Defining 'Sick'

By Rebeldad Brian Reid

Last Thursday, I was getting ready to bundle the little one up when she started coughing a little bit. Nothing too dramatic, kind of a low-grade hairball-esque hacking. Then she threw up. It wasn't much -- less than a tablespoon. Fifteen minutes later, she let loose with another micro-barf. I immediately scrapped the day-care plan and started preparing to hunker down for the day. I decided she was clearly Sick, with a capital "S."

Naturally, she was fine after that. She was in great spirits. There was no more heaving.

I struggle with how to determine how sick is too sick. Some things, including vomit, are beyond debate. The stomach flu is too much of a disaster to subject anyone to the risk. Ditto high fevers. But cold season is still upon us, which leaves the whole lot of gray area of coughing, sneezing and green gook in the nose. I figure if the kids aren't slowed down, far be it from me to sideline them.

Lately, it's getting trickier. My oldest is able to communicate non-specific symptoms with great precision now, and I get the occasional reports of headaches and stomachaches and the like. On the one hand, I come from a not-always-helpful tradition of sucking it up and pushing through minor ailments (days of high school missed due to illness=0). On the flip side, I want my kids to be taken seriously when they advocate for their health.

This must get even more difficult as children get older: At what point do you, as a parent, stop deciding what should and shouldn't require medical attention? When does a 9-year-old with nausea (and a quiz that morning) get a pass? Who decides -- kid or parent -- when a 13-year-old's acne is bad enough to see a dermatologist? Can a 15-year-old be trusted to tell if his ankle deserves a workup by an orthoped?

Since my kids are still at the young end of things, I'm particularly interested in the grizzled veterans: What kind of health decisions can you trust your kids with?

Brian Reid writes about parenting and work-family balance. You can read his blog at rebeldad.com.

By Brian Reid |  February 14, 2008; 7:00 AM ET  | Category:  Childcare
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Brian brings up one example I have very personal experience with, and that's teenage acne. To answer his question,"Who decides -- kid or parent -- when a 13-year-old's acne is bad enough to see a dermatologist?", the answer is neither -- go to a trained dermatologist and them him or her answer it for you.

I say this because I've seen too many parents take it upon themselves to make that decision when they shouldn't (unless you happen to be, in fact, a dermatologist). I, then, have seen too many teenagers suffer needlessly with acne that does not (and will not) respond to over-the-counter treatments, thus effectively killing their social lives, self-esteem, and their skin in the long run.

I say this as someone who had HORRID skin as a teenager (as in, I was on Accutane not once but twice), but because my parents were smart and got me the treatment I needed, acne did not ruin my life (as it so easily could have...) and my skin looks great today (no poc marks and such).

Just my PSA for this morning.

Posted by: Corvette1975 | February 14, 2008 7:48 AM

"When does a 9-year-old with nausea (and a quiz that morning) get a pass?"

Dunno, but please do not bring this kid to work!

Posted by: chittybangbang | February 14, 2008 7:52 AM

My mom's rule was always that if you had a fever or were actively throwing up, you could stay home from school. Otherwise, as far as she was concerned, it was all fakery designed to get out of school.

Posted by: jcadam | February 14, 2008 7:59 AM

Great topic. Hope to learn something today as well.
My 11 year old son's condition was always more simple to figure out: either he was really sick or not. He's generally healthy and recovers fast from his minor problems. But my 4 year old daughter is another story. She started having migraines some months ago (runs in the family, unfortunately) and though the episodes occur at very specific periods (night to dawn) and have a very short duration (approximately 2h), she often complains about light stomachache or headache (the two main symptoms of children migraines) during the day. Sometimes I guess she just wants more attention; sometimes I'm not sure; sometimes I don't have a clue. Plus, I believe she actually enjoys taking the medication, both because it's sweet and because Mommy takes migraine medication as well so it gives her some sense of status. I try to access whether its just a mild discomfort or a light pain (sure it's nothing like the intensity of the night crisis), and since she is very verbal she tries to explain, but it's not that helpful because she always makes an enormous fuss about whatever small scratch or bump she gets, so she is not to trust on this particular issue. Well, I don't want to give her medication if it's not strictly needed, but I don't want her to endure pain either. So it's a hard call most of the times.

Posted by: portuguese-mother | February 14, 2008 8:18 AM

My parents' views were similar to jcadam's mom's. In fact, in my family we still laugh about the line in Ferris Bueller "If I was bleeding out of my eyes you guys would make me go to school". The presence of a fever over 101 or serious upchucking meant we got to stay home, but it wasn't enjoyable. We stayed in bed, no TV, etc. This was a-okay by me since I was/am a reader, but I had plenty of friends who would stay home "sick" and watch MTV all day.

How about the parents who allow "R&R" days for their kids? Where's the truancy officer anymore?

Posted by: WorkingMomX | February 14, 2008 8:19 AM

My husband had a mom who sent him to school with appendicitis and his appendix burst and he nearly died -- so he always wants to err on the side of giving them a pass and letting them stay home.

The one I personally struggle with is sports injuries. My daughter developed some odd sort of tendonitis in her hips related to swimming and my dad told me I was the worst parent in the world for allowing her to continue swimming. I'd love to know how other parents deal with the gymnastics injury, the running injury and so forth. At what point is it too much strain and time to stop the sports?

But regarding kids' health, I think it kind of comes down to whether you view your kids as hardy or fragile and whether you view the world as threatening or benevolent. If you view the world as extremely dangerous, you tend not to be cavalier about their health.

Personally, I have this weird phobia about MRSA, and am completely paranoid this time of year about all the snot and germs on the desks and on the keyboards in the library and so forth.

Posted by: justlurking | February 14, 2008 8:32 AM

WorkingMomX could be my sibling! My mother's attitude was "if you're too sick to go to school, you're too sick to watch TV". Also, if you could do much of anything besides sleep, you could go to school. Amazingly, she was a nurse. These days it seems like the school decides for you--"if you're sick enough to go to the nurses office, you're sick enough to go home".

Posted by: trishat40 | February 14, 2008 8:35 AM

I don't know, but these situations always arise during the morning rush, and you have to start cutting and pasting sitters and sick leave and transport and all that, literally at a moment's notice. In our house it always happens when my husband's traveling. Natch. - It's actually a bonus if they barf in the middle of the night, giving you the rest of the night (every single one of the wee hours) to think about how to organize your day. Yay.

Posted by: kavvakumovits | February 14, 2008 8:39 AM

Trishat40, the scary thing is, given the anonymous nature of the blog, we COULD in fact be siblings . . . :)

I think it's something in our culture. I'll tell you what, my au pairs have NEVER taken a sick day, not once, and most of the host families I know experience the same thing. Whereas my stepdaughter feels the need to report to the ER if she gets a headache while she's got her period . . .

Posted by: WorkingMomX | February 14, 2008 8:42 AM

Interesting topic that definitely hits on balance. I think that strict family rules about this fail with very different children with very different personalities or ones with chronic illnesses.

My daughter is extroverted, highly motivated and enjoys school (even middle school) but has occasionally had either a horrible social crisis (in her mind, not mine) or feels unprepared for a test or just feels tired and down. She then asks to say home from school. I usually say fine. For her, just telling her that she doesn't have to go to school sometimes reduces the stress so that she usually gets motivated to go ahead and go. She only stays home or goes late once or twice a year to avoid some crisis. The good thing about this policy is that she really can relax and decide why she is avoiding school instead of lying to me and herself by saying she feels unwell. We have been doing this since kindergarten and it works very well for the highly strung kid. I work full time, and she may choose to pull this on a day that is very inconvenient for me but I just take a deep breath and adapt. It is better than having a hypochondriac and stressed kid. I hope she takes this habit of "don't sweat the small stuff" with her into the larger world.

We do not have this policy for our less motivated, introverted kid who would like to miss school 2 days out of 5, but at the same time he knows if he feels very unwell I will not force him to go to school. Messge to him...yes, you "do need to sweat the small stuff" because you perceive everything (including quarter finals and college applications) as small stuff.

Posted by: samclare | February 14, 2008 8:49 AM

Our rule is you can only stay home if you have a fever or have thrown up. We make a few exceptions based on parents judgment -- not the kids!

Recently DH took the kids to school. Our daughter said she had a fever. She had been fine at home so he told her to get out of the car and go to school. She did -- straight to the nurse's office. She DID have a fever. DH had to turn around and get her.

I sympathize and agree with the acne stories. I've seen parents be really harsh about this -- "just wash your face more" and turns out it was some kind of virus, impossible to get rid of without medication, and kid endured years of torment and was physically scarred forever.

The harder issue, actually, is determining if your kid has chemical or emotional problems and needs to see a psychiatrist. This can be especially hard when parents disagree. One family I know the mother felt strongly the child was in trouble, dad was in denial, and the child developed a terrible oxycodin addiction in her attempt to self-medicate.

There is a lot of negative press about anti-depressants for children these days, but the truth is they can help a lot of at-risk children and teenagers, especially those who are vulnerable to depression, suicide and drug problems.

I'm not a hypochondriac. But we live in a country with incredible medial expertise (if you have insurance) and we should make it accessible to our children when appropriate.

Posted by: leslie4 | February 14, 2008 8:58 AM

I have to ditto Corvette1975's acne comment. My dad had horrible acne as a teen, so when I was coming up with the same problem, their attitude was "It's a teenager thing, she'll be fine." As an adult I was able to seek the treatment I needed, but by that point it was late enough in the game that I do have pock marks and scarring, and my skin will never be attractive. I don't think my parents were trying to be neglectful, just unaware of the fact that acne is NOT normal and CAN be treated.

On the other side of the coin, they were pretty good about letting me stay home from school when needed. Most kids don't get sick or fake illness solely to inconvenience their parents.

Posted by: jaxom | February 14, 2008 9:04 AM

We're fortunate -- our children don't seem to want to play the "I'm sick!" game. I was the queen of it as a child, and I don't know why -- I liked school. I think it was because I enjoyed the challenge.

The problem we've dealt with is with our 10-year old daughter's mysterious leg pains. For example, she could be perfectly fine on the way to dinner at a restaurant and then be unable to walk without severe pain when she gets up to leave the restaurant. At first these pains seemed to be part of her dramatic personality. However, when pain affected her ability to play soccer on occasion (which she LOVES), we started to take her seriously. We took her to an orthopedic doctor who diagnosed her with "growing pains." He showed her several stretches to either avoid pain before games or to work out pain. What a difference! The leg pains have dramatically reduced.

Posted by: S1234P | February 14, 2008 9:04 AM

Easy: If the kid felt she was too sick to go to school, no TV, no reading, no getting out of bed till the next day. Worked great.

Posted by: karen.farrell | February 14, 2008 9:08 AM

Leslie, Acne is caused by bacteria, not viruses.

Posted by: mehitabel | February 14, 2008 9:15 AM

A temperature and lethargic behavior are usually my measures.

Because throwing up is so messy, if a child upchucks in the morning before school that, even without a temperature would be a good reason to stay home. If it becomes a pattern, centered around tests etc... then it needs further investigation and "work."

In adulthood I have worked with too many poor performers who take days off around their periods to think that period related ills should warrant a day home from school. It's not the kind of habit that lends itself to a successful work life. A young girl with bad menstrual problems needs to see a GYN and figure out how to manage them.

IMO any acne that's even a bit cystic or widespread needs to see a dermatologist. Self-care instructions are often more effective when they come from a professional.

Posted by: RedBird27 | February 14, 2008 9:18 AM

Very good question. I was pretty sickly as a child - got strep every year and had mono in the 4th grade! But luckily our daughter seems to be a bit healthier. I don't send her if she has a fever, is throwing up or hacking and coughing a lot. I've also kept her home for a day when she was coming down with a cold to keep it from getting worse. That seems to be a preventive measure that has paid off. Besides, they don't want a kid who is sneezing and coughing and blowing their nose all the time - quite a distraction.

Posted by: mosere | February 14, 2008 9:20 AM

"How about the parents who allow "R&R" days for their kids? Where's the truancy officer anymore?"
Posted by: WorkingMomX | February 14, 2008 08:19 AM

I take an occasional "mental health day" so I don't see anything wrong with my kids doing it. Everyone needs a day off to recharge once in a while. I'm talking about once or twice a year, not every week.

As for the truant officers, they have much bigger problems than kids who miss a couple of days of school here and there.

Posted by: dennis5 | February 14, 2008 9:27 AM

Surely you don't think a 15 year old is responsible for the decision to see an orthopedic doctor? You're supposed to be the responsible parent.

If your child is contagious (other than a minor cold, or else no one would be in school) have the decency and courtesy to keep him/her home. Just because you can't work out child care doesn't mean your kid gets to get my kid sick.

Too many parents just don't care.

Posted by: Post43 | February 14, 2008 9:36 AM

Our rules are the same as my parents' rules when I was growing up: fever over 100 or vomiting = stay home from school. But that also means no going outside; no computer use; you're supposed to recuperate (although we do allow some TV for convalescents).

DS has gotten migraines since he was about 3; fortunately they're not as bad or as frequent and he now knows how to deal with them. (Tylenol at the first sign of a small headache, which he now recognizes, cuts the severity of the migraine dramatically.)

Re: more serious stuff like acne, pains in the limbs or joints, etc. - we always err on the side of safety. If the kid really wants to go to the doctor, we take the kid to the pediatrician. We have a wonderful pediatrician; we've been with her for 17 years now and she knows our kids well. If she says they need to see a dermatologist/orthopedist/whatever, off we go. She's also very well connected in the local medical community, and tends to only refer us to good specialists. We've only seen one or two doctors I'd consider "quacks" and then we request referrals to other doctors.

Same with mental health - when we were concerned about that type of issue, we had the child see the pediatrician first; then the pediatrician made the referral as necessary.

But we don't let the kids take "mental health" days off from school - if there's something you're afraid to deal with and want to skip school, you'd better be telling me about it and then I'm going to deal with it.

Posted by: ArmyBrat | February 14, 2008 9:38 AM

mehitabel is correct that acne is caused by bacteria, but virusses cause other skin conditions that are often mistaken for acne.

As for rebeldad's question about when to allow children to self-refer to a specialist, I suggest you take them to their pediatrician. A pediatrician can deal with things like acne and ankle sprains and probably has a better sense of when to refer and to what specialty than your nine year old does.

Posted by: mit2 | February 14, 2008 9:39 AM

Dennis -- I take an occasional "mental health day" so I don't see anything wrong with my kids doing it. Everyone needs a day off to recharge once in a while. I'm talking about once or twice a year, not every week.

You have GOT to be kidding me with this. Why does a child need a mental health day? You are raising a poor performer.

Posted by: WorkingMomX | February 14, 2008 9:44 AM

I use the day care 24 hour rule of fever over 100, diaherra (sp?), and vomiting. Otherwise, I let the school or day care call me if she is too sick. I find the school sends them home with anything.

Posted by: foamgnome | February 14, 2008 9:48 AM

Re: "Mental health days" - we keep in mind that the kids only go to school at most 178 days per year. They can "recover" and improve their mental health the other half of the year.

(For example, kids in the local public schools had last Friday off for teacher conferences/teacher professional day related to the first semester. Then they got this Tuesday off for the primary elections. They get next Monday off for President's Day. And that was even before they got Wednesday off for the ice storm - that one at least has to be made up. So the schedule was: four day week; three day weekend; one day of school; day off; three days of school; three day weekend; four day week. Sorry, I don't understand why you need an additional day off for "mental health.")

Posted by: ArmyBrat | February 14, 2008 9:53 AM

Matt from Aberdeen,

I found a news story about what you were asking about yesterday. Look near the end of yesteday's blog.

Posted by: Fred | February 14, 2008 9:54 AM

Besides the obvious of high fever, vomiting, diarrhea.... the other "test" of bona fide illess that was used in my household...... "If you stay home there will be no computer, TV, Ipod, phone. How bad do you really feel?". Usually when they realized their day at home was going to be extremely boring - it put their illness in perspective. When they were willing to forego all of their fun items - they WERE sick!

Posted by: cyntiastmancom | February 14, 2008 10:26 AM

My parents used similar rules for staying home from school - fever of over 100 and/or vomiting (and if there was just one instance of vomiting, it was iffy - kids learn how to vomit on cue pretty quickly). TV/video games (remember Atari 2600?) were prohibited/limited, although that rule was relaxed if it was apparent that I was very ill.

If I'd asked to stay home for a "mental health day," my parents (both public school teachers) would have stopped laughing only long enough to get my behind out the door. My father retired with more than 300 unused sick days - that doesn't happen by staying home if you have the sniffles, or taking mental health days.

Posted by: wgm | February 14, 2008 10:33 AM

My parents allowed me to take mental health days; however, I was a high-performer who had no problems making good grades and getting my assignments/projects in on time. Therefore, they knew if I said I needed to take a breather from school, I really did need a break -- I wasn't slacking off.

On the other hand, I'm sure if my schoolwork was suffering in any way, shape, or form, they wouldn not have allowed that policy.

Posted by: Corvette1975 | February 14, 2008 10:36 AM

Ugh! WaPo ate my previous post.

I think that the term "mental health day" implies slacking off, but I do think it's legitimate to let a child stay home if he is feeling especially run-down or complaining of general malaise. Especially for young children, some extra rest at the beginning of an illness might head off the development of more acute symptoms or reduce their severity or duration.

As children get older, they do need to learn to work through the discomfort of the average cold or stomach upset (without diarrhea or vomiting, of course).

I think it's important as kids get older to teach them to listen to their bodies. I've never been one to use many sick days, but when I've been sick (especially with something contagious), I've stayed home. We've all had days that we've had to go to work quite uncomfortable from an illness. Some days, the demands of the job require more fortitude than other days. That's part of life.

Some of the tough guy attitude about never taking a sick day just sounds like ego though. I feel the same way about people who brag about getting by on very little sleep.

I think it's possible to be sensitive to a child of any age who feels especially run-down without creating a malingerer. It would become clear pretty quickly if a kid were abusing the use of sick days. I agree with Corvette1975 that it make sense to trust a high-performing student to judge when he needs a break.

Posted by: marian3 | February 14, 2008 10:56 AM

I rarely took a sick day. But the reality is, my parents weren't so strict about it. It was dad who got us up in the morning, mom wasn't up til 10 or so, so by the time she got up and she had stuff to do, she certainly wasn't going to turn off the TV!

As for my kids, the older one is in Kindergarten and has been home about 2 days since he began school when he was 2. He just doesn't get sick. The rest of us in the house can be deathly ill and he wants to goof around and stuff. The little one get sick more, but still not so bad. They sent him home the other day, and SAID he had green stuff in his nose, but I didn't see it and when he got home he was his usual happy self. My kids love school - at these ages - so they would never stay home if they could go. Hopefully that will continue. And I don't completely agree with making kids go to school all the time - sometimes they may not be deathly ill, but they might be tired and need some rest. Nothing wrong with that if it's not all the time.

Posted by: atlmom1234 | February 14, 2008 10:56 AM

You have GOT to be kidding me with this. Why does a child need a mental health day? You are raising a poor performer.

Posted by: WorkingMomX | February 14, 2008 09:44 AM

My straight A kid is a poor performer? You have really high standards.

Posted by: dennis5 | February 14, 2008 11:04 AM

marian3

"Some of the tough guy attitude about never taking a sick day just sounds like ego though. I feel the same way about people who brag about getting by on very little sleep"

Ditto. I also question the motives of the people who MUST attend every kid's school, practice, and sports event, etc. and make sure the world is aware that their spouse doesn't! Why do they think I care who takes their kid to the doctor?

Posted by: chittybangbang | February 14, 2008 11:06 AM

Sick days? Heck I let my kids stay home if they get behind on their homework or need an extra day for a project. They don't need to play the "my stomach hurts" game to keep their grades up.

I even go one step further. Instead of taking a day off when run down and tired, why not a day off because the weather is great, everything is caught up, and there's a better life to live outside of the institution? I can't wait for my oldest daughter to get her driver's license, then all we have to do is wait for the perfect weather day and we'll both play hooky and go fishing.

Life is to be enjoyed, take the opportunities when you get them! School will always be there.

Posted by: DandyLion | February 14, 2008 11:32 AM

"On Parenting" today is all about poop, and "On Balance" is all about puke. It's enough to make me go back to doing work.

Posted by: tomtildrum | February 14, 2008 11:42 AM

"You have GOT to be kidding me with this. Why does a child need a mental health day? You are raising a poor performer"

Good grief. My parents let me stay home for what would now be called "mental health days" pretty darn often and poor performance has never been an issue for me. How many times can we say it on this blog? Kids are different! Not all children react to the same things the same way!

Posted by: LizaBean | February 14, 2008 11:47 AM

I completely disagree with the idea of letting your kids take mental health days from school. I'd rather FO4's prescription for taking the day off because it's beautiful. At least that teaches an appreciation for something. The concept of a kid getting a mental health day is going to create someone who can focus to the detriment of their career, life, etc. on themselves.

If a child in school needs time away from his/her life to maintain mental health, therapy is needed. Life comes at you fast and if you're in need of days off to deal with normal stuff, it's a problem.

As someone who's worked in HR for years, I understand the idea of feeling overwhelmed and like you could use a break. However, what's wrong with encouraging exercise, meditation, an activity that is loved and takes your mind off things for a brief period of time? I think it's absolutely ridiculous to put into a child's mind the idea that an entire day is needed to get yourself back on track. Walk it off!

Posted by: WorkingMomX | February 14, 2008 12:10 PM

I second (or third or fourth) the comments about acne. I always think it's unfortunatey when I see someone with horrible acne because I wonder whether they know about accutane. Of course, someone may know about it and choose not to take it, but for the most part, when I've talked with people about accutane, they've never heard of it.

There's simply no reason now for teenagers to suffer with acne. At an age when you're already so self-conscious about your looks and worried that everyone else is paying close attention to your looks, acne is just the icing on a nasty cake.

Posted by: rlalumiere | February 14, 2008 12:36 PM

I have a theory that stress is more of a culprit to triggering the flu than exposure to germs. Why else would the kids only get sick when mommy and daddy are fighting?

My youngest son attends all day kindergarten. Way too much for a kid his age if you ask me, but I have the choice of letting him stay home when its convenient and enjoyable, or pushing him to the point where the stomach problems become real and then have to clean up the barf and take off work when its inconvenient.

WorkingMomX, you sound a little stressed today. Perhaps you could use a day off?

Anyway, I want to wish everybody a Happy Valentine's Day!

Posted by: DandyLion | February 14, 2008 12:38 PM

Dandylion, yup, I'm stressed. It "snowed" (you might call it a dusting) in this area last night and the number of people who appear to believe their very lives are in danger if they get in their cars and drive to work is outrageous. There is nothing wrong with the roads, the local schools aren't closed (except for a few west of here), but any excuse to not come to work, I guess. The idea that people give kids an umbrella excuse not to show up in life because they don't feel like it that day really irritates me. (Didja notice?) Today's R&R day kids can easily morph into tomorrow's slacker employees.

Posted by: WorkingMomX | February 14, 2008 12:49 PM

Starting in middle school, I began having seriously problems with my stomach. It hurt all the time. I took zantac for years (among other things), which helped somewhat but it was awful, and there were days I didn't even want to eat. One doctor told my parents this was all in my head, and that I just needed therapy. Finally, when I was a freshman in college the research came out about H. Pylori infections. I had a blood test, and of course that's what I had. After an extensive round of antibiotics, I was totally fine. I haven't had any trouble with my stomach ever since.

I guess my point is, I'm glad my parents listened to me and didn't tell me to "suck it up." It would have been easy enough for them to do, since I was in pain for years and no one knew what was causing it.

Posted by: floof | February 14, 2008 1:06 PM

My son's young enough that this isn't an issue but I thought I would chime in on the 'mental health day/slacker' issues.

I WISH the people I worked with would have some idea how to manage their own productivity. So many people just show up to get the perfect attendence mark, but they leave their brains at home!

When I work I have periods of high productivity and low productivity. I work in a field where this is okay (creative; it would be different in say, teaching, where class happens at 2 pm no matter what). It took me about three years under a great mentor/boss to learn to respect my own work processes. I consistently work better when I have some flexibility around how I get things done. I do however, show professionalism - I show up for meetings, I make my deadlines. I do not sit around and wait for inspiration. But if I'm stuck and I know leaving early that day will give me a chance to get a bit of extra sleep and come at it fresh in the morning - I just might do it.

My husband is the same way, but he hasn't really learned to take a break. As a result he has seriously burned out twice in ten years, to the point that his health was affected. He hasn't learned to spot the signs in himself that an extra long weekend or even an hour's lunch break could make a critical difference. He never takes sick days but spreads his germs throughout his team. He is just starting to now, in his 40s, and already his performance is improving.

My point kind of is that I think part of teaching "productivity" is to teach our kids WHEN and HOW to take breaks. You do not take a break on the day of the test, and you don't take a break from a class where you know critical material is coming. You can, however, look at your week's schedule and see that your English teacher is sick and your substitute is going to let you work on your essays, and your last class is math and you're going over a test that you aced, and decide to use that time more productively.

Also just on the sick theme, a lot of times people are most contagious when they're just getting sick, so they feel lousy but don't have a lot of symptoms yet. Do I EVER wish people would stay home then! :)

Posted by: shandra_lemarath | February 14, 2008 1:19 PM

Shandra, I usually find your posts spot on, but I disagree with this:

"My point kind of is that I think part of teaching "productivity" is to teach our kids WHEN and HOW to take breaks. You do not take a break on the day of the test, and you don't take a break from a class where you know critical material is coming. You can, however, look at your week's schedule and see that your English teacher is sick and your substitute is going to let you work on your essays, and your last class is math and you're going over a test that you aced, and decide to use that time more productively."

Here's why: I think that this skill is something you teach adults, not kids. (And even then, let's face it, most people do not have jobs where they get to pick and choose when they're present at work.) I know very few kids who have the maturity and foresight to know when and how to use time more productively. There are definitely high school-aged kids who could, but most could not. A child's "job" is school, and that's where they receive reinforcement about values they've (hopefully) learned from their parents: the importance of showing up = attendance, following through via homework, respect/caring for others, responsibility, etc. I would wager that with some exceptions, people who have poor attendance at work had similar problems in school. I'm not talking about people who were chronically or seriously ill.

Posted by: WorkingMomX | February 14, 2008 1:31 PM

Shandra,
Unfortunately, not everyone has such luxuries. I work for the Fed Gov't. Great leave benefits - right? It depends on the circumstances. After 5 yrs of infertility treatments (lots of leave taken), I finally became pregnant! Maternity leave comes from leave accumulated. When my first was 2, I gave birth to my 2nd. Again, I used up my leave and ended up having to go on leave without pay (since I had 8 weeks of bedrest). After scrimping and saving leave (i.e., going to work when I didn't feel well), my mother became ill and eventually passed away leaving an elderly father. During all of this, my husband is repeatedly receiving grief any time he's taking a day off to care for a sick child. Well, I had little choice but to drag myself into work no matter how I felt. My situation has changed considerably, and I no longer come to work when I feel like I'm coming down with something. But not everyone has the choice!

Posted by: S1234P | February 14, 2008 1:36 PM

Shandra, I agree. Adults and kids who are self-motivated, responsible, and high-performing can and should learn how to manage themselves and their productivity. If a kid in that category wants to stay home from school, the parent can talk it through - why? what will you miss? how will you make it up?

That's basically what my parents did and I think it has served me well. In my experience, people who work hard, have a strong sense of personal responsibility and who do good work without constant supervision are rewarded with more autonomy, trust, and flexibility. Learning how to manage yourself, manage your time, and stay healthy is a big part of being successful and happy.

Posted by: LizaBean | February 14, 2008 1:47 PM

Okay, this may be off-putting for some of you (avert your eyes, please), but there was one school year where one child or another was regularly claiming to be "too sick" to go to school. I reached a point where I walked into the bedrooms with thermometers, said "Wake up", and then popped them under the tongue.

They were "cured" of this by my telling them that if they were too sick to go to school, then I needed to determine their "core temperature", and roll over and drop your underwear.

Miraculous recovery rates.

Oh, regarding yesterday, I'm chiming in late, obviously.

I permit my kids to have a sip of wine here and there (Thanksgiving, Christmas) at a meal where the adults may have cracked a bottle open. I will not buy alcohol for their personal consumption while the individual is underage. I will not permit anybody else's child to consume it in my home. It's illegal and I don't FEEL comfortable doing it, even IF both parents said it was okay.

The kids and I have had lots and lots of discussions regarding the issue. Including the possibility of alcoholism. There are a few people with problems in the family tree, here and there. Why tempt fate?

Neither of them like the taste of it anyway. So far.

Posted by: maryland_mother | February 14, 2008 1:54 PM

"They were "cured" of this by my telling them that if they were too sick to go to school, then I needed to determine their "core temperature", and roll over and drop your underwear.

Miraculous recovery rates."

LOL, awesome. The rectal thermometer - almost as good as the Rope of Truth.

Posted by: LizaBean | February 14, 2008 2:00 PM

MM:That is the best. I am going to keep that in my bag of Mommy tricks.

Posted by: foamgnome | February 14, 2008 2:12 PM

What's the difference between a rectal and oral thermometer?

The taste!

*rimshot*

Posted by: maryland_mother | February 14, 2008 2:35 PM

"They were "cured" of this by my telling them that if they were too sick to go to school, then I needed to determine their "core temperature", and roll over and drop your underwear."

My husband preferred the rectal thermometer...

Posted by: chittybangbang | February 14, 2008 2:44 PM

Well, that sure killed discussion. Unless something's wrong with my browser and it's not reloading right....

Posted by: LizaBean | February 14, 2008 3:19 PM

This was a foreign topic to me until a few years ago. My mother often TRIED to get me to call in sick to school- too many projects and tests and chapters and labs. But I wouldn't- I was a control freak perfectionist who needed her scholarship and awards.

Of course this led to severe burnout and backlash.

As long as they aren't suffering in grades and performance, and can get the job done when it matters, who cares? We all know adults need mental health days, kids do, too.

Posted by: EmeraldEAD | February 14, 2008 3:37 PM

Well, DH and I came from families who were adamant about attending school and neither of us got a pass for much. By the time I got to HS, mom had loosened up a bit and I was allowed one "mental health day" each school year. Had to be careful not to burn it early, LOL.

We are lucky that DD likes school, but she does have hypochondriac tendencies so I really have to see evidence before I believe there's a real illness. Sometimes, it's just her drama, though I'm happy to report she appears to be outgrowing that phase.

As for missing school for other reasons, we're pretty stingy about that, like our parents. Other than illness, DD has missed school for a couple of funerals (never a question of skipping those). She dances and has had to miss a few days of school over the past few years for an occasional performance or rehearsal. We always make arrangements in advance with the teacher and any classwork, homework or tests are made up.

I think occasionally skipping school in favor of visiting with family or friends from far away or to take advantage of a unique opportunity is usually fine, as long as the student understands the expectation that work has to be made up. Likewise, a mental health day, especially for a high schooler, is not going to ruin the work ethic of a kid who is normally a hard worker.

A former boss had to take an extended (3-week) business trip to South Africa. He had to talk to a lot of teachers and administrators and untangle a heck of a lot of red tape, but he finally got permission to bring his HS-age son along for the entire trip. Normally, an absence that lengthy would result in an automatic suspension. Son had to make up all of his work and write and present a report on the experience, but it was a once-in-a-lifetime opportunity. I would have done the same, no question.

Posted by: vegasmom89109 | February 14, 2008 4:28 PM

"I think occasionally skipping school in favor of visiting with family or friends from far away or to take advantage of a unique opportunity is usually fine, as long as the student understands the expectation that work has to be made up."

Parents know their kids best, of course, and make different calls -- all appropriate for their household. In our household, our kids would never choose to miss school for a family visit or unique opportunity if we didn't decide for them. The dread of making up all the work is an intimidating turn-off to both kids. As a result, DH and I set the priorities and, from time to time, decide that, for our kids, living and experiencing new things is more important than checking the attendance box. Hypothetically, if we have an opportunity to take them on a family trip to a destination they'd otherwise never see, meet great people they'd never otherwise meet, and if that opportunity means they have to miss a few days of school, we'll live with a zero on middle-school Math Quiz #16 or the three first-grade worksheets. We'll make an effort to remind them about the worksheets, but the "educational" and relationship component of such a trip is priceless. Our school isn't going to have a hissy fit. Our choices are consistent with the school's values. That's perhaps one good reason why we're fortunate our kids attend where they do. Although, I'd make the same call whether or not the school agreed with our choices.

With respect to the initial question, we know our kids. I don't run a fever and I rarely vomit when ill. Neither does my son. Our daughter suffers from headaches that we suspect are the beginning of migraines. No easy tests here. We just have to watch them and make the call. Neither of them wants to stay home for the sake of avoiding school, so we don't have to deal with trust issues. As a result, we also don't have no tv, no computer, prohibitions. Nothing would be served in our household by imposing them, other than burdening the then-current stay-at-home parent with some one-off arbitrary rule to have to enforce.

Posted by: mn.188 | February 14, 2008 4:52 PM

i hate to say this, but i've gotta side with the "stick in the mud" parents who tell their kids to suck it up and go to school every day (unless clearly sick).

My parents allowed me to stay home whenever i felt like it. sure, i made straight As without ever showing up for class, but i learned really awful habits and a total disregard for "duty". I still haven't become a worker with as good motivation to show up on any given day as most people have. Therefore, I really struggled with a number of jobs and bosses who were pissed when i'd show up late or call in "sick". after years of being coddled and allowed to take time off whenever i felt like it, i thought all of my bosses were completely unreasonable jerks.

finally, i've found a great match, where my bosses care only that the projects get done well and on time (which has always been the case) but honestly don't care much when or where. I get to work from home frequently and if i'm late or leave early, they just don't care. Most jobs do NOT have this degree of freedom or flexibility.

Posted by: newslinks1 | February 14, 2008 5:03 PM

WorkingMomX - You're right, I was thinking of older kids. At the elementary school level I think it is generally a good idea to be there unless it is some unforgettable family thing or whatever. (I remember missing a week of school to go visit my dying grandfather in grade 4, and that was time very well spent, I have more solid memories of him and his love than I would otherwise.)

For the comments about lots of workplaces not being flexible, or people not having enough leave time, I think that's absolutely true and I have had those jobs (not just retail and teaching, but at earlier points in my career).

But I was able to be aware of the needs of those jobs because I could evaluate that my presence was needed. I don't think learning when you can take a break means that you are forever unable to make the decision not to when it's not appropriate. :)

I may just be surrounded by too much crazy management (esp. over the dot-com boom and bust a while back) but honestly, productivity at certain levels and jobs is not just about the hours, but about the quality of THINKING.

I have seen a number of poor decisions made by teams and managers that were just tired out, especially after travel, where a timeout of one kind or another would have saved hundreds of thousands of dollars in the long run. It's a bit of a thing with me right now, the idea of quality over speed.

Posted by: shandra_lemarath | February 15, 2008 9:27 AM

Figuring out if kids are sick is tough. They don't just lay around -- unless they are really, really sick.

But what's even trickier is when you and your spouse don't agree on the definition. My hubby and I several times have parted ways on whether a child should be home. There was even one time when I decided my daughter should stay home, and my husband - who works very flexible hours -- stayed home with her. An hour later, he brought her to school, saying she was fine.

On her attendance records it says: "Mother says sick; father says fine." Fortunately, the school didn't dispute that.


Posted by: gchen | February 15, 2008 4:41 PM

"Can a 15-year-old be trusted to tell if his ankle deserves a workup by an orthoped?"

Run, do not walk, that kid to the orthopedist. Do not trust your kid who wants to keep playing a sport to know whether his/her shoulder/knee/ankle is OK or not. Take the results to the coach yourself. Do not trust that kid to tell the coach. Watch the kid's coach like a hawk to make certain that instructions from the orthopedist/physical therapist are followed to the letter. Follow those instructions to the letter at home. Don't be afraid to nag the orthopedist to write a second prescription to extend physical therapy for another month or two.

Likewise, do trust your not whiny at all kid who reports on recurring joint discomfort, and get that kid to the orthopedist.

I write this as an aunt who watched a darling nephew nearly destroy both shoulder joints because of his love of the swim team (he finally quit when the Dr. asked if he wanted to swim competitively that year or if he wanted to still be able to swim for fun when he was 18), and as a mom whose not at all whiny daughter complained of minor recurring discomfort that proved to be shoulder, wrist, knee, and hand issues. I've got the ortho guy on speed dial now.

Posted by: contrarymom | February 20, 2008 9:36 AM

I'm with contrarymom on erring on the side of caution. When my daughter was 5, she developed a nasty cough that got worse at night to the point where she would vomit. I assumed it was a cold, but made her an appointment with her pediatrician after this was ongoing for about two weeks. I couldn't get an appointment sooner then another week and a half, and in the interim, she went into respiratory distress at her daycare, and had to be taken to the emergency room by ambulance. I'm thankful the daycare teachers were all trained in CPR and first aid, or they might not have recognized immediately how sick she was. I found out at the hospital that she had asthma. I (maybe cluelessly) never realized that coughing (as opposed to wheezing) could be an asthma symptom. She's now 10, and has been on two daily medications, in addition to Albuterol for asthma attacks, for the past 5 years. When my 5 year old son developed similar symptoms, albeit without the vomiting, I took him to his pediatrician and an immunologist without waiting. I found out that he has both asthma and multiple allergies. My daughter has seasonal allergies. Figuring out whether to send the kids to school/daycare when they say they're sick is very complicated for me, because it's hard sometimes to tell if they actually have a cold or if they're just manesfesting allergy/asthma symptoms.

Posted by: lauraconeal | February 29, 2008 1:58 PM

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