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    What you need to learn about homeschooling

    Effective health care for the homeschooled child requires understanding of the issues, an open line of communication to parents, and the vigilance to ensure that children not covered by the safety net of school screening get the care they need.

    DR. ABBOTT is a pediatrician in private practice in Berkeley and Orinda, Calif.; clinical professor of pediatrics at the University of California San Francisco School of Medicine, and attending physician at Children’s Hospital and Research Center Oakland (Calif.) DR. MILLER is attending physician at Children’s Hospital and Research Center Oakland. The authors have nothing to disclose in regard to affiliations with, or financial interests in, any organization that may have an interest in any part of this article.

    Parents "most important reasons to homeschool
    The United States Department of Education estimates that 1.1 million students were homeschooled in 2003.1,2 Other estimates put the number as high as 1.7 to 2.1 million, and the rate of homeschooling is increasing at an estimated 7% per year.2,3 Pediatricians and other child health-care providers who care for homeschooled children need to understand the controversies surrounding homeschooling, be sensitive to the value that families place on homeschooling, engage families in nonjudgmental dialogue about homeschooling, and ensure that homeschooled children receive the health care they need.

    The American Academy of Pediatrics (AAP) makes no recommendation about homeschooling for normal, healthy children; it addresses the issue only with regard to children who are medically unable to attend school. The AAP states that "all school-aged children are entitled to obtain their education in a school setting..." based on both legal mandates and the "social and developmental advantages the school setting provides all children, including those with special needs."4

    Demographics of homeschooling: Who and why

    The most recent data on the prevalence of homeschooling and characteristics of homeschooled children is derived from the 2003 National Household Education Surveys Program (NHES). The NHES report, "Homeschooling in the United States: 2003," considered a child to be homeschooled if parents reported that the child was taught at home, was not enrolled in public or private school for more than 25 hours a week, and was not homeschooled solely because of temporary illness.5

    The 2003 NHES survey was based on interviews with parents of students between 5 and 17 years of age. Of the 11,994 children included in the study, 239 were homeschooled—a 29% increase from the 1999 survey ("Homeschooling in the United States: 1999")—and a rise in the homeschooling rate from 1.7% in 1999 to 2.2% in 2003.5,6

    The survey asked parents to identify all the reasons they chose homeschooling and also state the most important reason. Parents often gave multiple reasons, including:

    • environmental concerns, such as safety, drugs, and negative peer pressure (85% of parents)
    • desire to provide religious or moral instruction (72%)
    • dissatisfaction with academics at other schools (68%)
    • child's physical and mental health problems (15.9%)
    • child's other special needs (28.9%)
    • other reasons, including the child's choice, flexibility, and greater parental control over education (20.1%).

    When parents were asked to state the single most important reason for homeschooling, the reasons they gave most often were environmental concerns (31.2%) and a desire to provide religious and moral instruction (29.8%) (see the figure, above). The National Center for Education Statistics plans to collect and report data about homeschooled students every four years, with the next survey scheduled for 2007.

    Many of the 2003 survey findings about student and family characteristics paralleled the findings of the 1999 survey:

    • White students were about four times more likely to be homeschooled than Hispanic students
    • Students in households with three or more children were about twice as likely to be homeschooled as students with no siblings
    • Students in two-parent households in which one parent was in the labor force were about five times more likely to be homeschooled than students in two-parent households in which both parents were in the labor force
    • Students who had at least one parent with postsecondary education were more likely to be homeschooled than students whose parents' highest level of education was a high school diploma or less
    • 82% of students were homeschooled only, whereas 18% were enrolled in public or private schools part time.5


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