Editor's note: This article was sponsored by Pacific Medical Centers.
For many families, this back-to-school season marks a return to a traditional classroom and daily routine. Pediatricians hope this season also ushers in the return to routine physical exams and preventive care for children, something that declined sharply during the pandemic. Concerns about COVID-19, financial instability, and the demands of managing remote school and work responsibilities kept millions of kids out of pediatrician offices last year, particularly children from low-income households. For children enrolled in Medicaid and the Children’s Health Insurance Program, the Centers for Medicare & Medicaid Services reports a 40 percent decline in preventive health screenings, a 44 percent decline in outpatient mental health services and a nearly 75 percent drop in dental services.
Reduced access to primary and preventive care services can negatively impact kids’ physical, social and emotional health, as well as academic outcomes. Happily, it’s never too late to get back on track, and the back-to-school season offers families the chance to catch up on physical examinations, vaccinations, sports physicals and health screenings. Your pediatrician can also help you and your child address social and emotional concerns related to returning to school after months of remote and hybrid learning. Read on for expert advice for working with your child’s pediatrician to prepare for a healthy, happy school year.
Social and emotional health
Well-child visits track important developmental milestones and safety guidelines for growing children — from when children can be expected to perform chores at home to seatbelt use and water safety precautions. During a well-child exam, health-care providers also offer guidance and support for a child’s social and emotional health, notes Christina Chen-Milhone, D.O., a pediatrician and internal medicine doctor at Pacific Medical Centers’ (PacMed) Totem Lake clinic.
This year in particular, many school-age children are nervous about heading back to the classroom. “There’s so much anxiety right now, because this school year will be different and represent a new routine for them,” says Dr. Chen-Milhone. “And while most of my patients 12 and older are super excited about the opportunity to get the COVID vaccine, some of them are really nervous about it, too.”
Kids’ apprehension may center around the unknowns awaiting them at school: How will school drop-off and pickup change, compared to past routines? Will students still have access to lockers or other places to store books and belongings during the day? Will they still be able to sit with their friends during lunch?
Parents can help kids feel more confident about returning to school by asking school administrators about daily routines and requirements for students, and by sharing the information with their children well before the first day. “It really helps to talk about these things with kids and even practice them at home, whether it’s hand hygiene or mask wearing,” says Dr. Chen-Milhone. “Talking to school administrators about school policies and then talking to kids about what they can expect is very helpful.”
For children with heightened anxiety or another mental health consideration, reach out to your child’s provider sooner rather than later, says Nawal W. Alkharouf, M.D., a pediatrician at PacMed Canyon Park. “We have seen an increase in mental health concerns, and going back to school full-time can provoke anxiety. We recommend that families come in and seek attention during the summer if they have any concerns.”
As kids prepare to return to school sports — for many, their first formal participation in sports in more than a year — a physical exam is more important than ever. “We’re really checking to see if it’s safe for kids to participate and work hard in sports, and over the pandemic, as we’ve gotten away from organized sports, kids may be a little deconditioned. It’s a good opportunity to see what’s safe and not safe,” says Alexander Hamling, M.D., a PacMed pediatrician who treats a number of conditions, including asthma and diabetes, in children and teenagers.
Do children really need both a well-child examination and a sports physical? If kids plan to participate in organized sports, a pre-participation exam is essential. As it turns out, a sports physical is one of the most comprehensive exams a child can get. Although annual well-child checkups look at a child’s growth and development, a sports physical includes extra focus on nutrition, hydration, sleep and mood.
A sports physical includes a full medical history, taking into account a family history of any serious illnesses and chronic conditions, previous hospitalizations and surgeries. Health-care providers also look at cardiac function to ensure that the heart is healthy enough for vigorous exercise. “We want to look at the heart and lungs to make sure there are no underlying issues, including breathing issues, that would make sports participation unsafe,” says Dr. Hamling.
Getting back into a routine
Your child’s health-care provider can also answer questions and offer guidance for a perennial back-to-school challenge: getting back to a school-year routine. This year, reestablishing more structured daily routines feels especially daunting for many families, says Dr. Alkharouf. “A lot of parents have been off their family routines during the pandemic, so summer is a good time to start thinking about getting into a more structured school-year routine.”
Establishing consistent daily routines isn’t just practical; it can help alleviate some back-to-school anxiety, says Dr. Chen-Milhone. “Establishing a good routine at home is helpful for everyone, because people know what to expect, with fewer surprises. It also helps people obtain better-quality sleep, which helps alleviate excessive anxiety.”
Parents may get discouraged about enforcing a bedtime routine after months without much daily structure. Instead of focusing solely on the bedtime routine, Dr. Alkharouf recommends looking at the entire day. “We want to think about setting up routines throughout the day,” she notes. “A good routine will vary depending on a child’s age, but we know that we want to have good morning, after-school, dinnertime and bedtime routines in place.”
Older children respond best when routines are created with their input and understanding, says Dr. Alkharouf. “Dinnertime is a great time to discuss the events of the day and talk about what’s going well and what didn’t go well. Parents can also talk to middle school kids about screen time and the importance of reducing screen time in the evenings to prepare for sleep.”
Whether families want to reestablish more consistent daily routines or return to a more predictable pre-COVID bedtime, this school year offers an opportunity to establish healthy habits. “The right routines are going to be targeted to each child and family based on their needs and their schedule,” says Dr. Alkharouf. Your child’s pediatrician can help you work out an approach that works for your family and sets your child up for school-year success.