Five tips for back to school time

Back to school time can be problematic for both children and parents. UNC Health Care experts offer tips for dealing with five issues that might arise.

Tip No. 1: Know the signs of school phobia, separation anxiety and social phobia
Starting or returning to school can stir up a bevy of emotions with a range of effects, from bothersome to debilitating. Knowing a little bit about a few of these problems helps parents and children manage and overcome them.

  • School phobia – extreme anxiety from going to school or even talking about it. Causes could range from being bullied to grieving for a lost pet. Reassure the child that fear is normal, remind him of good things in school, and don’t give in to a desire to stay home.


  • Separation anxiety – afraid of being without mom or dad can be paralyzing and have long-term effects. Focus on fun things, provide rewards and be consistent about leaving your child or he won’t learn that anxiety is temporary.


  • Social phobia – extreme fear and avoidance of social situations or of being the center of attention can begin in elementary school as extreme shyness, difficulty making friends or not speaking up. See a mental health professional. The disorder can manifest in adulthood as trouble keeping a job or staying in a relationship.

Tip No. 2: How to help your student return to healthy sleep habits
“One thing is clear; everybody is not getting enough sleep,” says Dr. Leslie Boyce, director of the UNC Pediatric Sleep Center.

Many problems are related to poor “sleep hygiene,” but others can be attributed to more serious problems such as sleep apnea or restless leg syndrome. In teenagers, a normal shift in their biological clocks could be to blame.

Kids up to 12 need about 10 to 11 hours of sleep a night; they average seven to nine. Teenagers need at least nine, and they get seven. In children, lack of sleep can manifest in poor attention and foul mood.

Some tips include:

  • Tonsils may cause obstructive sleep apnea; have your doctor consider that cause.
  • Lights out – including computers and games – an hour before bedtime
  • Melatonin might help regulate your teenager’s sleep time


Tip No. 3: Common myths, and reality checks, about sexually transmitted diseases
Dr. Nicole Swiner of UNC Health Care’s Durham Family Practice clinic says she has seen an increase in teens and 20-somethings with sexually transmitted diseases this summer. Back to school time could add to the increase, and many of these patients put themselves at risk because of certain myths they believed, Dr. Swiner said, such as:

  • Myth: “I feel fine and don’t have any problems, so I don’t need to be tested for STDs.”
  • Reality check:  STDs can linger in the body for years before you notice symptoms, and even if you don’t have symptoms, you could still infect your partner. If you are sexually active, then you need to be tested for STDs when you have your annual physical exam, Dr. Swiner says. This is true for both sexes, from teens to older adults, who are sexually active.

Tip No. 4: Prescription meds can make back-to-school time tricky, and risky, for kids. Here are tips for a smooth and safe transition.
For children taking prescription medications, schools often require documentation from the physician and a separate prescription that will stay at the school, says Mary W. Roederer, Pharm.D., from the UNC Department of Family Medicine. So, before the school year starts, parents need to get an extra prescription from their physician, fill out all required forms and coordinate with their child’s teachers and/or school nurses.

Back to school time can be very stressful, a trigger that causes some older children to rummage through their parents’ medicine cabinets, while younger children may mistake prescription drugs for candy. For these reasons, parents should keep prescription drugs out of their children’s’ reach, preferably under lock and key, Roederer says.

Tip. No. 5: Know your child’s heart risk
Heart disease starts early in life, with sedentary lifestyles and poor eating choices. Dr. Cam Patterson, director of the UNC McAllister Heart Institute, explains the physiology and provides tips to help kids chart a heart-healthy course.

With sudden cardiac death, however, there seems to be little anyone can do to prevent it. It’s rare – about one in 50,000 for kids 12 and older, but the topic arises each year as our kids start playing school sports. There are things people can do to help prevent a catastrophe:

  • Be sure your child has a physical every year before beginning sports; The American Heart Association recommends a 12-point screening exam before beginning participation in sports
  • Be aware of symptoms of heart problems, including shortness of breath, chest pain or fainting
  • Encourage your community to install AEDs – automatic external defibrillators – and teach people how to use them
  • Make your doctor aware of any cardiovascular problems in your family’s history