What are school attendance and chronic absenteeism? 

Most children miss a few days of school each year without long-term consequences.  Students are usually considered chronically absent if they miss ten percent of instructional days—regardless if the absence is excused or unexcused—or about 18 days in most school districts. During the COVID-19 pandemic, 18% of school districts reported an average attendance substantially lower than pre-pandemic times. Schools are working to re-engage children who were “lost” (chronically absent) during virtual learning.  When children and adolescents are chronically absent from school, they are academically at risk. Chronic absenteeism can translate into students having difficulty learning to read by the third grade, achieving in middle school, and graduating from high school. Students who do not graduate from high school have worse health outcomes and greater health risks as adults than their peers who graduate. Chronic absence is especially problematic among students living in poverty: they are most likely to have poor attendance over multiple years and least likely to have the resources to make up for lost time in the classroom. In some communities, chronic absence affects more than one out of four children.

The terms “school attendance” and “chronic absenteeism” are related and sometimes used interchangeably to talk about the importance of regular school attendance. This playbook uses “school attendance.”

Attending school regularly is essential to students gaining the academic, social, and emotional skills they need to succeed. Importantly, school attendance is a leading indicator of child well-being and can reveal that a student needs help long before test scores or grades do. Organizations, such as Attendance Works, have helped to identify and communicate the important connection between school attendance and health:

1. Poor health and undiagnosed conditions can cause too many absences.  
2. Chronic absenteeism is linked to poor socioemotional outcomes.
3. Successful learners are healthier adult

What domains can be used to assess school attendance?

Jurisdictional laws, regulations, and policies determine what constitutes an absence, the definition of tardiness, the time unit for counting attendance (e.g., minutes, hours, periods, days), whether an absence is excused, and the definition of truancy. However, the following domains, defined by the National Center for Education Statistics, are typically included in assessments of school attendance:

• Excused absence:  “A student is not present at school or at a school-endorsed or sponsored activity, but is temporarily excused from attendance because he or she: 1) is ill and attendance in school would endanger his or her health or the health of others; 2) has an immediate family member who is seriously ill or has died; 3) is observing a recognized religious holiday of his or her faith;  or 4) is otherwise excused from school in accordance with board policies.”

• Unexcused absence: “A student is not present at school or at a school-endorsed or sponsored activity without acceptable cause, parental knowledge, or authorization from the school administrator or his or her agent.”6
• Truancy: A type of unexcused absence distinguished by lack of parental knowledge or excuse or lack of consent by the teacher or administrator in charge. “If a student is absent without an excuse by the parent/guardian or if the student leaves school or a class without permission of the teacher or administrator in charge, it will be considered to be an unexcused absence and the student shall be considered truant.”

The National Center for Education Statistics has also developed an attendance code taxonomy to provide a basis for standardizing student attendance data—currently documented and coded in a number of different ways across the nation—and establish a mutually exclusive set of codes that document a student’s attendance status at any given time.6 The taxonomy includes two major categories—Attending/Present and Not Attending/Absent—then breaks those categories into approximately 16 codes that describe how the student spends his or her time, whether present or absent (e.g., present in regular instructional program; present but in disciplinary action; absent due to illness, injury or heath treatment; absent due to willfully skipping school). We know that these measures can have inherent bias and are sometimes problematic for youth of color, children in urban areas, or those that have other stressors out of their control. However, monitoring school disciplinary actions can indicate trends in mental health or indicate a specific context is problematic for students.

Who collects data on school attendance and for what purpose?

Individual schools collect and record student absences in electronic databases, manual paper systems, or handwritten attendance tallies. Other schools use school information systems to track attendance (e.g. PowerSchool, Skyward). Regardless of the manner in which attendance data are collected, the data typically become part of an administrative dataset that is reported up to the school district level.6  

Every state is required to report absenteeism rates for schools under the Every Student Succeeds Act (ESSA), which was signed into federal law in 2015. ESSA represents the first time that federal education law specifically mentions a measure of attendance for assessing school and student success. The primary purpose of collecting and reporting school absenteeism data is to measure how much time a student is present in school. Collecting and reporting detailed attendance data can help schools, districts, and states identify patterns in the frequency of student absences and understand the reasons why students are missing school. Staff can then use this information to develop, implement, and assess the outcomes of attendance interventions. 

In addition to school attendance data that is a part of administrative datasets, attendance data is sometimes collected as self-reported data from students or parents. However, research has shown that there is a weak association between self-reported absenteeism and absences reported in administrative data, with students and parents frequently underestimating days absent, particularly when absences are unexcused.

Although schools and school districts collect and report school absenteeism data to describe how much time students are present in school, health departments can also use measures of school attendance to:

• compare trends over time 
• compare schools or school districts across a larger jurisdiction
• identify schools or school districts that are experiencing an increase in school absences

All of the above may be an indicator of mental health needs.  

Are there current examples of organizations using school attendance data to monitor trends?

The National Association of School Nurses (NASN) created a data initiative called the National School Health Data Set: Every Student Counts! (Every Student Counts!). This dataset allows for the collection and review of school data that can influence policy, determine best practices for school health, increase advocacy for electronic health records, and help better understand children’s health. Every state is participating in this voluntary initiative at some level. Six districts in four states are piloting a nurse-led surveillance system for school attendance that helps identify students who may be suffering from an undiagnosed health condition such as myalgic encephalomyelitis/chronic fatigue syndrome. This nurse-led surveillance system will allow nurses to better identify chronic health conditions that may become part of Every Student Counts!

Instead of waiting until all states have similar data capacity, NASN meets school nurses where they are and encourages all states to participate in Every Student Counts! regardless of their current data infrastructure. Data point definition documents and data point worksheets help school nurses collect and submit the data. This documentation ensures all states are collecting and submitting comparable data. All data are de-identified and aggregated, but with the switch to a new data platform, school nurses can submit chronic conditions and school attendance data at the school and grade level. Access is restricted on the platform so only authorized individuals can see data by the district and state level. The platform is both HIPAA and FERPA compliant, and participants must attest they are following all state and district data policies before they can gain access. Understanding the importance of school attendance, NASN added it as a data point for the 2020-2021 school year. NASN uses the nationally accepted definition of chronic absence as a student missing ten percent or more of school days during a school year.

Every Student Counts! provides the tools and resources needed for school nurses to collect, understand, and monitor school data over time to identify trends. Trends and root causes of issues are then shared with the principal and local health department as appropriate. For example, if a school nurse noticed children continuing to leave the classroom for asthma, this could indicate that something else is going on. There have been times where the public health and legal authorities have become involved and identified that a specific housing complex the school serves has mold issues. Collecting the data and forming partnerships with the local health department has allowed issues like this to be addressed quickly so children can remain in school.

This example demonstrates the importance of not waiting for perfect or complete data, because change can occur just by collecting and sharing the data that are currently available. A new platform is making it easier for school nurses to report data to the Every Student Counts! dataset and see how their data compares to other schools like theirs. The initiative provides various training related to data with the understanding that the more work done upfront to help school nurses who have competing priorities, the better the compliance of submitting accurate information to the dataset. While the ultimate goal is to get to individual grade-level data at some point, starting with state or district aggregated data allows for surveillance of data points to recognize a change and implement interventions to improve a child’s health.