AAP News TODAY 2016 - Sunday, October 23, 2016 - 8
8 | AAPexperience.org
School Absenteeism Can Have Long-Term Consequences
You know which of your patients have a
chronic illness and how it may affect them
down the road. But do you know how
many are chronically absent from school
and what that means for their future?
If you don't, you're not alone. Most school
districts don't even have a handle on which
students fail to show up on a regular basis.
Moscone West, Room 3018
Hedy Chang is hoping to change that by
raising awareness of what chronic absenteeism is, how to measure it and what to
do about it. Chang is executive director
of Attendance Works, a national and state
initiative that promotes awareness of the
important role that school attendance plays
in achieving academic success.
"All the investments that schools make
in quality instruction, better curriculum
don't pay off unless the kids are in the
classroom," said Chang, who will present
a session titled "Promoting School Attendance and Preventing School Failure: Is
There a Prescription for That? (F2123)."
The session will be held from 2:00-2:45 pm
today in Room 3018 of Moscone West.
Chronic absenteeism often is defined as
missing 10% or more of the school year
- or two days a month - for any reason,
including excused and unexcused absences
as well as suspensions. Reasons for chronic
absences may include physical or mental
illness, unreliable transportation, and
When tracking attendance, many schools
only look at average daily attendance (the
number of students who show up each day)
and truancy (unexcused absences). Both
of those metrics can mask high levels of
absences, particularly in the early grades,
"If you just look at unexcused absences,
health-related absences aren't there," she said.
"But if a kid misses two days a month, 10%
of the school year, there's plenty of research
that shows those kids are falling behind."
Many parents might not hesitate to keep
a kindergartner or first-grader home, but
Chang stressed that missing a lot of school
in the early years puts a child behind in
"Even if your attendance improves," she
said, "we don't have systems that are aimed
at helping kids catch up."
Another challenge is that many people
don't worry about health-related absences
because they are excused.
"We can understand why they might be
staying home," Chang said, "but there are
still some adverse consequences of missing
that much school."
Chang said pediatricians are "critical, key,
unlikely allies to help us address this issue."
Pediatricians can talk with families about
why going to school every day matters,
They can help
families understand when
OK to go to
school with a
If a student
has a mental
health issue, they can come up with strategies other than missing school.
During the session, Chang plans to encourage doctors to work with their schools
and communities to determine the causes
of chronic absence and determine how it
can be addressed.
"There's a lot of health innovation that
can be integrated with schools and doctors
can help schools think about," she said.
What to Do About Prenatal Urinary Tract Dilation?
Prenatal urinary tract dilation is common, occurring in 1% of pregnancies.
While it is benign in most circumstances,
certain conditions such as urinary tract
infection or kidney obstruction will predispose to significant morbidity.
Since the disease is being detected
increasingly, pediatricians often are asked
about the need for intervention. Yet the
answer is not clear-cut.
Come hear the rationale for different
approaches during the Point-Counterpoint
Session "Perinatal Urinary Tract Dilation:
Intervention or Observation? (D2166)"
from 4:00-5:00 pm today in Room 3022 of
C.D. Anthony Herndon, MD, FAAP,
professor of surgery/urology, division chief
pediatric urology and co-surgeon in chief
at Children's Hospital of Richmond at Virginia Commonwealth University, will argue
in favor of intervention. Poyyapakkam Srivaths, MD, MS, FAAP, associate professor
of pediatrics, Renal Section, Baylor College
of Medicine, will support observation.
"This point-counterpoint format will
bring out the best of both worlds and
hopefully leave the audience with a balanced approach," Dr. Srivaths said.
Moscone West, Room 3022
Dr. Herndon pointed to several papers
that support intervention, including the
Society for Fetal Urology consensus statement on the evaluation and management
"The evaluation and
an indiscriminant approach towards postnatal screening in the majority of patients," said Dr.
Herndon, a member of the AAP Section
on Urology Executive Committee. "This
AAP Kids' Camp
AAP Kids' Camp hosted more than 300 kids
and kids at heart Friday evening. Guests
were treated to healthy food, music, fun and
games, as well as an opportunity to meet
the Cat in the Hat and Sophie Blackall, the
talented illustrator behind the popular Ivy &
Bean book series.
shift relies on
the development of a risk
in turn is
used to guide
tract imaging and surgical intervention."
Dr. Srivaths said evidence for the effectiveness of prenatal intervention even in
the most severe cases of antenatal dilation
(lower urinary tract dilation) is not very
strong, and the only randomized controlled
trial did not show clear benefit. The main
evidence that supports watchful expectancy for the most common abnormality
of the urinary tract, i.e., vesicoureteral
reflux, came from the Randomized Intervention for Children with Vesicoureteral
Reflux (RIVUR) study, which showed
prophylactic antibiotics did not prevent
"The observation position is a nuanced
one since it involves a triaged approach for
expectant management," Dr. Srivaths said.
"This position also is influenced by the fact
that renal survival is not affected very much
by any of the interventions."