Early Matters: District and Site Level Practices

Offer Supports to Reduce Health-Related Absences

In preschool and kindergarten, health is a top reason families cite for keeping students home, according to research. In addition, the pandemic has changed the way families think about school and whether to keep their children home. There is much districts and schools can do to prevent unnecessary health-related absences, and helping to keep students healthy is essential.

Districts, preschools and schools can provide students and their families with information and access to services, both in school and in the community, that help children stay healthy throughout the year.

Efforts to reduce unnecessary health-related absences are even stronger when districts, schools and early education programs partner with health providers in the community. Consider using our Making the Case statement for health providers, and the American Academy of Pediatrics, The Link Between School Attendance and Good Health, to enlist health providers in preventing health-related absences.

Ideas and Resources

Integrate comprehensive health information into the school enrollment process. Districts should create a standard set of materials that can be distributed by schools and preschools. At each school, make sure that front office staff are equipped to share materials with families and know how to refer families to health resources. Ensure a proper handoff from preschool to kindergarten of any health-related supports each student received in preschool.

Offer clear guidance about when a child should stay home or show up to school for health-related reasons. Consider using the health guidance for families we created with the National Association of School Nurses and Kaiser Permanente. Or use it to inspire the creation of your own document that aligns with local health policies. Districts can post this information on their website and  provide it to school staff to share with families.

Teach basic hygiene practices that prevent acute illness. School staff can model and remind students to use practices that prevent the spread of illness like handwashing or sneezing into their elbows.

Help families to recognize and respond to anxiety. If a child has a headache or stomachache, schools should help families to quickly determine whether this is related to anxiety or a physical illness. If the challenge is anxiety, staying home may worsen the situation. Consider using our anxiety handout for families.

Help families meet basic needs (food, housing, clothing etc.). No Kid Hungry provides information about how to improve access to healthy nutritious meals as a proven strategy for improving attendance. SchoolHouse Connection is an excellent resource for addressing homelessness through education.

Collaborate with health providers and local health departments to offer onsite screening and services. Districts should work with health partners to ensure schools can provide students with needed access to health insurance or Medicare, dental care, vision and hearing exams and immunizations as well as resources to ensure early identification of developmental delays and other health challenges. Schools should promote awareness that these services are available on site. The Healthy Schools Campaign Toolkit for Action, Addressing the Health-Related Causes of Chronic Absenteeism also includes tips for working with key health partners.

Promote asthma-free classroom environments. The transition into a new school is a perfect time for the district to take steps to ensure that the classroom and home environments are free of asthma triggers. Find resources in the American Lung Association’s Back to School Asthma Toolkit and these from the Center for Disease Control and Prevention.

Address attendance as part of transition plans for incoming kindergartners with known chronic health conditions. According to this brief from the National Association for School Nurses, federal law, especially related to students with disabilities, requires coordinated transition planning for students with chronic health conditions to ensure they have equal access to a school experience. Districts should work with schools to make sure students have plans in place that ensure school health staff and teachers are aware of their health needs and include strategies for ensuring excellent attendance.

Use data on chronic absence from preschool and kindergarten to identify where to target health and trauma-related supports. Districts should use data on high levels of chronic absence to determine where they most need to identify and invest resources to address physical and mental health–related challenges.

Include a health professional, such as the school nurse and/or social worker, in the school team monitoring attendance. Ideally, each school has a team monitoring attendance data and organizing a multitiered system of support that also includes a school health professional. Learn more about forming school and district teams.  

Explore Early Matters: Cultivating Engagement and Attendance In Kindergarten

Production of Early Matters: Cultivating Engagement and Attendance in Kindergarten was made possible by the generous support of the Heising Simons Foundation.