During lunch, one afternoon at P.S. 36, an elementary school in Harlem, New York, a shy first-grader named Josiah plays with cards, action figures, and building blocks with his best friend.

A scene like this, where Josiah is healthy and contently playing at school, is one his school’s administrators and teachers would like to see more of. Josiah has asthma and, in large part because of this illness, has been absent from school a lot in the past.
Parents and schools are often unaware of how missed school days can add up, but both excused and unexcused absences can seriously hinder a child’s learning. At Josiah’s age, missing a lot of school time can lead to an increased risk for reading difficulties. Children who do not read at the appropriate age level by third grade are four times more likely to drop out of high school than proficient readers. Poor school performance and dropping out then increase a child’s risk for unhealthy behaviors and even long-term health issues.
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Missing just 15 or more days of the school year is considered ‘chronic absenteeism.’ Last year, Josiah had already missed 12 days of school by mid-October.
Why Attendance Is Difficult for Some Students
Why do some children have so much trouble with attendance? Some missed school days can be attributed to health-related issues like dental pain or asthma. But chronic absenteeism is also caused by other complex social issues facing families and children impacted by poverty, such as homelessness and mental health issues.
Simply put, health conditions, including social conditions that impact health, have a strong impact on learning. These conditions are called health barriers to learning (HBLs): the physical and mental health issues that impact a child’s ability to attend school, pay attention, and to live up to their potential.
The team at the Children’s Health Fund Healthy and Ready to Learn initiative (HRL) is dedicated to addressing health barriers to learning. The team works closely with students, parents, and administrators at schools in New York City, giving students individual interventions to help them thrive.
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Being Present for Josiah’s Success
The HRL team at Josiah’s school saw his high absence rate and stepped in to help address the underlying factors that were keeping him from the classroom. Because he has missed so many school days in the past, the HRL program considers Josiah a “Rocket,” a student who receives the highest attention and interventions from the team.
To help him be more present in school, HRL site manager at P.S. 36 connected with Josiah three times a week to encourage good attendance. She also met with his mother to discuss the importance of completing a medical consent form so that the school nurse could administer Josiah’s asthma medications, making it easier to manage his illness.
Josiah’s parents had been unaware of the cost to their son of each missed day of class, and how poor health can jeopardize educational outcomes. They were eager to help Josiah succeed. The school team called his parents whenever Josiah was absent, offering them regular support to ensure that his asthma was controlled so that he was healthier and able to attend and be present in school.
Josiah’s support from HRL has even included regular sessions with his school’s on-site mental health counselor, who gave him tools to better communicate his wants and needs.
A Rocket Soars
With the support of the HRL team, Josiah’s health and performance have started to take off. Josiah’s teacher, who was also his kindergarten teacher last year, has noticed him be more social and more comfortable speaking up for himself this year. His mother says that Josiah is also more communicative and cheerful outside of school. And his health habits have improved, too. Last year, getting Josiah to brush his teeth was a twice-daily battle at home. But after a visit to the school-based dental clinic for a cleaning, he’s now a tooth-brushing champ.
As for his attendance? He’s only missed one day so far this year.