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Kink in Federal Law Is Prompting Schools To Stop Picking Nits

June 1, 2006;  Wall Street Journal Page A1

Laissez-Faire Approach to Lice Minimizes Absenteeism, But It Distresses Moms

Education-reform mandates like the No Child Left Behind law are putting a contentious new spin on a classroom issue that makes parents' skin crawl: head lice.

Schools used to take a hard line on the sesame-seed-sized parasites, which suck human blood and glue their eggs to individual hairs. At the first sign of an outbreak, pupils got scalp checks. Those with lice were immediately banished from the classroom until all lice and eggs -- known as nits -- were gone.

But to the dismay of many parents, these "no nits" policies are disappearing as school districts face state and federal pressure to reduce absenteeism and boost academic achievement.

No Child requires that 95% of students be present for mandatory achievement tests. It also allows states to use attendance to help determine whether school districts are making adequate educational progress under the federal law. Those that don't do so face sanctions that could include state takeovers of their schools.

At the Todd County Public Schools, a rural district based in Elkton, Ky., students found to have lice often used to miss a week or more of school. The old rules barred them from school until they could produce a letter from a doctor or a public-health agency certifying them lice- and nit-free. Under new guidelines adopted last year, a box top from an over-the-counter lice treatment does the trick.

Bruce Gray, the assistant Todd County superintendent who spearheaded the change, says pressure to reduce absenteeism and boost student achievement was a big consideration. "The more your students are out of school, the less likely you are to meet the academic goals of No Child Left Behind," Mr. Gray says. He says some miffed parents claim he's insensitive to the issue because he is bald.

Dawn Harper, a part-time Todd County teacher and mother of two, wants the district to go back to doing routine scalp checks and warning parents as soon as a single case of lice is discovered. Ms. Harper's third-grade son, Hunter, got lice this spring. She doesn't think children should be humiliated because they suffer an infestation but says the new policy isn't hard enough on "repeat offenders" who continually bring nits back to class.

"As a parent, you have to rip everything apart in your home when you get it," she says.

Jeff Glazier, school board president for the Allentown School District in Pennsylvania, says the No Child law and related state statutes were a major reason his district abandoned its no-nits rule last year. "Attendance is a benchmark you get graded on," he says. "Schools have failed because one kid missed one additional day.

Head lice, which are wingless, are spread by close personal contact or when children share things like caps and combs. Studies say that each year about 12 million Americans -- the vast majority of them children -- get head lice, but researchers say such estimates are very imprecise because most health departments don't consider pediculosis capitis, or head-lice infestation, worth tracking.

Many scientists say that in most cases, by the time nits are discovered only a small percentage are likely to produce live lice, since most have either already hatched or were never fertilized. Retreatment in a week, which is often recommended, generally ends the problem.

Since the late 1990s, groups like the American Academy of Pediatrics have gone on record opposing "no nit" policies, saying there is no medical justification for them. But the move to abandon such measures didn't really gather steam until after the No Child law went into effect in 2002. "That's what finally caught people's attention," says Barbara Frankowski, a professor of pediatrics at the University of Vermont College of Medicine and a longtime head-lice researcher.
Under a policy adopted last year in the Los Angeles Unified School District, children found to have head lice may now stay in class until day's end. After they have been treated at home to kill the lice, they can return to school even if they still have nits.

The new policy upsets Barbara Bernato, whose daughter, Mikayla, got head lice last fall while attending kindergarten at Riverside Drive Elementary School, in the affluent Sherman Oaks area of Los Angeles. After discovering a second infestation in February, Ms. Bernato spent six hours combing the nits out of her daughter's waist-length hair.

"This is not a Third World country," says the mother of two, who is lobbying school officials to rescind the new policy. "Why would we lower our standards?" Kimberly Uyeda, director of student medical services for the Los Angeles district, says the new policy is in line with research indicating head lice are not a serious health threat. She says it's not specifically related to No Child Left Behind, but adds: "I'm not going to make any apologies for trying to get kids into the classroom and accessing their education."

Many schools have stopped sending warning letters to the homes of all students in a classroom at the first sign of lice. And that is another source of friction. The Bristol Township School District, in Levittown, Pa., stopped sending letters in 2002 as part of an overhaul of its head-lice policy designed to reduce absenteeism, but parents still raise the issue at school-board meetings. "Head lice are a nuisance, not a hazard," says Avis Anderson, the district's coordinator of health services. "I am not obligated to tell the world we have two cases of head lice."

Kim Norton disagrees. Her son is a fourth-grader in the Bristol district and recently got head lice. She says that over-the-counter remedies didn't work, so she spent more than $100 for enough prescription medication to treat all four members of her family. They had to leave it in their hair for 14 hours, while wearing shower caps, she says. "And the amount of laundry you have to do," Ms. Norton adds. "It's more than a nuisance."

The new policies have also sparked opposition from the National Pediculosis Association, in Newton, Mass. Founded in 1983, it maintains that removing lice eggs is the only safe and reliable way to end infestations.

Deborah Altschuler, president of the nonprofit association, says abandoning no-nit rules will make parents think it is enough to use commercial treatments, most of which are pesticide-based and opposed by her group. The association markets a $9.95 nit-removal comb called the LiceMeister. She maintains that leaving lice eggs in children's hair amounts to neglect. "It's not prudent, it's not sensible and it's not logical to turn away," she says.

A company called Hair Fairies is also in the thick of the debate. Its hair salons in Los Angeles and New York specialize in nit removal, charging up to $90 an hour. While the decline of no-nit policies might seem to threaten the company's bottom line, co-founder Maria Botham says she is considering expansion. "I think what it will turn into is one massive infestation," she says. "We are going to have a lot more business."