Regular attendance in school is essential for a child's educational success as well as their social well-being. School not only provides children with the tools to do well academically, but it also provides a setting for children to interact and socialize both with other children and adults outside the family. Many studies have been done on problems with school attendance. However, almost all of these studies have been about children with continual illnesses that cause them to be absent for a few days, many times throughout the school year (ie: asthma, sickle cell disease or epilepsy). According to the New York Board of Education, students who miss more than 15 days of school in a 90 day semester are "nearly impossible to educate" and those students who miss 11 to 15 days in a semester "require extraordinary efforts to educate."
Other studies have also have been done to show that more deprived children are already at a significantly higher risk to miss school than less deprived children. Therefore, we also decided to focus the study on an inner city population whose low socioeconomic status maybe combine with school absence to put these children at an increased risk for educational failure. And although much has been learned about the effect of chronic (longterm) illnesses and school absence, very little is known about the effect of prolonged, single episode absences from school such as in orthopaedic cases. Treating injuries such as these (for example a broken leg), often stretches from weeks to months and it is possible that the absence a child has from school could last the same amount of time. Thus, we focus our study on determining whether some children experience difficulty attending school after an acute orthopaedic injury, and if they do, what kind of problems cause the child's inability to attend school.
Methods:
Every child from the age of 5 to 18 years old that received treatment in our clinic for an orthopaedic injury between February 2002-June 2002 were asked to participate in the study. The clinic provides service to patients living in northern Manhatten and the Bronx who are either uninsured and on Medicaid. In the clinic we collected the following data from all 73 patients:
How they were injured.
What kind of injury they had.
Whether or not they were unable to move around because of the injury.
How they helped themselves move around.
How old the patient was.
What the patient's gender and race was.
What school the patient went to and who their principal was.
Of all 73 patients, 34 were not able to return to school immediately. We contacted those patients and gathered the following information from the parents:
How many days the child was absent from school.
Whether or not home instruction was provided.
If home instruction was provided, how many hours of instruction the child received.
Whether or not the parent had to miss work to stay at home with the child.
Whether the child had to attend summer school or repeat a grade as a result of his or her absence from school.
Also, we compared the official school policies on school absence because of an injury that were given to us by the principals to the actual school attendance of our patients.
Results:
The study consisted of 46 males and 27 females.
The average age was 11.2 years old.
78% of participants were Hispanic.
About 3/4 of the children attended school in Manhatten and about 1/4 attended school in the Bronx.
Overall only 53% of children were able to return to school immediately while only 47% were not.
The students who were not able to return to school immediately were absent for about 40 days. -Of those children who were unable to return to school nearly 3/4 said that it was because the school did not allow them to return and about 1/4 said it was because their parents did not allow them.
1/3 of the patients who were not able to return to school received home school instruction. -Those children were absent for an average of 56 days and only received instruction for 44 days. And of those children who received home instruction, 36% of the parents missed one or more days of work.
Discussion:
The primary conclusion that can be drawn from this investigation is that acute orthopaedic injuries (those due to sudden trauma) and their treatments can contribute to school attendance. Nearly 50% of the children in the study were not able to return to school immediately following their injuries. Also, we discovered that the school's refusal to allow the children to attend was the main reason children were absent. The children in our investigation are at high risk due to low socioeconomic status and those same students missed on average 40 days of school. This number is much higher than the 15 days per semester quoted by the New York Board of Education as an overwhelming educational obstacle. Last, we found that nearly 3 out of 4 otherwise healthy children said that they had tried to go to school but the principals would not let them because the schools were too overcrowded, the children were too rambunctious, and the stairways were too narrow. Although the child's safety within a school setting is very important, we feel as though this concern must be balanced with the already high risk for educational failure the child already has. We might suggest that a child with an injury be given extra time to get from classroom to classroom–possibly with the help of another teacher. Policies like this would take both the child's safety and educational future into concern.
Introduction: