When doctors at Children’s National Hospital in D.C. learned a high school student was missing a lot of class time, they contacted his family.
The student had a complex medical history with neurological and developmental issues, according to Dr. Danielle Dooley, a pediatrician at Children’s National. Because of the pandemic, he lost touch with many of his doctors. But the outreach team was able to reconnect him with them, so that he could get the needed medication and return to class on a consistent basis.
In the aftermath of the pandemic, many D.C.-area school systems have grappled with how to handle students who are chronically absent, meaning they miss 10 or more school days in a 180-day academic year. But even before the pandemic, Dooley said, it was clear that schools alone shouldn’t be responsible for making sure students attend class.
For years, Dooley’s team at the hospital has been working with D.C. Public Schools through the CARE-H program. The initiative allows schools to securely share attendance data with health care providers, allowing them to intervene when necessary. About 2,000 families have opted in, allowing the group to monitor trends and connect with families when absences start to stack up.
“Our work has focused on really trying to make school attendance a vital sign in pediatric practice,” Dooley said. “Just like I see a child’s blood pressure, their height and their weight, I also really need to know how things are going for them in terms of school attendance, if I’m going to be able to deliver the holistic care that a child needs.”
Once parents consent to sharing attendance data with a pediatric practice where their child is a patient, a community health or social worker reaches out to families to offer support. Sometimes, Dooley said, that means connecting them to medical or mental health appointments, or appointments with specialists.
“Sometimes, it’s addressing social resources,” Dooley said. “Our biggest request is for access to food resources.”
The outreach traditionally involves three phone call attempts and an email. The provider asks about the reason for the absences, the majority of which are usually medical absences, Dooley said.
“We ask if they need a primary care appointment follow-up or a telehealth appointment,” Dooley said. “We ask about dental and mental health care services, and they can opt-in to do a social needs screening by phone, which asks about food, housing, transportation, child care and employment.”
Many absences are tired to respiratory illnesses, but the team monitors symptoms such as headaches or stomach aches, “because sometimes stomach aches and headaches are indicative of an underlying mental health issue or something that needs more support.”
The Children’s National group also reminds families about the guidelines for returning to school after an illness, Dooley said.
After the pandemic, many families haven’t been sending kids back to school until their symptoms are fully resolved.
Because students weren’t physically in school during the pandemic, Dooley said, “that disconnect from school and those routines, I think, have been a lot harder to reestablish than maybe anyone anticipated.”
Chronic absenteeism, Dooley said, requires cooperation from “all agencies and nonprofits and other community-based organizations to help ensure our kids are going to school.”
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