According to research published in BMJ Open, undiagnosed chronic fatigue syndrome (CFS/ME) may be responsible for almost 1% of non-truant children who miss extended time off school. The authors state that earlier estimates, based on findings in just less than 3,000 pupils aged between 11 to 16 years at three secondary schools in the southwest of England, where specialist CFS/ME services are well established, have indicated that CFS/ME affects between 0.1 to 0.5% of children.

The study included children who had missed over 20% of schooling over a 6-week period, but excluded children who missed school for a defined episode of ill health, those who had a known medical reason that explained their absence, and others known to be truanting.

Over a 6-week period, 461 children had missed more than 20% of school with 3 children because of CFS/ME. The reason of absence for the remaining 146 children was unexplained. 112 of these children attended a clinical review at school, where two children unknown to the school, had already been diagnosed with CFS/ME, whilst 42 children were referred on to a specialist clinic, which resulted in 23 children being newly diagnosed with CFS/ME. The figures demonstrate that 28 of 2,855 children, i.e. the equivalent of 1% of the school roll who missed over 20% of schooling over a six-week period suffered from CFS/ME.

Researchers also compared the children who were referred to specialist services via school-based clinics with 604 children who were referred to specialist services by healthcare professionals, and discovered that both groups of children had suffered from CFS/ME for an average of slightly longer than 18 months. However, those referred via school-based clinics displayed less disability, less fatigue and fewer symptoms compared with those referred by healthcare professionals. The researchers also observed that children identified through school-based clinics appeared to make rapid progress. Six of 19 children whose health was monitored following diagnosis recovered fully after 6 weeks, whilst a further six fully recovered after six months.

The researchers declare: “There are several possible reasons why children missing significant amounts of school with chronic fatigue syndrome/ME are not identified,” explaining that, “Those with moderate/mild symptoms may not see their GP or may not be recognized as having the condition if they are seen. Alternatively, GPs and pediatricians may not be aware of specialist services or feel that their child’s [condition] is sufficiently serious to warrant a referral.”

They conclude, saying:

“This project suggests that undiagnosed chronic fatigue syndrome/ME may be an important and under-appreciated cause of school absence in children aged 11-16 years.”

Written by Petra Rattue