When should my child stay home? What is "too sick" for school?

For the protection of your child as well as the school community, students should be kept home from school or will be dismissed from school under the following circumstances:

• The child has a communicable disease. Students who are prescribed antibiotics must complete 24 hours of treatment before returning to school. For all other communicable diseases, the student may return to school based on DPH guidelines.

• The child has a temperature of over 100 degrees. The student may return after he/she is fever free for 24 hours without the use of fever reducers. 

• The child has any eye infection that has not been diagnosed by a physician. Students may return the day after any indicated treatment has begun. 

• The child has persistent coughing or trouble breathing. He/she may need to be evaluated for asthma, or a serious respiratory infection. A cough alone may be ok, but the student's ability to engage during the school day must be weighed if the cough is persistent/bothersome enough to prevent learning. Head, nose congestion are also symptoms that can be tolerated alone, but need to be evaluated for severity and how that effects the school day.

• The child has an undiagnosed rash. Rashes may need to be evaluated by a physician to rule out communicable disease.

• The child has head lice. The student may return to school after the first treatment is completed and all nits are removed.

• The illness results in a greater need for care than the staff determine they can provide without compromising their ability to care for other children.

• The child has vomited or is having diarrhea (watery stools). The student may return when he/she has been symptom free for 24 hours.

• The child has an illness that prevents him/her from participating comfortably in activities. Regardless of the combinations of symptoms, the underlying take away is that if your child is not comfortable they are not ready to learn.  There is at times a very delicate balance between getting through all the common childhood illnesses, building immunity and also learning how to carry on when we don't feel our best. 

We understand that when a child is sent home or home sick from school, the ongoing responsibilities of life do not pause for anyone. Please know that we do hold space and support our families to the best of our abilities, our main priority is providing for your children.

There is so much information available about ADHD, here are some resources I hope you find useful:

The Centers for Disease Control and Prevention (CDC) report that, “As of 2016, 6.1 million children aged 2-17 years living in the U.S. had been diagnosed with ADHD” (CDC 9\9\20). ADHD is the most common neurodevelopmental disorder in childhood. (CDC 1\21) How do you know if your child has ADHD? You can inquire with his/her/their teacher, school nurse, school counselor and/or the school psychologist for their professional input. DSM-5 Diagnostic Criteria is listed in the following chart by the American Academy of Family Physicians: (AAFP): chart

As a school nurse, when assessing a child for signs and symptoms of ADHD, I often ask his/her/their teacher or parent/guardian the following questions: Is the child forgetful, disorganized, and unable to sit still? Does the child have messy handwriting and have difficulty getting started on non-preferred activities? Does he/she/they not complete and/or rush through school work, invade others’ personal space, and/or hyper-focus? 

As noted in the DSM-5 Diagnostic Criteria for ADHD Chart there are different classifications and severity levels of ADHD. What’s important is how well your child is functioning in his/her/their daily life. ADHD symptoms can impact academics, as well as social-emotional and physical health. Early interventions both at home and in school allow for positive outcomes now and in the future. 

If your child has ADHD, you are not alone. There are many resources available for you. The nonprofit organization, Children and Adults with ADHD (CHADD) has a parent link providing information and support from other parents. This link includes an online module. One of my favorite resources is ADDitude magazine, which provides strategies and support for ADHD and LD. I enjoy listening to their podcasts. Their other sources of information include newsletters, discussion forums, guest blogs and webinars. You do not need to subscribe to have access to information. 

One last site that I find valuable is The Child MInd Institute. This organization provides tips, articles, and insights about children’s mental health and learning disorders. Your school nurse is here for you, working closely with teachers and administrators to best support your child’s learning experience. 

CDC 9\9\20 https://www.cdc.gov/ncbddd/adhd/features/national-prevalence-adhd-and-treatment.html 

CDC 1\21 https://www.cdc.gov/ncbddd/adhd/facts.html

• National Suicide Prevention Hotline: 1-800-273-8255                    

• Parent Stress Line (Multiple languages available): 1-800-632-8188 

• Call 911 if you feel that you or your child is at imminent risk

• Child-at-Risk Hotline (Call to report child abuse and neglect): 800-792-5200 

• National Domestic Violence Hotline 1-800-799-SAFE (7233) 

• Safe Passage Hotline: 1-888-345-5282

• National Suicide Prevention Hotline: 1-800-273-8255                    

• Parent Stress Line (Multiple languages available): 1-800-632-8188 

• Call 911 if you feel that you or your child is at imminent risk

• Child-at-Risk Hotline (Call to report child abuse and neglect): 800-792-5200 

• National Domestic Violence Hotline 1-800-799-SAFE (7233) 

• Safe Passage Hotline: 1-888-345-5282

Massachusetts Communicable/Infectious Disease Guidelines

If your child has a communicable illness, please notify your child's school nurse. Before returning to school, your child will need to be checked by the school nurse or have a certificate from your doctor (contact the school nurse to see which is applicable).

Isolation and Quarantine Regulations are as follows:

Impetigo - 24 hours after medical treatment has begun, lesions must be covered in school.

Meningitis/Bacterial - 24 hours after antibiotic therapy has begun.

Meningitis/Viral - No restrictions.

Meningococcal Infections without Meningitis - 24 hours after start of treatment.

Pinworm - Students do not need to be excluded assuming treatment has begun.

Ringworm - 24 hours after treatment has begun. Scabies - Note from Doctor that child has been treated and may return.

Scarlet Fever - 24 hours after prescribed medication has begun.

Strep Throat - 24 hours after antibiotic therapy has begun.