Saying that no healthy child should be barred from school, the American Academy of Pediatrics is recommending that schools back off tough head-lice policies.

Many schools have "no nit" policies, which say that every single nit - or head louse egg - must be removed before a child can return to school.

"The presence of nits, per se, doesn't indicate active infection," said Leonard Weiner, a pediatrics professor at the State University of New York in Syracuse and one of the authors of the report published today in the journal Pediatrics.

The "no nit" policy isn't sensible because nits are only nuisances when they are viable, or less than one-quarter of an inch away from the scalp, said Weiner. Normally, nits further away cannot become full-grown lice.

"People see dead nits or empty egg cases, which are then mistakenly assumed to be an infection," he said.

"Numerous anecdotal reports exist of children missing weeks of school and even being forced to repeat a grade because of head lice," wrote the authors.

Head lice, which don't spread any disease, each year affect about 6 to 12 million children, ages 3 to 12. The report also said school staff involved in head-lice detection should be properly trained. Currently, school screening for nits is neither accurate nor cost effective, it said.

The authors say parent education programs would be more appropriate than school screening programs for head lice.

The authors suggest parents treat lice with permethrin 1 percent, commercially known as Nix. At the time of treatment, parents should consider removing as many nits as possible, whether they are viable or not, to decrease diagnostic confusion and the possibility of unnecessary treatment.

School nurses and other trained personnel could help by rechecking a child's head for lice, if requested, said the authors.

In addition, on the day of diagnosis, school officials should be practical when determining how contagious a child could be; a child with "hundreds versus a child with two live lice" are different, wrote the authors.

Some Philadelphia-area school officials agreed with the recommended policy.

"They appear to me to be sound recommendations," said James Newcomer, the assistant superintendent for pupil services/elementary education at the Quakertown Community School District in Bucks County.

The guidelines are consistent with the way the Quakertown schools, which do not have a "no nit" policy, approach the problem of head lice, he added.

"Even after treatment, there may be some nits that remain in the hair which are no longer viable," he said. "That can cause confusion. We encourage parents to brush nits out of the hair."

"We don't want children to miss school," said Newcomer.

Deborah Altschuler, president of the National Pediculosis Association, an organization that looks at education, prevention, and research regarding head lice, was critical of the new guidelines, saying they missed the point.

The organization supports a "no nit" policy, but such policies are not keeping children out of school, she said. Rather, ineffective treatments are the reason.

"Resistance and cross resistance to the most popular remedies including permethrin are well established," said Altschuler in a written statement.

"Pesticide treatments or chemical agents of any kind are contraindicated for a variety of individuals. Treating for head lice is unique among health problems as it puts both the person applying the treatment, as well as the person receiving treatment at risk," she added.

The American Academy of Pediatrics, however, said that while resistance to permethrin 1 percent and other lice treatments has been reported, the extent of drug failure is not known.

It is a misconception that lice jump. They crawl, and their spread is usually through shared combs, brushes, hats or through carpets where an infected child may have been lying.

Contact Aparna Surendran at 215-854-2795 or asurendran@phillynews.com.