Avoyelles School Board may change ‘no-nit’ policy on head lice

It may come with a call from the principal’s office, a note sent home from school or the discovery of a white speck in your child’s hair while you are getting him ready for school.

Head lice.

It is as much a part of childhood as skinned knees.

The main difference is that children aren’t required to stay home until their skinned knee heals.

The head lice burden on parents and students may be lessened if the Avoyelles School Board approves an Executive Committee recommendation to eliminate its “no-nit” policy for the child to return to school.

Nurse Supervisor Dawn Pitre presented a request to amend the district’s head lice policy at the Executive Committee’s April 11 meeting.

“The head lice problem is no worse this year than it has been in the past,” Pitre said, noting the issue was brought up due to an American Academy of Pediatrics’ (AAP) recommendation that children not be excluded from school when they have no active live lice -- and probably not even if they do.

PROPOSED POLICY

The revised lice policy states that a child with “positive evidence of head lice shall be sent home that day of school.”

The student will have an excused absence for one day for treatment and removal of lice and nits, which should be sufficient for effective treatment.

Additional absences will be unexcused “on an incident by incident basis,” but a principal may authorize an extension of excused absence when conditions warrant.

“If a student is found with just nits (eggs), they will remain in school,” the revised policy states. “A letter will be sent home with the child informing the parent of the findings. It will also include proper treatment and removal instructions.”

The policy states a classroom will not be inspected for lice unless there are at least three students found to have lice/nits.

A designated school employee will be responsible for checking students to ensure hair is free of lice before being readmitted to school. A student must be accompanied to school by a parent, guardian or responsible party when they are checked for readmission.

AAP RECOMMENDATION

A May 2015 AAP clinical report by Cynthia D. Devore and Gordon E. Schutze of the Council on School Health’s Committee on Infectious Diseases strongly discouraged keeping children out of school due to lice.

“No healthy child should be excluded from school or allowed to miss school time because of head lice or nits,” the report stated. “Pediatricians may educate school communities that no-nit policies for return to school should be abandoned.”

That report went on to state, “School exclusion of children with nits alone would have resulted in many of these children missing school unnecessarily. In addition, head lice infestations have been shown to have low contagion in classrooms.”

Head lice (Pediculus humanus capitis) have probably been a part of humankind since ancient times. It is estimated the tiny louse is responsible for more than $1 billion in treatment costs, lost wages and school system expenses each year.

Despite their tiny size --about the size of a sesame seed -- and relatively small impact on life, head lice still have a high “yuck” factor and have the power to instill panic in parents.

They feed exclusively on human blood, but are not a health hazard and do not spread disease. They are not a sign of poor hygiene.

Head lice infestation is not significantly affected by hair length or by frequent brushing and shampooing.

They affect members of all socio-economic groups and are found around the world.

STILL A STIGMA
Despite those facts, there is also still a stigma attached to a child with lice. They are kept out of school, ostracized by friends and excluded from other social events.

The AAP said that “catching” lice is not as easy as one may think.

Lice do not fly, hop or jump and would rather not leave the head where they feed. Lice are most often spread from one child to another by head-to-head contact. The spread of lice through sharing personal belongings such as combs, brushes, hats, etc. is less likely to occur.

Lice can only live about 24 hours when they are separated from a food source.

“It is important not to confuse eggs or nits, which are firmly affixed to the hair shaft, with dandruff, hair casts or other hair debris which are not,” the AAP article noted. “It is also important not to confuse live eggs with dead or empty egg cases.”

That report found that many “lice and nit” samples submitted to a lab for analysis turned out to to be dandruff, hairspray droplets, scabs, dirt or other insects, such as aphids, that had been blown by the wind and caught in the hair.

The AAP does not propose a laissez-faire attitude toward lice. It recommends that in “environments where children are together, infested children should be treated promptly to minimize spread to others.”

Children should be taught not to share combs, brushes, etc. with other children.

The AAP said children should not refuse to wear protective headgear, such as batting helmets or bicycle helmets, due to fear of lice.

Parents should periodically inspect their children’s hair for signs of lice and treat any early infestation. If one person in a household is identified with lice, all members should be checked. If lice are found, they should be treated.

LICE IN SCHOOL

The AAP report noted that since a child with head lice “likely has had the infestation for one month or more by the time it is discovered and poses little risk to others from the infestation, he or she should remain in class but be discouraged from close direct head contact with others.”

The article said “confidentiality is important.” In short, the child’s “uninvited guests” should not be a topic of classroom discussion.

“The child’s parent or guardian may be notified that day by telephone or by having a note sent home with the child at the end of the school day stating that prompt, proper treatment of this condition is in the best interest of the child and his or her classmates,” the report recommended.

It noted that immediate removal of nits is not necessary to prevent the spread of lice, but “in the school setting, nit removal may be considered to decrease diagnostic confusion and social stigmatization.”

The AAP said it is important that school personnel assigned the task of detecting lice infestations are adequately trained due to the difficulty in correctly diagnosing an active lice infestation.

The organization also cautions against extensive and expensive screening programs, which it said “have not been proven to have a significant effect over time on the incidence of head lice in the school setting and are not cost-effective.”

AAP said a parent education program is a more effective tool in managing head lice in a school.