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This month marks the return to school for your patients. Here are some tips to help both students and their parents get a good start.
1. Preschool is as much about socialization as preacademics. A child does not need to learn to read before kindergarten but should be taught to love books.
2. Parental control of electronic equipment has often eased up over summer vacation. If needed, parents should reestablish ground rules for the school year.
3. Although exercise is, of course, to be encouraged, do not casually clear the otherwise healthy obese child for sports without restrictions. At the least, order gradual conditioning to get them in shape.
4. Please do not give a medical exemption for parents who refuse indicated vaccines.
5. Children with attention-deficit/hyperactivity disorder (ADHD) often have associated learning disabilities. Medicine will not help the latter, which needs to be treated educationally by the school. Help the parents push the school for proper evaluation and support (eg, by writing a letter requesting so-called 504 accommodations).
6. I like to get
1 on elementary school children with ADHD early, rather than waiting until teacher conferences. I find doing these with the first medication refill after school has started is a good way to remember to do this.
7. Hyperlexia (recognizing words) is seen in many children with autism. Without comprehension, it is not indicative of advanced reading.2
8. This is a clinical observation, not specifically evidence-based, but I do not believe that red-shirting a child (delaying school entry despite being of age) because they have a late birthday is a good idea if the child is intellectually ready. As a former short boy with a late birthday, I admit to some bias here.
1. National Institute for Children’s Health Quality (NICHQ). NICHQ Vanderbilt Assessment Scales. Available at::
. Published 2002. Accessed June 27, 2018.
2. Farber JM, Caputa AJ. Understanding autism. Clin Pediatr (Phila). 1984;23(4):199-202.