Aspergers Children and Poor School Attendance


My child with Aspergers often convinces me that he is too sick to attend school. I end up calling-in for him at least a couple times a month. How can I tell if he’s really sick – or if he just doesn’t want to go to school that day?


Is your Aspergers (high functioning autistic) child really too sick to attend school - or is he faking it?

Many moms and dads have a hard time deciding if their children are well enough to go to school. After all, what well-intentioned mother or father hasn't sent a youngster off with tissues in hand only to get that mid-morning "come get your son" phone call? But making the right decision isn't as tough as you might think. It basically boils down to one question: Can your youngster still participate in school activities? After all, having a sore throat, cough, or mild congestion does not necessarily mean a student can't be active and participate in school activities.

Determining whether or not a youngster has a fever offers a fairly reliable way of judging whether or not he is truly too sick to go to school. Additionally, it is one of the few symptoms that can actually be quantified. States often have requirements regarding the exact temperature at which kids need to be sent home, especially in early childhood and child-care settings.

The time of day during which a youngster is experiencing a fever can also make a difference. Fevers usually run a bit higher in the evening than they do in the morning. So a high temperature in the evening may abate overnight. However, a high temperature in the morning will likely only get worse as the day progresses, so moms and dads should consider keeping children home in this case.

The child should probably stay home if it is the first day of the illness and the temperature is over 101. If it is the third day or later, and the youngster has been acting well during the day, but has a 101 temperature in the evening, he probably should go to school.

A fever isn't the only symptom to track when it comes to judging a kid's ability to attend school. Vomiting, diarrhea, rashes and a host of other indicators can also mean the difference between a desk at school or the couch at home.

Vomiting and diarrhea can also be a tremendous source of discomfort for kids if severe or uncontrolled. In these cases, a day at home may be the best option. If the youngster is vomiting, it is inconvenient for the teacher and the other classmates. If mild and controllable, however, a bit of diarrhea may not be a big problem. In elementary age kids, diarrhea isn't as much of an issue if it doesn't interfere with their ability to remain in the classroom and if they aren't sick enough to potentially have accidents, have to run to the bathroom, or be in pain.

Rashes, particularly those that cannot be readily explained, may also be cause to keep your kid at home -- and perhaps even require a doctor's opinion.

And kids with severe cases of conjunctivitis -- commonly known as pink eye -- should also be kept home from school. However, some doctors note that mild cases of this affliction may not warrant a day off.

Many moms and dads may also wonder when it is safe for their youngster to go back to school after recovering from their illness. The answer to that one is a little bit trickier. In general, nobody would recommend that a youngster goes back to school unless he has been fever-free for 24 hours, and some would even say 48 hours. A full day of fever-free downtime is probably sufficient to safeguard the youngster's health, as well as that of his peers. It is fairly standard that kids are required to be fever-free for 24 hours before returning, which is a useful method of limiting the spread of infection during the febrile period when kids are thought to be most contagious. When the fever is gone for 24 hours, the contagiousness is greatly diminished.

The 24-hour rule may prove to be more than sufficient for vomiting. Vomiting is a temporary nuisance most of the time. So if the youngster feels OK and has not vomited since midnight, consider allowing him to go the next morning.

In most cases, however, the decision of whether or not to send a sick kid to school will not be clear-cut. In these cases, moms and dads must ask themselves certain questions to help them decide. Will the illness prevent the youngster's participation in normal school activities? Also, will the youngster's illness place an unusual burden on the staff? A third and very important question to consider is whether or not the illness that the youngster has poses a risk to other kids and adults.

Moms and dads must also keep in mind that those complaints of abdominal pain could be from a food-borne illness -- or they could just be due to anxiety over the prospect of going to school. But in these situations, it may be better to err on the side of caution.

Moms and dads have to be willing to trust their instincts. Even when their youngster is not having any objective signs of illness, if they think that the youngster is different from how she normally is, they need to trust their instincts and keep her at home until they figure out what's wrong.

Moms and dads should also be aware of symptoms that suggest the youngster should be brought to a doctor. If the youngster cannot touch her chin to her chest, it could be a sign of meningitis, a serious infection that warrants immediate medical attention.

Deciding whether or not to send your kid to school can sometimes be a tough call. After all, it's not always easy to distinguish simple theatrics from true illness. Worse yet, a diagnosis and decision must often be made in the few spare moments after breakfast (and before an angry call from your boss). Fortunately, there are a few rules of thumb that you can follow when determining whether a youngster is up to the task of a full day at school. And doctors say a mild case of sore throat or the sniffles is not necessarily a mandate to keep children at home.

Trust your instincts. If your child has the sniffles but hasn't slowed down at home, chances are he's well enough for the classroom. On the other hand, he may need to take it easy at home if he's been coughing all night and needs to be woken up in the morning.

My Aspergers Child: Preventing Meltdowns at Home and School


Chris said...

The response here, while very thorough, does not address one important issue. Autism Spectrum Disorders could very well be linked to anxiety and/or school avoidance.

While physical symptoms may not be present (ie. a fever), that does not make the experience any less real to the child at the time. An anxiety attack is limited in duration. Try giving the child some time, without threats or pressure, to allow the anxiety to pass. If the child is more comfortable with going to school after an hour or so, it is very possible that anxiety was a factor.

Mary said...

That's an excellent point, Chris. I also feel anxiety should be considered as a possible reason for a child's reluctance to go to school. In fact, I wouldn't be surprised if anxiety plays a larger role in school absence and avoidance for Aspergers children altogether. This occurs sometimes on a weekly basis with my 10-year-old Aspergers grandson who lives with me. He does have other medical issues that compound the problem but his anxiety is severe enough that he vomits and has pounding headaches. It's tough and we used to struggle weekly with this dilemma. But I have found that giving him some time to lie down in a quiet place and discuss why he doesn't 'feel good' is a positive way to find out if anxiety is at the root of his feeling ill and most often it is. Quietly listening and comforting him helps him release his anxiety. This approach works 99% of the time and once he's feeling better I bring him to school. I like to refer to the adage, "better late than never" as a positive motto to live by.

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