Patient Presentation
A 5-year-old male came to clinic for his health supervision visit. He had attended a preschool for the past year three times per week and had done well. His mother reported that the teachers had no concerns about him entering kindergarten. She however was worried about him taking the bus and also needing help in the lunchroom. The past medical history showed a broken arm from falling off a bike. His immunizations were current.
The pertinent physical exam showed a well-appearing male with normal vital signs and growth parameters in the 75-90%. His physical examination was normal. The diagnosis of a healthy male was made. The pediatrician filled out the school health form and recommended that he see a dentist as he hadn’t seen one in more than 1 year. He also recommended for the parent to contact the school to see if there was a new parent orientation to learn more about the school, ask questions and meet other parents. “Even if they don’t have one, you can get your questions answered by the school personnel,” he said and then went on, “I know he knows many colors, letters and numbers, but I recommend he knows his street address and your name so if there is a problem an adult can help him.” “You can also practice the bus route with him and show him ahead of time where he will be going. Find another child who will be taking the bus and see if that child can be his “bus-buddy.” In that way he has someone else he knows will help him.” He reassured the mother by saying, “The teachers know that the kids can’t open all their containers, so they just help the kids. They also get a lot of the older kids to help the younger ones. The older ones remember having that problem too and are usually really happy to help the little ones.”
Discussion
Many parents look forward to but worry about their child starting school. These are normal concerns as the child may not have had a school experience before or has school experience but not for as long a time as a regular school day. The child often will be traveling a different route to school such as taking a bus. Kindergarteners also need to be more responsible for their own self, their belongings and often will be handling other adult items such as notes from school and money.
The most important part of kindergarten though is to instill a love of learning. It isn’t how much the children already knows or will learn, it is about them learning that school can be an enjoyable place to learn about the world.
- Relax and enjoy your child’s kindergarten time – its the small things that you will remember
- Have your child registered and fill out all the other paperwork and forms
- Have your child vaccinated and receive the health care and dental care they need
- If you can, attend parent orientation or back to school nights that the school offers to learn more about the school
- If you can, have your child attend their own orientation
- Children can be very tired after school. They have been very busy learning and it takes all their energy.
- Give them a snack (sometimes you have to pack one in the backpack or bring it for the car ride).
- Allow them some quiet time. Remember they have been around other noisy kids all day and may need some quiet time. That may also mean that you don’t ask lots of questions right away when they get home from school.
- Phase out naps over the summer so your child is ready to not have a nap at school. There will be rest time but usually this is not for actual sleep.
- Ask your child about what they are doing in school. Sometimes they won’t say much, so ask more specific questions such as “What did you do in math today?” or “Last week you were playing soccer in gym class, are you doing the same thing?” We often ask children what they like about something, so try the opposite like “So what was bad today?” It surprises the child and then they will tell you more about what is happening in their life.
- Clean out the homework folder every night with your child and send information back to school if needed.
- If you can afford it, send in extra school supplies or donate items for special days
- Write a note to the teacher with or without your child to thank them at holidays or end of year. Email or saying a special thank you with a big smile goes a long way for teachers to know that you are involved and see that they are trying to do their best for your child.
- If you can attend or volunteer for a special event, do so. If you cannot, then don’t beat yourself up over it. Not everyone can do everything or afford everything.
- Read to your child. Have an older child read to the younger one.
- If you don’t read well, then do what you can do. Consider talking with the teachers about help for yourself.
- You will never know all the answers. Tell your child it is okay to not know or to be wrong. Show them how to find answers and be gracious when they are wrong.
- Read the notes teachers send home. Sign and send the notes back if appropriate.
- Communicate with the school about issues in your family if it might concern the school. Family stress such as losing a job, changing homes, deaths in the family, financial worries, etc. affect the child and if the teacher is aware can be of help to the child.
Some schools also have resource centers, social workers or guidance counselors who may be able to help you. - Communicate with the teacher if you have any questions or concerns. Understand that they have many more students than you do so respect their time. But they do want to hear from parents if you have concerns. Write a note, email or telephone.
- Trust the teacher but trust yourself when things don’t seem right.
- Teachers have worked with lots of kids and lots of parents. They probably have a good sense of how your child is doing in the very broad “normal” area. If the teacher has a concern remember that they are bringing this to your attention because they care about your child. Similarly if the teacher is not concerned about your child, but you truly think differently, talk it out with them and see their point of view. You know your child best so be their advocate but don’t be an adversary to the teacher.
- If you cannot get the information you need from the teacher or you have a larger concern the teacher cannot address, then contact the principal. If you feel you cannot talk with the principal, then the school guidance counselor can often help or contact the central administration of the school district.
- Find a “parent-buddy” who can also give you information about the school that your child may not bring home or be aware of. They often know the unwritten rules or ways that the school works.
Learning Point
Children should know (and it is a lot):
- Self-care
- Their own first and last name
- Street address
- Phone number
- Parents/guardians first names
- Where parents work
- Safety
- How to dial 911
- Who will they go home with
- How they will get home and by what route
- What will they do if they get off bus, get home etc. and parent is not there
- What will happen if school gets out early or starts late
- What they should do in an emergency
- Academics
- Colors – some
- Letters – some
- Numbers – some
- How to wait at least 1 minute
- How to raise hand to be acknowledged
- Lunch room
- How to open food containers – but there will be lots of other personnel and students to help
- How to pay for school meals with money or if receiving free or discounted meals
- How to carry a tray
- Bathroom
- Bathroom etiquette – close door, use toilet paper, flush toilet, wash hands
- General
- Label everything – especially clothing and anything else they take to school
- Keep it simple – all papers go in the homework folder – clean out the folder every night
- What should they do if they lose something
Questions for Further Discussion
1. What should children know before starting middle school?
2. What should young adults know before starting college? See case here.
Related Cases
- Disease: Starting Kindergarten | School Health
- Symptom/Presentation: Health Maintenance and Disease Prevention
- Specialty: General Pediatrics | School
- Age: School Ager
To Learn More
To view pediatric review articles on this topic from the past year check PubMed.
Evidence-based medicine information on this topic can be found at SearchingPediatrics.com, the National Guideline Clearinghouse and the Cochrane Database of Systematic Reviews.
Information prescriptions for patients can be found at MedlinePlus for this topic: School Health.
To view current news articles on this topic check Google News.
To view images related to this topic check Google Images.
To view videos related to this topic check YouTube Videos.
Peters T. 8 things I wish I’d known before my child started kindergarten. Today Parents.
Available from the Internet at http://www.today.com/parents/8-things-i-wish-id-known-my-child-started-kindergarten-1D80005092 (rev. 8/8/14, cited 6/2/15).
10 Things to Think About Before Your Child Starts Kindergarten. Harvard Homemaker.com.
Available from the Internet at http://harvardhomemaker.com/10-things-to-think-about-before-your-child-starts-kindergarten/ (rev. 7/25/13, cited 6/2/15).
Countdown to Kindergarten. Scholastic.com (Collection).
Available from the Internet at http://www.scholastic.com/parents/resources/collection/what-to-expect-grade/count-down-to-kindergarten (cited 6/2/15).
Starting School. American Academy of Child and Adolescent Psychiatry.
Available from the Internet at http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Starting_School_82.aspx (rev. 3/11 cited 6/2/15).
Author
Donna M. D’Alessandro, MD
Professor of Pediatrics, University of Iowa Children’s Hospital
Pediatric Education 