Back to school can be an exciting time but it can also be stressful. Pamela Schoemer, MD from UPMC Children’s Community Pediatrics explains what you can do if your child is experiencing back-to-school anxiety.
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– This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgments when advising their patients. Patients in need of medical care should consult their personal care provider. Back to school is an exciting time, but it can also be stressful. So, what can you do if your child is experiencing back-to-school anxiety? Hi, I’m Tonia Caruso. Welcome to this UPMC HealthBeat Podcast. And joining us right now is Dr. Pamela Schoemer. She’s a pediatrician with UPMC Children’s Community Pediatrics. Thank you so much for joining us.
– Yeah, thank you for having me. This is a great topic for this time of year.
– So, there is so much involved for families with children going back to school. Is it understandable that a child might be nervous?
– Absolutely. I mean, you think about anything — a change in our routines, even as adults, there’s some nerves that come along with that, let alone expectations and all that comes along with school. Plus, they have to get up early and do homework, which, you know, never is anybody’s favorite.
– It really is a big adjustment there. I guess it would depend on the individual, but is this something typically that a child comes out and says to their parents, “I’m having problems,” or are there signs that parents should be looking for?
– Some children will be able to tell you that they feel nervous or kind of express their emotions a little bit better. But I think more often we see other things, such as headaches, tummy aches. Maybe their appetite changes or their sleep patterns change, or they’re just a little more irritable, they’re just a little more short-tempered and don’t want to talk about school, don’t want to talk about the things that are associated with it. And those are things you need to tune into as well.
– If you are leading into the school year, still in August, not there yet, what are some of the things as a parent you should be talking to your child about?
– I think it’s really talking about what to expect in that year. You know, kids have nerves about multiple parts of the school day. How are they going to get there? What time do they have to get up? What’s their sleep schedule going to look like? What time do they have to go to bed? So, starting to introduce those ideas makes it a lot easier than just doing it all at one time the night before school starts. And then, reviewing what was good about last year’s school: what they might miss, what they can look forward to. And then, hyping up some of the special things: thinking about the first-day outfit, any traditions that you might have around school, any of those, just so that they’re really anticipating it instead of not looking forward to it.
– So, do you find that there are certain years where it would be even more understandable that anxiety might be heightened, sort of like those transition years like going to first grade, or middle school, or high school?
– Those are really great examples. Or changing schools because it’s just an unknown. So, again, that school building is new. There is a lot more unfamiliarity with it. So it’s just more difficult as they move from one stage to another. So you want to pay a little bit more attention at those ages.
– In a situation like that, would you suggest it’s a good idea if a parent takes a child to visit the school earlier?
– Absolutely. Even if the school isn’t offering to get into the school, which most do, even just the trip, how are we going to walk there? What’s our day going to look like? Kind of doing some dry run-throughs can make that easier. And then taking advantage when the schools do have those open houses. Go and meet that teacher. Go walk their schedule if they’re in middle school or high school and going to be changing classes. And then, really listen to what they’re nervous about. You know, it might be something very different than what we think about. It may be, how am I going to carry all those books? Or, how do I get back to my locker? And then it gives you some opportunity to focus on those, or practice those particular skills.
– So particularly in younger children, what if, you know, the first day of school, there’s a giant tantrum and they don’t want to leave the house? And then, once you get to the school, they don’t want to leave the parent? What do you say to parents if you’re leaving your child kicking and screaming, “Don’t leave me, mom, don’t leave me”? What approach should parents be taking for that?
– So, I think it’s you have to put your emotions a little bit on the back burner and be consistent. This is an expectation that you have and that the kids are going to go to school. So being compassionate and empathetic, but also being firm, not saying, oh, because you’re having a tantrum or because you’re saying, “Don’t leave me,” not leaving them and letting them skip school. Because then you’re really confirming to them that maybe there is something to be worried about. So, explaining, talking through the day, again, but making that goodbye short, sweet, let them know the expectation, and then live up to that expectation. If you tell them that you’ll be home when they get home or off the school bus, try to do that so that, again, it builds that trust, builds that daily routine.
– Is it good or bad to say, “Stay at school. When you get home, we’re going to have a treat. We’re going to have ice cream.” Is that, like, setting up a reward? Is that, then, reinforcing if I have a tantrum every day, if I go home, I can have some ice cream?
– Yeah, it’s a really controversial question. And I think that goes a lot to parenting and what you kind of set as expectations. I think many of us don’t do things in life unless we know there’s going to be a positive consequence. So, carving out some special time or a little special treat, I think, is fine. Trying not necessarily to make that the only reason but more something to look forward to: When you’ve completed this task, when you’ve established and achieved that goal, then we’re going to spend some time, we’re going to do something, we’re going to have a special snack. Rather than it seeming like that’s the bribe. But, honestly, would most of us do many of the things we did if we didn’t know there was something positive at the other end of it.
– Is it better to do something like, “We’ll have story time” because that’s enriching no matter what?
– Exactly. I am always in favor of something that’s more of a privilege, or a special time, or a special event because we always want those. If we start to promise something as an item, a toy, going somewhere, that’s hard to be continuous with and keep up that consistency. It’s always easy to have a little extra story time or a little extra something, but once they have their 15th Matchbox car, do they really need that 16th one that day, or can they put that off for a couple of days?
– How long should these jitters last? And is there a time, then, when a parent should really become concerned?
– Yeah. Most children over the first couple of days to weeks will actually get over some of these kind of jitters or just being anxious about it. I think there are cues of when things are going in the wrong direction. And that would be, you mentioned about kids kind of refusing to go to school, or really not being able to get there. Also, if they have those big body complaints: those headaches, those bellyaches. You know, that pain is real, even though we know it may not come from their head or their stomach. So we don’t want to minimize that. We really want to address that. And sometimes that’s with their pediatrician or with their physician. The other kind of point that I would say is if kids start to act outside of their age, so they’re acting much lower age range — so your middle schooler is acting more like the 3-year-old that you didn’t miss. Or, they’re worrying about something that they can’t control or is way in the future, kind of out of context to what it is. Those are other reasons to kind of contact and have a discussion about next steps. So, I absolutely think starting with your pediatrician is best because they can assess and make sure that there isn’t something medical going on, can also kind of talk with you and maybe try to help isolate what are those triggers that are causing it? And come up with some strategies to help eliminate that. And, then. if we’re still having problems, certainly connecting you with somebody in behavioral health — a therapist, someone to work with in that aspect. Whether it’s in their office, or community office, or even at the school sometimes.
– And what sort of conversations should parents be having with teachers?
– So, I think if you can reach out to a teacher beforehand, it’s nice because you can point out things that you might be concerned about off the radar of the child. So, things that maybe they struggled with the year previously, or that your concerned might be a problem. Or, even sharing some strategies that did work. If you know your child’s been anxious in the past and you’re going to send a little reminder of home, a picture or a little toy, again, making sure that procedure is there. And then, most teachers who probably also are a little nervous at the start of the new year like to connect with their students. So, knowing what that student likes to do or how to best approach them may ease that relationship-building that goes on at the beginning of the year.
– Can kids pick up on a parent’s anxiety, and what tone should parents be setting?
– Right. So I think, sort of like we talked about with the tantrums, is consistent, but sympathetic or empathetic. Understanding we’ve all been there, and we all remember first days of school, or that kind of dread of a big test or a big change. So, not minimizing their feelings, but talking through what they feel, maybe bringing up some of their strengths to them. But, again, being very consistent that school is part of our life. These are kind of our expectations. We’re going to support you through it, we’re going to be there. Your success isn’t how much we love you, it’s that we’re going to get to school, and this is really important for your future and achieving all of those goals that you want to achieve as an adult. Sometimes, a hard concept for a kindergartner or a first-grader, but as we kind of continue that consistency, it gets a little easier for them to understand education’s important to us as parents.
– So, is it best for a parent to start that conversation, or do you wait until your child mentions back to school?
– So, I think it just naturally grows because oftentimes we’re preparing for back to school, whether it’s back-to-school supplies or thinking about clothing, trying on, seeing what we’ve outgrown, and just looking at adjusting sleep schedules. All of those little things that we need to do as the school year approaches, I think those will just grow kind of out of those actions. You don’t really have to sit down and say, “OK, first day of school is this. Let’s talk about it.”
– It’s time. So, you touched on bedtime. That’s a huge issue when heading back to school. What are some of the things that parents can begin to do to prepare to get their children in the mode of heading back to school?
– Right. We’re starting to see it get dark a little earlier, which helps us, but I think most families kind of shift their time schedule during the summer months. So, really as a parent thinking about, “OK, how long does it take my child to get ready for school? When do they need to get up? When do they do best?” And then, slowly, moving that bedtime backwards. So I’m going to say if bedtime has snuck up to midnight when it really needs to be 9, you can’t all of a sudden expect them to just go to bed at 9. So maybe for a few days, 11:00 is bedtime and you have that bedtime routine right before. And then, 10:00. And then, ultimately, to 9:00. Setting an alarm or a reminder that we have to get up that hour earlier as well.
– So, in theory, how many weeks before the start of school should this start?
– It depends on how quickly your child adjusts. Some will do it like this, and other kids, it just takes a little bit longer. So, knowing your child and kind of adjusting to their needs is important. But I’d say at least a couple of weeks.
– Do you find, too, that getting a child involved, especially a young child, in packing your lunch, or picking out your notebooks, what are some other things that parents can do to really get them excited about school?
– Absolutely. So, again, just talking about what to expect, making that visit we talked about. But truly, just preparing, being part of all of that routine. So, maybe you don’t make the decision of what time they need to get up. Maybe they help you make that decision because they know how long it takes to get ready. A special meal the first night or the night before, packing that lunch, picking a new lunchbox, going school shopping, even if it’s in your own closet for picking that same day. And, then, there’s all the traditions people have. I think on social media, we see all the first-day pictures where kids year after year pose with a poster or a little sign. They may think it’s corny then, but when they get to the end, they’re going to actually really see how much that helped them track their progress and gives a parent an outlet to express their emotions as well. It’s hard to send your kids to school sometimes.
– I see pictures, the first-day-of-school pictures of the child with the sign and then the mother crying. So, it does become difficult. I think, for children, there’s the whole aspect of school itself and being nervous about classes, etc. And then there’s the whole social aspect with friends. What can a parent say if their child is sitting there saying, “I’m so worried I’m not going to have any friends,” or, “I’m going to a new school.”
– So, I think listening to what that concern is and kind of relating to that. You never want to minimize their concerns. So you never want to say, “Oh, you have friends,” when they say, “I’m concerned I’m not going to be.” It might be that they’re concerned they’re not in the same classes. So, really listening to what that sounds like. But then reminding them of past successes, and then giving them opportunities to build on what they see as gaps. So if they’re worried they don’t know kids in the new school, maybe looking for some activities that they can get involved. Since we’re not really supposed to talk in reading and English class anyway, getting them involved, inviting people over, talking with parents or getting involved in those groups. So that we can really put those kids together, but always keeping that ear open for when things aren’t going well. Because we know that there can be lots of, as I call it, drama, especially in certain grades. And so, again, you don’t want to minimize that but you also don’t want it to take on a life of its own and start kind of calling the shots and helping them make the decisions.
– So, we’ve talked about sleep, obviously, one of the biggest challenges heading back to school. Getting back into this routine of homework: What do you say to parents about the best way to ease that back into everything?
– So, again, it’s going to be a little bit child-dependent. So, what’s worked in the past is probably going to be how you start building it. But you also have to work in extracurricular activities in there because a lot of kids are coming home, and they have sports practices or other groups. So, knowing, does my child need a break after school and then need to start? Do I need to have it done by dinner? Making sure it doesn’t interfere with bedtime. And it may be a little bit of adjustments depending on what that expectation is. But, again, having that conversation and checking in with them. Letting them have a choice — you don’t have to come right home and sit down and do your work because we might need a break, but I need you to start by this time. Or, I want to check your homework by this time. Just to kind of check in with them. Again, a great discussion with teachers as well, is, sometimes teachers may let you know ahead of time how much homework, or what is going to be a heavier homework day, when a test schedule’s going to be? And then you can help adjust your weekly schedule for your family a little bit based on that as well.
– We always hear kids are so resilient. Do you find that that applies to this situation as well?
– I think in most cases it does. I think the last couple of years, with some of the switch in school and having virtual classes and differences in schedules has made them a little bit more fearful, a little less resilient, because it’s not just those transition years. For a lot of kids, it may be each year is a transition year because their school looked different the year before. But with that support, that listening, they really do well. It’s just, we need to make sure we have that right team around them to make sure they realize that school’s important, they can do it, and that we’re going to be there to make sure that happens.
– Do you get lots of calls this time of year?
– We do. It becomes a lot of the focus. This is the time of year when we’re doing a lot of back-to-school physicals as requirements. And so, sometimes the kids come in and it’s a little too early because they’re not used to getting up. So, that’s a great way for us to start talking about sleep. Or, they don’t want to talk about back to school because of all the negative. And it really gives us that ability to talk about the positives. What do you think you’re going to learn? What do you expect? What do you hope to learn? And sometimes, they can walk out just a little bit less anxious about it or feeling a little more positive. I worry probably as much about the kids who don’t express their concerns. Because keeping that stuff inside, I think, leads more to those headaches, sleep disturbances, all those other things that sometimes are a little harder to put your finger on beause they can’t say I’m feeling anxious, they can just say I’m not feeling well.
– And so, final words for parents. What do you want them to be thinking about?
– Think of each school year as an adventure. Don’t really hide your emotions: If you’re feeling teary-eyed, it’s OK. Just explain to them why you feel that way. They’re growing up, you know, “Oh, it’s hard to think about you being at this stage.” It’s usually not because we don’t want to be separated from them or see them go to school, although that might be what they say. And then keep that line of communication open throughout the school year. Don’t wait until that first grading period comes home to kind of check in and see how they’re doing. Take advantage of teachers’ conferences, or communication with them. And don’t always accept the “Oh, it was OK,” when the kids come home and you say, “How was your day?”
– Oh, that’s interesting. To say, “Don’t always just accept that.” Should you probe?
– So, I think, yeah, having your kids understand that you want a little more detail to that, that “It’s OK” probably isn’t enough. Ask some more of those questions. “What did you do today?” “What was really tough?” “What did you really like today?” And oftentimes when they know that you’re really listening to them, that conversation flows a little easier.
– Ah, well, always some great information. Thank you so much for coming in and spending time with us today. We’ll definitely have you back.
– Oh, well, thank you again. And here’s to a good school year.
– I’m Tonia Caruso. Thank you for joining us. This is UPMC HealthBeat.