Chronic Absence | California School-Based Health Alliance

Chronic Absenteeism Is Linked to Poor Grades and Dropout

Nationally, one in ten kindergarten and first grade students misses a full month of school in a single year, and the rates of chronic absenteeism in middle and high schools are even higher.¹ Unlike truancy rates, which distinguish between excused and unexcused absences, chronic absence rates reflect all absences. Looking at all absences is important because, regardless of why they are missing school, students do not learn when they are not in class. Research shows that chronic absenteeism increases a student’s risk of academic failure and is an early predictor of high school dropout.² It is essential that schools and districts track absenteeism on a student by student basis, as schoolwide attendance statistics can mask individual trends.

To learn more, visit the Attendance Works website.

School-Based Health Centers Can Help Schools Reduce Absence

Because chronic absenteeism is the result of complex mental, physical, and family health issues, school-based health centers (SBHCs) can play an integral part in strategically addressing attendance problems. In collaboration with educators, health center staff can identify and support students with unmet health needs so they can re-engage with school. Doing so improves student health and increases school attendance.³

At Elsa Widenmann Elementary School in Vallejo City Unified School District, educators saw an opportunity to reduce absenteeism by establishing a school-based health center. As former principal MaBella Gonzales explains, “Our concern was attendance, and how many non-urgent health needs were preventing children from coming to school. As we worked with our collaborative partners [to establish our new school-based health center] we wanted to create a hub for our school community where information and resources were available to support the health, well-being and positive lifestyles of students and families.”

To learn more about how SBHCs can maximize their impact on student achievement, including by addressing chronic absenteeism, see our Ready, Set, Success! toolkit.

Citations
(1) Attendance Works: http://www.attendanceworks.org/
(2) Attendance Works: http://www.attendanceworks.org/
(3)Lewallen, T., Hunt, H., Potts-Datema, W., Zaza, S., Giles, W. (2015). “The Whole School, Whole Community, Whole
Child Model: A New Approach for Improving Educational Attainment and Healthy Development for Students.” Journal of School Health. 85(11): 735.

Here you will find tips and tools to help you address chronic absenteeism at your school. One way to get started is to take this SBHC Self-Assessment.

1. Work with Administrators and the Attendance Office

Establish a mechanism for working with administrators and the attendance office to identify students who are chronically absent and have them referred to the school-based health center (SBHC). If you are able to participate in the school’s analysis of attendance data, you may find the following tools useful; if you are not able to participate in that process for privacy reasons, you may want to share the tools with school partners.

Tools for Collecting and Analyzing Student Attendance Data

Attendance Works is a national initiative that promotes awareness of the important role that school attendance plays in achieving academic success. Attendance Works offers several free assessments and tools for collecting and analyzing school attendance data.
The National Center for Education Statistics, at the U.S. Department of Education, is charged with collecting and analyzing data related to education. Every School Day Counts: The Forum Guide to Collecting and Using Attendance Data can help schools collect and analyze attendance data.

2. Participate in the School’s Absenteeism Intervention Team

This team should use an interdisciplinary process to identify and respond to the needs of chronically absent students. Such teams may be focused on attendance (e.g. School Attendance Review Team, or SART) or may address students’ needs more broadly (e.g. Coordination of Services Team, or COST). If your school does not have such a team, the health center should consider spearheading this effort.

Learn More About SARTs:

A School Attendance Review Team (SART) is an interdisciplinary intervention team, including teachers, administrators, and student support personnel (e.g., counselors, psychologists, nurses, and other school-based health center staff). Any student with frequent absences should be referred to the SART, which is responsible for developing an individualized plan for improving the student’s attendance. SART meetings should engage the student (if age-appropriate), as well as parents or other family members. If attendance does not improve after SART intervention, students are referred to the district or county level Student Attendance Review Board (SARB).
The California Department of Education website provides several resources for SARTs. These include a detailed list of school attendance improvement strategies as well as concrete resources for SARTs to use and/or adapt.

Learn More About Related State-Level Efforts:

Reducing chronic absence is a top priority for the California Department of Education. The state has a Model SARB Recognition Program to encourage schools to improve attendance.
This emphasis on reducing chronic absence is now reflected in the California Department of Education’s SARB Handbook. Offering concrete guidance about best practice and policy to school administrators and attendance workers, the handbook:
- Stresses the importance of early identification
- Offers a three-tiered approach to improving attendance
- Provides sample letters to parents of chronically absent students
- Recommends that attendance boards develop a policy that requires schools with unusually high levels of chronic absence to develop plans for improving attendance.

3. Conduct Health and Psychosocial Assessments

Conduct health and psychosocial assessments of chronically absent students and then either deliver indicated services or refer them to additional services not provided by your school health center. When possible, help patients and families make appointments with outside providers to ensure access to care. One successful example of a nurse practitioner-led effort to conduct assessments with chronically absent students is outlined in this research article: Does Contact by a Family Nurse Practitioner Decrease Early School Absence?

4. Interview Chronically Absent Students and Families

Interview chronically absent students and families to better understand the barriers to school attendance that they are experiencing and the types of incentives and supports that will re-engage them in school. This is particularly important for high school students, as they are more likely to make their own decisions about whether or not they will attend school, so attendance incentives should be determined by the teens they target.

5. Consult with School Administrators on Disciplinary Policies

Consult with school administrators on disciplinary policies to promote progressive disciplinary policies that address the causes of misbehavior rather than suspending or expelling students.

6. Conduct Home Visits

When you can’t reach chronically absent students or their families at school, conduct home visits to make personal contact. When possible, perform home visits in partnership with another school or health center staff member. When you find a student or family member at home, establish a non-threatening, non-judgmental approach by conveying your concern about the student’s absence, and inquiring as to how you might be able to help him/her attend school more regularly. It is not important to enter the home; even a brief conversation at the door and a personal invitation to come to the health center will help to build trust with the student and family.

Home Visiting Resources and Training Opportunities

Drawing on the work of other educational agencies, San Francisco Unified School District compiled a brief but helpful Guide to Team Home Visits.
The School Practitioner’s Concise Companion to Preventing Dropout and Attendance Problems includes valuable information on home visits. Chapter 6, Home Visits, is available for free online.
The Parent/Teacher Home Visit Project (PTHVP) is a nonprofit organization based in Sacramento. PTHVP provides training, consultation and resources to schools and school districts across California and the nation, with the goal of bringing parents and school staff together to support student success.

7. Provide Case Management

Provide ongoing, individual case management for chronically absent students and families.

Central Valley Attendance Campaign

(co-sponsored with our partner, REL West at WestEd)

Kerman, Parlier, and Tulare school districts have implemented partnerships with school-based health centers and community members to improve academic success by addressing absenteeism, school climate, and classroom behavior and performance. Learn how these districts and partners are making the connection between health, attendance, and school success.

Daly City Youth Center (Daly City, California)

A student was referred to the Daly City Youth Center because she was missing a lot of school, saying that she was feeling “sort of sick to her stomach.” After a sensitive and thorough consultation at the Youth Center, a clinician found that she had no physical ailment, but was experiencing severe anxiety, even panic, related to schoolwork.

The Youth Center provided one-on-one counseling and medication, both of which helped the student overcome her debilitating anxiety. She continued to struggle academically, however, and was referred for special education testing; ultimately, she was diagnosed with a learning disability. Throughout this process, the Youth Center staff provided case management services and advocated for the student with high school staff. The student’s parents, who did not speak English, participated in family counseling, and health center staff supported them in becoming empowered advocates for their daughter’s education.

In a new class, with supports for her learning disability, the student began to attend school regularly and do better academically. She continued to work with a counselor and also participated in a rigorous career internship at a child care center, an experience that built up her self-esteem. And, when she graduated, she accepted a job at the child care center where she interned.

Shop 55 Wellness Center (Oakland, California)

Shop 55, Oakland High School’s combined school-based health center and afterschool program, uses a rigorous case management model. Three case managers support the afterschool program; they each work with 40 prioritized students, developing trusting relationships and coordinating a strategic blend of services. Last spring, when a ninth grader began cutting class and getting into fights, she was referred to one of these case managers. The case manager, who met with the student at least three times a week, helped her focus on school by supporting her in goal setting, organizing work, and completing assignments. The student also met with a conflict mediator, to help her learn to resolve disagreements peacefully, and accessed first aid and reproductive services through the health center. Shop 55 was “an all-in-one one-stop shop” for her, and she felt very comfortable there. Over time, the student’s attendance, which was tracked by her case manager, improved—especially after lunch when the student had previously cut class.

Stagg Healthy Start Center (Stockton, California)

Stagg Senior High School’s dropout rate has been higher than the district and state averages and the school is committed to raising attendance and graduation rates. The Healthy Start Center is a leader in the school’s fight against chronic absenteeism, with staff members playing a key role in keeping students engaged and attending class.

The director of the Healthy Start Center participates actively in Stagg’s School Attendance Review Team (SART), an interdisciplinary team that also includes an assistant principal, a parent volunteer coordinator, a child welfare specialist, and a bilingual outreach worker. Healthy Start staff follow-up with chronically absent students who have been identified by the school’s attendance office by holding regular meetings with students and reaching out directly to parents. The Healthy Start Center responds to student needs by providing medical and mental health care; staff also coordinate student groups, including a conflict mediation group, to re-engage students in a positive school community. Until the recent budget cuts, case managers provided individualized support to students and families.