More than 6.5 million children in the United States, approximately 13% of all students, miss more than 15 days of school each year. Chronic school absenteeism, starting as early as preschool and kindergarten, puts students at risk for poor school performance and school dropout, which in turn, put them at risk for unhealthy behaviors as adolescents and young adults as well as poor long-term health outcomes.

What is Chronic Absenteeism?

Chronic absenteeism broadly refers to missing too much school for any reason, including excused and unexcused absences as well as suspensions. Most researchers and a growing number of states have defined chronic absenteeism as missing 10% (or around 18 days) of the entire school year.

Why is it Important?

Chronic absenteeism can occur as early as preschool and kindergarten and has been shown to be related to future chronic absenteeism, grade retention, and poor academic achievement, particularly for social skills and reading.

Students with poor attendance score lower than their peers who attend school regularly on national skills assessments, regardless of race or ethnicity. Chronic absenteeism can be a better predictor of school failure than test scores.

The Pediatrician’s Role

Pediatricians can address school attendance in their office-based practices and communities and/or states or nationally as advocates. Some important office-based strategies include (complete list found in the AAP Policy Statement):

  • Routinely ask at preventive care visits and sick visits about the number of absences a student has experienced
  • Encourage parents to bring copies of their child’s report card or share data available from their child’s online school information system during preventive visits
  • Praise patients and caregivers when patients are attending school
  • Support parents in addressing barriers to attendance
  • Assist families in documenting and interpreting their children’s medical needs or disability for an individualized education program or 504 plan
  • Encourage families to share their concerns about their children’s health with their school nurse
  • Provide firm guidance on when a child should stay home sick and how to avoid absences from minor illness or anxiety

AAP Policy

The Link Between School Attendance and Good Health: This policy statement focuses on absenteeism related to students’ physical and mental health, as well as the role pediatricians play in promoting school attendance.

Resources for Families

Additional Resources

AAP Voices is the official blog of the American Academy of Pediatrics, where AAP member pediatricians and others share their perspective on a wide variety of topics relating to children’s health and wellness. The student attendance-related blog posts below are written by AAP’s Council on School Health members:

AAP Voices: Every Day Counts: The Role of the Pediatric Provider in School Attendance
Heidi Schumacher, MD, FAAP & Danielle Dooley, MD, MPhil, FAAP – 01/29/2019

AAP Voices: How Pediatricians Can Help Families Navigate the Unusual School Year
Heidi Schumacher, MD, FAAP – 09/14/2020

AAP Voices: Let’s Work With Schools to Help Address Absenteeism
Ryan Padrez, MD, FAAP, Danielle Dooley, MD, MPhil, FAAP & Heidi Schumacher, MD, FAAP – 11/7/2022

America’s Promise Alliance, Grad Nation Campaign
American’s Promise Alliance launched the GradNation campaign in 2010, building on 105 dropout prevention summits we convened across the country to raise awareness and inspire action. GradNation is now a large and growing movement of dedicated individuals, organizations and communities working together to raise graduation rates and prepare all students for success.

Attendance Awareness Campaign
The Attendance Awareness Campaign is a nationwide recognition of the connection between school attendance and academic achievement. The goal is to mobilize schools and communities to promote the value of good attendance and to take concrete steps toward reducing chronic absence.

Attendance Works
Attendance Works’ mission is to advance student success and help close equity gaps by reducing chronic absence.

Everyone Graduates Center
The Everyone Graduates Center works to develop and disseminate the know-how required to enable all students to graduate from high school prepared for college, career and civic life.

Healthy Schools Campaign
The Healthy Schools Campaign works to ensure that all children have access to healthy school environments where they can learn and thrive.

National Center for Education Statistics, Every School Day Counts (NCES)
The NCES is the primary federal entity for collecting and analyzing data related to education in the U.S. and other nations.

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American Academy of Pediatrics