention. Instead, higher parent-rated physical functioning directly predicted decreased number of missed school days, while lower parent-rated social and child-rated physical functioning predicted increased missed school days. Parent-perceived HRQOL may have a direct effect on health-related behaviors such as school attendance. Future research should determine whether gains in parent-rated QOL are maintained in the long term and whether these continue to impact markers of functional well-being.

Comparative Burden of Influenza A/H1N1, A/H3N2 and B Infections in Children Treated as Outpatients.

Few studies have directly compared the clinical impact of different types and subtypes of influenza viruses in children. In a prospective study of respiratory infections in preenrolled cohorts of children ≤13 years of age, we compared the clinical features and the overall burden of illness between outpatient children with A/H1N1, A/H3N2 and B infections. The data were derived from structured medical records filled out by study physicians and from daily symptom diaries filled out by the parents throughout the follow-up period. Of 358 children included in the analyses, 203 (57%) had influenza A/H1N1, 96 (27%) had A/H3N2, and 59 (16%) had influenza B infection. Children with influenza A/H3N2 were significantly younger (median, 3.2 years) than those with A/H1N1 (median, 4.8 years) or B (median, 5.1 years) infections (P < 0.0001). When adjusted for age, children 3-6 years of age with A/H3N2 infection had a higher frequency of fever ≥39.0°C (67% vs. 38%; P = 0.002), longer duration of fever (median, 4 vs. 3 days; P = 0.02) and more antibiotic treatments (43% vs. 20%; P = 0.004) than did children with A/H1N1 infections. Overall, the clinical presentation, duration of illness, frequency of complications, children's absenteeism from day care or school and parental work absenteeism were comparable between children with A/H1N1, A/H3N2 and B infections. Adjusted for age, the clinical manifestations and the burden of illness are largely comparable between children with influenza A/H1N1, A/H3N2 and B infections.

Burden of Illness and Use of Health Care Services Before and After Celiac Disease Diagnosis in Children

Prevalence of celiac disease in children is approximately 1%, but most patients remain unrecognized by reason of variable clinical presentation. Undetected patients may have an increased burden of illness and use of health care services because of nonspecific complaints. We investigated these issues prospectively in newly detected patients with celiac disease before and after diagnosis in a large nationwide cohort of children. A validated questionnaire was sent to consecutive families whose children had been diagnosed as having celiac disease within 1 year. The survey contained questions about the use of medical consultations, on-demand drugs, vitamins and herbal products, children's absenteeism from day care or school and, parents' work absenteeism. A follow-up questionnaire was sent after 1 year of receiving a gluten-free diet. A total of 132 families responded. A total of 44 children were diagnosed because of gastrointestinal and 88 because of extraintestinal symptoms or by risk-group screening. On treatment, outpatient visits to primary health care decreased from a mean of 3.0 to 1.3 visits per year (P < 0.001), the number of hospitalizations from 0.2 to 0.1 (P = 0.008), and antibiotic prescriptions from 1.0 to 0.5/year (P < 0.001). Visits to secondary and tertiary health care increased from 0.6 to 1.4 (P < 0.001), mostly for celiac surveillance. Use of vitamins, micronutrients, and herbal products increased from 7.3 to 10.2 pills per month (P = 0.028). Implementation of a gluten-free diet resulted in reduced use of health care services and antibiotic prescriptions in children. Our findings support active case-finding and risk-group screening for celiac disease.

School-Located Influenza Vaccination and Absenteeism Among Elementary School Students in a Hispanic Community

Seasonal influenza is recognized as a significant health burden to children and is a cause of excess school absenteeism in children. In 2008, the Advisory Committee on Immunization Practices recommended annual influenza vaccination for all children 6 months to 18 years of age. School nurses influence participation in this recommendation by conducting school-located influenza vaccination (SLIV) programs at their campuses. Knowing the effect of SLIV programs on student absenteeism may motivate school nurses and district administrators to conduct such vaccination programs. This study examines the impact of an SLIV program on elementary school absenteeism in an inner city school district with a predominantly Hispanic population. Using Poisson regression models with robust standard errors, we analyzed data from 3,775 records obtained by stratified random sampling. Results of the study indicate that students vaccinated through an SLIV program have fewer absences than unvaccinated students. A surprising result of the study shows that students vaccinated through an SLIV program had fewer absences than students vaccinated elsewhere. These results are of particular importance to school nurses who work with large Hispanic populations. Our study illustrates one way that a school nurse can assess the effect of an SLIV program on absenteeism.

Association between increased BMI and severe school absenteeism among US children and adolescents: findings from a national survey, 2005–2008

School absenteeism may be an underlying cause of poor school performance among overweight and obese children. We examined the associations between school absenteeism and body mass index (BMI) in a nationally representative sample. We analyzed the data of 1387 children (6-11 years) and 2185 adolescents (12-18 years), who completed an interview and anthropometric measurement as a part of the National Health and Nutrition Examination Survey, 2005-2008. The CDC 2000 growth chart was used to categorize BMI status, and the number of school days missed during the past 12 months was assessed by asking the proxies or interviewees. The prevalence of obesity and overweight were 18.96±1.44% (s.e.) and 16.41±0.78%, respectively, among study populations. The means of school days missed in the last 12 months were not statistically different between the normal-weight, overweight and obese groups, 3.79±0.56, 3.86±0.38 and 4.31±0.01 days, respectively. However, when >2 days missed per school month was defined as severe absence, the prevalence of severe absence were 1.57%, 2.99% and 4.94% respectively, among 6-11-year-old children with normal, overweight and obese. The adjusted odds of severe school absence were 2.27 (95% confidence interval=0.64-8.03) and 3.93 (1.55-9.95), respectively, among overweight and obese children compared with normal-weight peers (P for trend test <0.01). No significant association was found among adolescents. Increased body weight is independently associated with severe school absenteeism in children but not adolescents. Future research is needed to determine the nature, and academic and social significance of this association.

Intestinal Protozoan Infections in Relation to Nutritional Status and Gastrointestinal Morbidity in Colombian School Children

While Giardia duodenalis infection has been consistently associated with nutrient malabsorption and stunting in children, the effects of other protozoans on nutritional status or gastrointestinal morbidity are less clear. We sought to determine whether infection with common intestinal protozoans including Giardia duodenalis, Entamoeba coli and Blastocystis hominis was associated with anthropometric and micronutrient status, gastrointestinal symptoms, visits to the doctor or school absenteeism in children 5-12 years of age from Bogotá, Colombia. We obtained stool samples from 442 children enrolled in primary schools in 2006 and examined the presence of intestinal protozoans in relation to height, body mass index, plasma concentrations of vitamins A and B12, ferritin and zinc and erythrocyte folate. In addition, we examined the associations between protozoan infections and the incidence of common gastrointestinal symptoms, which were registered prospectively in morbidity diaries. The prevalence rates of G. duodenalis, E. coli and B. hominis infection were 6.3, 23.1 and 22.4%, respectively. Giardia infection was associated with lower height-for-age z-score (p = 0.04), whereas E. coli infection was associated with low erythrocyte folate (p = 0.04), and B. hominis infection was related to higher vitamin A levels (p = 0.05). Infection with E. coli was also associated with a significantly higher incidence of fever but fewer visits to the doctor, while B. hominis infection was associated with significantly less diarrhea, diarrhea with vomiting, doctor visits and school absenteeism. In conclusion, G. duodenalis and E. coli infections were associated with indicators of poor nutritional status in this population, while B. hominis was related to apparently decreased morbidity.

Traumatisme de la cheville sans fracture chez l’enfant : immobilisation plâtrée versus traitement symptomatique. Impact sur l’absentéisme et la qualité de vie

Treatment methods for ankle injury in children are numerous and have comparable results. The impact on absenteeism and quality of life is an interesting criterion to consider in order to help doctors in their initial treatment choice. The objective of this study was to compare two therapeutic strategies for ankle injury without fracture in children in terms of the impact on school absenteeism, parents' professional absenteeism, and quality of life. The strategies compared were cast immobilization of the ankle and a purely symptomatic treatment with no immobilization. We conducted a prospective, comparative, and randomized study. The population comprised children between 8 and 15 years of age, consulting for a first episode of ankle injury in a pediatric-emergency department of a hospital center in Marseille, France. A clinical and radiographical report was systematically done. Children were seen after 1 week to provide the clinical monitoring, assess the child's and parents' absenteeism, and assess the quality of life. Sixty-two patients were studied. There was no difference in clinical progression after 7 days between the two treatment groups. Quality of life was also comparable. However, the children's absenteeism and the parents' absenteeism were higher in the casted group.

Addition of Omalizumab Reduces School Absenteeism in Children with Moderate-Severe Persistent Asthma

Addition of Omalizumab Reduces School Absenteeism in Children with Moderate-Severe Persistent Asthma

School Absenteeism in Children with Asthma in a Los Angeles Inner City School

To investigate the pattern of school absenteeism in asthmatic children within a Los Angeles inner city school. Five hundred twenty-eight students of predominant Hispanic ethnicity, from a Los Angeles inner city school were divided into 3 groups: known asthma, high probability of asthma, and low probability of asthma using a previously validated instrument. Attendance records of these students were analyzed to determine total and respiratory absences over a year. School records were compared to the corresponding answers on 513 surveys to determine the accuracy of parental responses in regard to their children's absenteeism. Children with known asthma missed on average 2 more days of school than children with low probability of asthma and high probability of asthma. This was only significant in the younger age groups. Survey responses were found to have a 45.6% agreement with school attendance records. Underestimation occurred more often when school-recorded absentee rates were highest. Overestimation occurred more by parents of children with known asthma or a high probability of asthma. In a Los Angeles inner city population, younger children with known asthma miss more days of school than those with no asthma. Survey-reported absenteeism is less accurate than school attendance records.

School attendance in children with Type 1 diabetes

To determine whether children with Type 1 diabetes mellitus (DM) miss more school than their non-DM siblings and peers and to identify factors associated with school absenteeism in children with DM. School absenteeism data for the 2000-01 school year were obtained for 78 children with DM, 38 non-DM siblings and 118,269 age-matched peers in Toronto, Ontario. Questionnaires and hospital records were utilized to evaluate child-, family- and diabetes-related factors associated with school absenteeism in children with DM. Children with DM missed only slightly, albeit significantly more school than both their non-DM siblings (mean +/-sd: 10.9 +/- 8.9 vs. 8.1 +/- 8.1 days, P < 0.001) and peers (median: 8.8 vs. 5.5 days, P = 0.0005). A multiple regression analysis indicated that school absenteeism in children with DM was associated with their parents' attitudes towards school attendance (P = 0.002), poorer metabolic control (P = 0.006), shorter disease duration (P = 0.006) and a lack of aggressive behaviour (P = 0.02). With current management strategies, near normal school attendance is a reasonable goal for all children with DM and should be strongly encouraged by parents, educators and health care professionals.

Prevalence of asthma in a Portuguese countryside town: repercussions on absenteeism and self-concept

Background Childhood asthma represents an increasing health problem and is the leading cause of hospital admission and absenteeism in children with chronic disease. It also compromises quality of life, eventually contributing to disturbances in self-concept. Self-concept is a recent and global perspective of “the self” and relates to skills, self-image and self-esteem. Little information is available on this topic and there are no data from Portuguese countryside towns. Objective The aim of this study was to determine the prevalence of asthma among all school children in the 5th and 6th grades in a Portuguese countryside town and to establish its possible correlation with absenteeism and self-concept. Methods In April 2002, two questionnaires were administered in the presence of the researcher to a group of 950 children attending different schools. The children completed the internationally renowned questionnaires: ISAAC and the Self-Concept Scale by Susan Harter. Results Our sample (n = 818) had a mean age of 11 years (10-15 years) and a male-to-female ratio of 1/1. The cumulative prevalence of asthma was 11.9% and that of active asthma was 8.8 %; 63.9% of asthmatics were male and 36.1 % were female. The mean age of asthmatics was 11.34 years and 74 % had active symptoms. Comparison of this group of 97 asthmatic children with the remaining children revealed a statistically significant correlation between the presence of asthma and school absenteeism (global: p = 0.04; gymnastics: 0.05). Regarding the Self-Concept Scale a statistically significant association was found between the presence of asthma and school achievement (p = 0.027), physical appearance (p = 0.015), behavior (p < 0.000) and self-esteem (p < 0.000). No statistically significant correlations were found in social acceptance (p = 0.289) or athletic competence (p = 0.085). Asthmatic boys had higher self-concept scores than girls, except in the domain of behavior. Conclusions Twelve percent of the population studied was asthmatic. In asthmatic children, absenteeism was higher and self-concept was lower for almost all domains, except social acceptance and athletic achievement, probably due to overprotection.

Predictors of severity of absenteeism in children with anxiety-based school refusal

Examined possible relations among sociodemographic, clinical, and familial variables and level of school absenteeism in children with anxiety-based school refusal. These children exhibit a great deal of variability in the severity of school refusal, with some youngsters missing only an occasional day of school, whereas others exhibit pervasive school absenteeism. Participants were 76 children referred for treatment of anxiety-based school refusal. Children and a parent completed a structured clinical interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children) and self-report measures that assess children's levels of fear (Fear Survey Schedule for Children-Revised), trait and somatic anxiety (Modified State-Trait Anxiety Inventory for Children), and depressive symptomatology (Children's Depression Inventory), as well as family environment characteristics (Family Environment Scale). Regression analyses revealed that older age, lower levels of fear, and less active families were primary predictors of greater levels of school absenteeism.

Preschool children's absenteeism from Swedish municipal day-care centres because of illness in 1977 and 1990. Geographical variations and characteristics of the day-care centres.

A study was undertaken to compare the absenteeism from Swedish day-care centre departments (DCCDs) because of illness in different geographical areas in 1977 and 1990, and to determine whether any characteristics of DCCDs could explain variations in absenteeism. Recordings of absenteeism were made during the same three months among 0-6-year-olds enrolled at 476 DCCDs in 1977 and at 561 DCCDs in 1990. Absenteeism was measured as the number of days in which the children did not attend their DCCD because of any illness divided by the total number of days for which they could have attended. The results, which are representative for Sweden, showed that absenteeism was highest in the three largest cities and their suburbs and in industrial areas, and lowest in rural and sparsely populated municipalities. In all geographical areas absenteeism was higher in 1977 than in 1990. Among the 0-2-year-olds, absenteeism was higher among those enrolled in groups for young children that among those in extended groups for siblings. For the 0-2-year-olds, the amount of time spent outdoors together with the day-care group was inversely associated with absenteeism.

Pre-school children's absenteeism from Swedish municipal day-care centres in 1977 and 1990: methodology and socio-demographic factors.

The absenteeism of Swedish pre-school children from municipal day-care centre departments (DCCDs) was studied for the years 1977 and 1990. The research questions were: (1) has absenteeism due to illness changed from 1977 to 1990?; and (2) is absenteeism caused by illness which is influenced by socio-demographic factors? Absenteeism was recorded during February, March and April for 92% of 0-6 year olds enrolled in 476 DCCDs in 1977, and for 88% of the children in 561 DCCDs in 1990. It was measured as the number of days the children were not in attendance due to any illness, divided by the total number of days they could have attended their DCCD. Absenteeism was higher in 1977 than in 1990 for all ages. In 1977 and 1990, among 0-1 year olds it was 20.5% and 14.3%, respectively. The proportion of 0-2 year olds who had been absent for 25% or more of possible days of attendance was 24.5% in 1977 and 14.0% in 1990. Children 0-2 years of age with self-employed mothers were absent less from their DCCD than those whose mothers were manual workers or non-manual employees. Among 0-2 year olds living in the largest cities, absenteeism was higher for those living in apartments compared with the children living in single-family houses.