Navigating school attendance: Parents weigh physical and mental health in decisions

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Parents are frequently asked to decide whether their child should attend school or stay home because of sickness. This decision is often straightforward if the child has a contagious disease or is seriously ill. For example, a vomiting child or one with a high fever should be kept home, as would one with chickenpox or measles rash.

Conversely, in many other situations, the outcome is more nuanced. Parents need to consider a range of factors to make the right decision. Aside from the illness itself, the need to navigate the physical, mental, and emotional stresses of a crowded school and typical academic day program must be considered.

The C.S. Mott Children’s Hospital in Michigan recently released their report on a national poll asking parents of middle and high school students how and what they decided when their children reported feeling sick.

Study: Mott Poll Report. Image Credit: FamVeld /

Parental concerns

In over 50% of cases, parents decided to let the children stay home when it was unclear if the child was too sick to attend school. About 25% of parents indicated that they would still send the child to school, while 20% left the decision to the child. Less than 4% of parents sought medical help to make the decision.

For 55-60% of the parents, some of the different factors they considered while making their decision included whether the child was well enough to complete a full day at school or whether attendance would affect the health of others. Moreover, 35-40% of parents considered the child’s behavior and whether staying home involved missing an important academic activity.

Additionally, about 20% of parents considered whether at least one parent could stay home with the child. The same proportion of parents considered the child’s need for a mental, rather than physical, break from school.

Student concerns

About 66% of parents reported that their children expressed concern about whether their absence from school would cause grades to fall or that they would miss their friends or school activities. However, almost 80% of parents did not consider that their children would be stressed by having to make up for lost day(s), as they were provided sufficient time and a reasonable amount of homework.

Attendance policies

Overall, about 33% of parents reported that their children missed one or fewer days of school from January to February, with a similar number missing two to three days during the same time period. About 20% of children missed four to five days, whereas 15% missed at least six.

Although 75% of parents believed that school attendance policies are necessary to enforce student attendance, 25% of parents indicated that these policies did not work well for children with chronic illnesses. In fact, over 20% of parents believed that these policies encouraged them to send their children to school even when sick. Those whose children missed six or more school days over the year were more likely to be dissatisfied with the attendance policy.

The inconvenient or unpleasant consequences of letting their child miss school for too many days included teachers’ notes or calls, doctor’s note requirements, having to meet school staff, and truancy charges, which were reported by 63%, 50%, 35%, and 40% of parents, respectively. About 20% of parents reported their child being barred from activities due to their absence.

Recognizing the need

Both parents and children considered the adverse impact of missing classes, though in different proportions. About 66% and 40% of students and parents, respectively, worried about the adverse effects of missing school, and about 40% of parents considered.

A child’s reluctance to stay home when sick may be reassuring, as this behavior may suggest the child is highly motivated to attend class. However, this reaction may also reflect insecurity about school performance, which could indicate anxiety or poor preparation. Thus, parents must listen to their children to better recognize these factors when making decisions.

Addressing mental health needs

About 20% of parents indicated that they considered their decision to let the child stay home to provide them with a ‘mental health day.’  This may mirror the stress of a typical school setting to perform well academically and keep up socially. Romantic breakups, disruptions of close friendships, or being shamed, deliberately or otherwise, on social media may indicate that the child is unwilling to face peers immediately.

Concerned parents may try to help the child by allowing school absences. However, this is essentially a self-limited response, as children will eventually return to school and face these issues directly.

Nevertheless, mental health days may encourage the child to think out or plan a response, learn and use new methods to de-stress and dissipate anxiety, as well as identify support people at school. For children with a mental disorder like depression or anxiety, the child’s psychologist or psychiatrist should be involved in making these decisions.

Helping sick children

Children with chronic medical conditions are a significant challenge, as they often require specialist care or more frequent healthcare visits, thus necessitating more extended periods of absence from school. These parents should let the school know in advance about their child’s need for extra healthcare services.

Schools may ask the child’s doctors for notes requesting greater flexibility in attendance requirements, including allowing schoolwork to be completed at home or extending the deadline as appropriate.

Journal reference:
Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.


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