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Pediatricians discuss gradual return to school, sports to rebuild kids’ physical, mental strengths

March 10, 2021

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Just as children need to return to physical activity gradually to avoid overuse injuries after being inactive due to the pandemic, they also need a gradual return to learning, according to experts at a virtual AAP town hall meeting.

AAP Chief Population Health Officer Anne R. Edwards, M.D., FAAP, moderated the town hall, which explored how pediatricians can help communities address the challenges of returning to school and physical activities. Joining the discussion were Susannah “Suz” M. Briskin, M.D., FAAP, member of the AAP Council on Sports Medicine and Fitness Executive Committee; Carol Cohen Weitzman, M.D., FAAP, immediate past chair of the AAP Section on Developmental and Behavioral Pediatrics Executive Committee; and Danielle G. Dooley, M.D., M.Phil., FAAP, member of the AAP Council on School Health.

There is a considerable range in how kids are responding to the impact of the pandemic, but pediatricians can help by talking with families about their child’s social, emotional and developmental needs and tailoring guidance based on individual needs, Dr. Weitzman said.

“There are some kids who can’t wait to get back to sports and can’t wait to get back to school. There are other kids who are very nervous about it,” she said. “To think that kids are just ready for that next curriculum without modification, you’re going to have a lot of stress fractures, metaphorically.”

Dr. Dooley agreed. “I don’t think any person who did sixth grade this year is necessarily going to be ready to start in September with the regular seventh-grade curriculum.”

She has spoken with parents who are concerned about how the pandemic will affect their child’s standardized test scores. She tells them that standardized testing is important “to see where kids are and what the magnitude of the learning loss is so that we can make a better plan for school resuming.”

Ideally, schools would consider a gradual reentry starting in summer, particularly for children with an Individualized Education Program (IEP), Dr. Weitzman said. “Those extended school year programs are like reducing mental stress fractures.”

Other ways to boost students’ learning include summer school programs, subsidized summer camps and other outdoor activities, Dr. Dooley added. With children spending most of their day sitting at a computer for the past year, summer camps would provide an outlet for physical activity and learning.

The panelists expressed particular concern about children impacted by economic, racial and ethnic disparities. “We’re really going to have to follow this and listen to families and work with the community to understand what differences, what disparities might evolve and how each community will likely need unique support,” Dr. Dooley said.

In her community, the pandemic has limited the English as a Second Language (ESL) services provided to students. Students in ESL programs and their families may have struggled to navigate school attendance and class technological platforms, and many have missed deadlines for enrollment and lotteries for in-person learning.

Dr. Weitzman has observed some welcomed aspects of the pandemic like smaller class sizes for children with developmental and behavioral issues and a break from bullying at school.

Returning to physical activity and school sports will look different depending on where pediatricians are in the U.S., Dr. Briskin said, adding that the AAP recently issued updated guidance to help pediatricians determine when children can resume physical activity after COVID-19 infection. Warmer weather and the availability of vaccines are encouraging signs that life is moving in the right direction.

“We’re really trying to tackle the whole gamut from the kid who is sitting online all day to the kid who is up and traveling (for sports) and a little bit of everything in between … and hoping that translates to more physical time for their mental and emotional and physical well-being and more social time.”

But Dr. Weitzman said a lot of work lies ahead. She urges her families not to let down their guard as school resumes.

She has learned valuable lessons from patients, such as a child with autism who is nonverbal and mastered mask-wearing despite everyone’s doubt. “I have seen kids rise to certain challenges over the course of this year in ways that are remarkable,” she said. “We should not underestimate children and families. They can do a lot.”

Register hereto attend the next AAP Town Hall at 7 p.m. CDT on March 18.

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