Require a comprehensive health evaluation for students with frequent or extended absences from school.

Formal health assessments of students with frequent or extended absences often uncover previously undiagnosed chronic conditions, recurrent health concerns that can be prevented or managed, and family issues that interfere with attendance (for example, difficulty accessing health care or a family's incomplete understanding of a health condition).

There are many valid health-related causes for keeping students at home, but when these problems have been recurrent and are anticipated to continue, schools have an obligation to make accommodations that will allow safe school attendance for these students (e.g., a school could provide short periods of rest and administer prescribed pain relievers for a student with recurrent headaches). Parents, acting in good faith, may keep their child at home for health-related reasons that in fact do not really warrant being home-bound (e.g., mild symptoms of the common cold).

Request a note or other form of direct communication from the health care provider responsible for managing the problem thought to be causing the student's absence from school. Notify parents that school staff members are concerned about their child's frequent or extended absence from school. A form letter to parents can be used to explain district policy and to request medical verification of illness or injury. Offer to assist parents with finding a health evaluation if the student has no access to health care. Provide parents and the student's health care providers with details of potential health-related symptoms, signs, or patterns that are noticed by school staff.

State or local regulations may help determine time periods that students can be absent without physician verification. Where this is not regulated, school staff should consult with local health care providers to establish a magnitude of absenteeism that should raise concern and subsequent investigation (e.g., "more than three consecutive days" or "more than ten days a quarter, consecutive or not").

American Academy of Pediatrics, Council on School Health. Role of the school nurse in providing school health services. Pediatrics. 2008;121(5):1052–1056.

American Academy of Pediatrics, Committee on School Health. School health assessments. Pediatrics. 2000;105:875-877.

Centers for Disease Control and Prevention. Strategies for Addressing Asthma Within a Coordinated School Health Program. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 2006. Available at: www.cdc.gov/HealthyYouth/asthma/strategies.htm.