Texas A&M Health Science Center School of Medicine, College Station (Drs. Williamson, Roberman, and Sopchak); Texas A&M University College of Education and Human Development, College Station (Taliyah M. Mosley) meredith.williamson@tamu.edu
The authors reported no potential conflict of interest relevant to this article.
Many students want to skip school from time to time. But when absenteeism becomes chronic, it may indicate a more serious underlying issue.
Juana*, a 10-year-old who identifies as a cisgender, Hispanic female, was referred to our integrated behavioral health program by her primary care physician. Her mother was concerned because Juana had been refusing to attend school due to complaints of gastrointestinal upset. This concern began when Juana was in first grade but had increased in severity over the past few months.
Upon further questioning, the patient reported that she initially did not want to attend school due to academic difficulties and bullying. However, since COVID-19, her fears of attending school had significantly worsened. Juana’s mother’s primary language was Spanish and she had limited English proficiency; she reported difficulty communicating with school personnel about Juana’s poor attendance.
Juana had recently had a complete medical work-up for her gastrointestinal concerns, with negative results. Since the negative work-up, Juana’s mother had told her daughter that she would be punished if she didn’t go to school.
● How would you proceed with this patient?
* The patient’s name has been changed to protect her identity.
