In the classic ’80s film Ferris Bueller’s Day Off, a teenager heats a thermometer to prove to his parents that he’s too sick to go to school. Something you might expect from a devious teen, but could a younger elementary-age child be quite so cunning?
Probably not, according to Susan Pease Banitt, a Portland licensed clinical social worker. “To a young child, there is really no such thing as ‘faking,’ which implies conscious intent — something a young child is not yet capable of. I think we all do a lot of projecting onto a young child’s mind from an adult mind.”
A child may claim to be sick when he’s not — if he’s under stress, Banitt says. Symptoms such as headache or stomachache can be the result of emotional issues that a young child may not be able to verbalize.
“Kids engage in what is known as ‘school refusal’ for a variety of reasons,” says child and family therapist Wendy Young. Anxieties, like separation or social anxiety, depression or other psychiatric disorders, as well as changes in the household (new baby, divorce, death in the family) can play a role, Young says. “Also, we must consider the possibility of bullying or undetected learning disabilities.”
And, Banitt adds, parents should look for the underlying issue: “Why is the child so motivated to stay home? That’s the important question.”
What to do if you think your kid isn't really sick
Dr. Richard Horowitz, author of Peaceful Parenting: Parent Empowerment and Child Empowerment, says you should start by validating the child’s feelings so the child knows he has been heard. Diagnose illness to the best of your ability. If symptoms are not clear, a parent could ask, “I know you’re not feeling 100 percent, but do you think you can get through your day at school?” Let the child know they can always call to come home if needed.
If it seems to you that the “illness” may be psychosomatic, try to uncover the reason. Start by asking your child if anything is bothering them or if they are having problems at school. Talk to the child’s teacher to see if they can give you a clue. Often the “illness” may coincide with a certain activity or social interactions.
Advice for parents
Seattle mom Anna’s son suffers from chronic and very serious sinus infections; he’s really sick — a lot. But she has found that even when his symptoms improve, he’s sometimes reluctant to go back to school. “He gets nervous that everyone else has plunged ahead with a project and that he’d be behind,” says Anna. “He has been out due to real illness up to two weeks at a time. It’s hard for me to force him back, but I don’t want to keep him out too long.
“It’s hard to determine whether or not he’s really well; I don’t always get it right. I think the thing that works out the best is I tell him I’ll pop in at lunchtime and see how he’s doing, so he knows he might only have to hold out a few hours. Sometimes he’s fine and stays, and other times he has needed to come home.”
Kathi Joy experienced the more classic situation. “My daughter frequently spent her first-grade year ‘feeling sick.’ She would tell me she had a headache or her stomach hurt. She never had a temperature and she usually was fine upon waking up. Only after breakfast did the ‘symptoms’ kick in.
“We talked about the issues with her teacher and determined that what was really going on was nervousness about the new situation. We decided that we’d determine if she was ‘sick sick’ or ‘home sick’ and each one would have a different remedy. The remedies for homesickness were pictures of home, a favorite stuffed animal, small treats, etc. Once that distinction was made, my daughter’s needs were met. She wasn’t sick anymore.”
Laura’s daughter has no problem going to school, but she often complains of illness to avoid social situations. “She’s a homebody — likes to be around her stuff, likes to be home on the weekends where she’s comfortable,” says Laura, who lives in Seattle. “If I ask her to go for a bike ride with me, she’ll say she doesn’t feel good. When I signed her up for swim lessons and she wasn’t very excited about that, she woke up saying she didn’t feel well.
“She doesn’t like to talk about why she doesn’t like to go somewhere; she doesn’t like to express herself. Once she’s there, she’s usually fine.”
With so many reasons why a child may be “too sick to go to school,” a parent’s best defense is to know their child well. Stay informed about what is going on in their world, and use that knowledge to help make the best possible diagnosis.
When to keep her home from school
Children who have the following symptoms should stay home from school for at least 24 hours after the symptoms persist without the help of medication, or until a doctor gives a clean bill of health.
Fever. If the child’s temperature runs higher than 100 degrees. At most schools, children must be fever-free for 24 hours, without the use of medicine, before returning to school.
Vomiting/diarrhea. If these symptoms happen more than once in a day or are associated with fever, the child should be kept home.
Skin rashes. If their rash has any fluid or pus coming from it, the child should be seen by a doctor before returning to school. If a rash is associated with fever, it could be a sign of a contagious disease, such as measles or chickenpox.
Red eyes. If accompanied by drainage or crusting, this can be a sign of conjunctivitis, also known as pink eye. Red eyes can also be caused by allergies. When in doubt, see a doctor.
Pediculosis (head lice) or scabies. Check with your school nurse to get information on treatment and when your child may return to school.