School attendance and juvenile chronic arthritis

We studied the school attendance of 113 children and adolescents (mean age 11 yr, S.D. 3.8, range 3-18 yr) with juvenile chronic arthritis (73 with pauci- and 40 with polyarthritis). The mean attendance rate for the group was 92% (equivalent to 15 absent days a year) with a median of 97%. Attendance was significantly lower in the more severely affected poly group (90% vs 98% in the pauci group; P = 0.03). We found associations of school absence (i) with decreased compliance with physical treatments (r = -0.35, P < 0.05 for compliance with physiotherapy) in the poly group and (ii) with child psychological deviance (r = 0.36 for parentally rated and r = 0.42 for teacher-rated psychological deviance; both P < 0.05) in the pauci group. We conclude that school attendance can be good in severely affected children. Severity of illness, treatment compliance and psychological problems in the child may affect school attendance.