Safety and health checklist to help kids avoid emergency room

With the school year underway, Children's Hospital Los Angeles experts have developed a safety and health checklist to help kids avoid the emergency room and develop productive extracurricular and learning activities to enhance the classroom experience. What do parents need to consider? Many symptoms of childhood conditions are often discovered in the classroom. Prevention is key and heading off many health issues requires proactive measures. Here are a few back to school tips to keep your child healthy and happy as the school year begins.

“If your child sees you being rude and offensive to others, they may feel this is a acceptable behavior.”

1. Is Your Child Snoring at Night?

Asking for "five more minutes" of sleep and foot dragging are normal in the transition from late summer nights to the earlier wake-up call for school. However, if your child is getting the recommended eight to 10 hours of sleep per night and still exhibiting signs of sleepiness, Sally L. Davidson Ward, MD, head of the division of Pediatric Pulmonology and medical director of the Sleep Center at Children's Hospital Los Angeles, recommends checking to see if your child is frequently snoring at night. In overweight children especially, snoring can be a sign of sleep apnea and other breathing difficulties. "Even brief moments of labored or absent breaths can disrupt a child's sleep cycle and may impact attention and learning," Ward explains.

2. Back to School Jitters

Many kids feel nervous about going back to school, and may express apprehension. New teachers, a new school and new classmates can lead to anxiety. Parents can help by listening and asking open-ended questions about their child's particular worries, rather than making assumptions. "Try to establish a routine and schedule before school starts to ease your child into the rigorous school schedule and help them be prepared," says Stephanie Marcy, PhD, a psychologist at Children's Hospital Los Angeles. "Encourage your child to be open minded about making new friends, while also allowing them to maintain contact with old friends."

3. Avoid Processed High-Salt Foods and Drinks in Packed Lunches

Once the school year begins, overbooked schedules might tempt parents to send their children to school with prepackaged lunches that are high in sugar, salt and fat. Steven Mittelman, MD, PhD, director of The Saban Research Institute's Diabetes and Obesity Program, says learning about healthy food choices begins at home, and can be an important step in preventing or reversing obesity. One idea: Prepping a week's worth of lunches during the weekend can make it easier for busy parents to pack a nutritious lunch. "Try cutting up colorful fruits and veggies and packing them to grab and go," says Megan Lipton, director of the Kids N Fitness Program at Children's Hospital Los Angeles. "By opting for a recyclable water bottle instead of juice, you can cut down on your child's excess sugar."

4. Busy and Distracted Children can Encounter Health Issues

As children head back to the classroom, their schedules fill up with activities and homework. Countless hours are spent in front of the computer, television, smart phones and iPads, including texting and playing video games, but the distraction can also cause a child to hold their urge to use the restroom and may lead to constipation or urinary tract infections (UTI). "Kids don't want to go to the bathroom at school; they don't have time, so they drink less and move around less," says Dan Thomas, MD, pediatric gastroenterologist at Children's Hospital Los Angeles. "Parents should limit their child's time in front of electronics and encourage them to take frequent bathroom breaks. Exercise and routine are essential for healthy bowel movements in school-aged children." If a child experiences symptoms of a UTI or constipation, make an appointment to see a doctor.

5. Bullying in the Classroom

Stop bullying before it starts. "Parents need to be a positive role model in how to treat others," says Gloria Verret, RN, an RN Remedies nurse blogger at Children's Hospital Los Angeles. "If your child sees you being rude and offensive to others, they may feel this is a acceptable behavior." Open the lines of communication with your child by talking about the issue of bullying. Encourage your child to inform you right away when they, or someone they know, are being bullied at school or online. "If bullying is an issue at your child's school, get involved," urges Verret. "Go to the teacher, the principle, the PTA or the school board and rally the adults to stop bullying in the school."

6. Annual Eye Screenings

A comprehensive vision exam should be as routine as a normal physical or check-up before school starts. Studies conducted by the American Optometric Association indicate that sixty percent of children with learning difficulties actually suffer from undetected vision problems. As a parent, it is important to ensure that your child's vision is at its best. "Good eyesight is a fundamental part of learning in the classroom, yet many children do not have the recommended annual eye screenings conducted at school or by pediatricians," says Mark Borchert, MD, a pediatric ophthalmologist in The Vision Center at Children's Hospital Los Angeles. "Parents should monitor symptoms and signs of vision problems throughout the school year, especially because eye sight changes as children grow older."

7. Full Diagnostic Hearing Test

Make sure your child's learning is at its best by getting their hearing tested. Kids are susceptible to chronic ear infections which can potentially lead to hearing loss. "Not all hearing problems can be detected by a school screening, so it's important to have a full diagnostic test," says Bea Smith, AuD, pediatric audiologist at Children's Hospital Los Angeles. "Hearing loss often goes undiagnosed, which can lead to a longer learning curve for children, speech and language delays and even behavioral problems due to the child not hearing or understanding instructions. It's important to see an audiologist to be sure their hearing is adequate for communication."

8. Asthma and Allergy Action Plans for Teachers and School Nurses

Work with your child's doctor or nurse to prepare an action plan for any health issues your child may encounter. "Children with allergies or asthma may need special accommodations in their food or treatment to maintain normal activity levels. Review any medical records or prescription information with the school nurse or teachers to ensure proper dosage and care," says Ronald Ferdman, MD, pediatric asthma and allergy specialist at Children's Hospital Los Angeles. Armed with the knowledge of how your child's asthma or allergies are triggered, you can take preventive measures such as knowing the symptoms that precede a reaction. Download a copy of an Asthma Action Plan or Food Allergy Action Plan.

9. Playground Safety

Teaching children safe playground behaviors at home or in a public park is a great way to avoid injury at school. According to the U.S. Consumer Product Safety Commission, nearly sixty percent of all injuries are caused by falls to the ground. "It is critical for parents to actively supervise children, check for broken equipment and make sure children are wearing protective gear," says Helen Arbogast, MPH, CHES, manager of the Injury Prevention Program at Children's Hospital Los Angeles. There is no substitution for adult supervision, and whenever possible children should be supervised during play at home and school. "Evaluate your child's behaviors around others and make sure that they follow the playground rules. Children tend to increase risk by using equipment intended for older children and by improperly using equipment, such as sliding down equipment backwards or jumping off monkey bars. Be sure to stop that behavior in its tracks to avoid a trip to the emergency room."

10. Update Your Child's Vaccinations

"Check with your doctor to confirm that your child has received the recommended vaccinations to protect them from illnesses carried by other students at school," says Jill Hoffman, MD, a pediatric infectious disease specialist at Children's Hospital Los Angeles. "It's particularly important that children receive vaccines for pertussis (whooping cough), influenza, chicken pox and measles; these vaccine-preventable diseases continue to circulate worldwide and cause infections in unimmunized children in the United States." To see a list of recommended vaccinations for different age groups, the American Academy of Pediatricians (AAP) offers parents an online immunization schedule.