Is Your Child Sick Or Just Faking It?

As a paediatrician and a father, I’ve perfected some easy ways to tell whether your groaner has a flair for the dramatic or genuinely doesn’t feel well.

- David L. Hill

THE MOVIE Ferris Bueller’s Day Off—an iconic comedy that taught a generation how to steal someone else’s lunch reservation and commandeer a parade float— was one of the most formative films of my high-school years. As a teenager, I found the premise hilarious—but now that I have four school-age kids of my own, watching a young Matthew Broderick lick his palms to fake clammy skin mostly makes me wonder whether I’m ever being played like that. If I am, it’s particularly embarrassing because I’m a paediatrician. How do I know when my children are actually ill versus when they want to miss school? Honestly, I can not always tell, but over the years I’ve come up with a number of tactics to help me in reaching a fair verdict.

Borrow my strategies to get to the bottom of your own kids’ pleas to hole up at home.

THE COMPLAINT

My head hurts.

Fact-check it: Kids may have a hard time describing the severity of their pain, so doctors often rely on a tool called the Wong-Baker FACES Pain Rating Scale—a series of pictures that range from smiling to crying—to gauge their distress. The abridged version: If your child is sobbing, closing her eyes, or unwilling to play or joke around, she’s in bad shape. In fact, if her headache persists for more than an hour or two and doesn’t respond to acetaminophen or ibuprofen, she not only needs to miss school but also needs to see a doctor. Severe headaches that recur (particularly those along with changes in vision, nausea, or an aversion to light or noise) could be migraines and warrant a diagnosis and pain relief. Take your child to the emergency department if she ever has trouble moving her neck; difficulty talking, walking, thinking, or using her hand; or if the headache awakens her from sleep or causes vomiting.