Jeffrey Upperman, MD, Trauma director at Children’s Hospital Los Angeles, discusses back to school safety concerns including using car seats for young passengers, wearing bicycle helmets, and teaching kids how to obey traffic signals.

Going back to a “back to school” routine that includes early mornings, long days in the classroom and homework every night after having a summer of fun can take a period of adjustment. Specialists at Children’s Hospital Los Angeles have compiled a list of recommendations to keep children safe and healthy as they get into the new Fall semester.

Child pedestrians are at greater risk of injury or death from traffic crashes than adults due to their small size, inability to judge distances and speeds, and lack of experience with traffic laws. Rules to follow include:

Children under the age of 10 should not walk alone.

When walking to school, stay on the sidewalk. If no sidewalk is available, walk in the direction facing traffic.

Always use crosswalks when available and never dart out into traffic without first looking in both directions.

Do not wear headphones while walking and refrain from walking and texting as both activities are distractions and impede a person’s awareness.

If riding a bicycle or scooter to school, “be safe and be seen by wearing reflective gear and lightly colored clothing,” says Dr. Jeffrey S. Upperman, trauma director at Children’s Hospital Los Angeles.  “A helmet that is sized and worn properly is essential to reduce the risk of a severe head injury.”

Back problems aren’t just for adults. Children who wear ill-fitting backpacks or who carry overstuffed book bags are at risk for injury.

“The more weight children carry in a backpack, the more likely they are to have back pain. If children are able to lighten the load by putting books in a locker, they are likely to have less back pain,” says David L. Skaggs, MD, chief of the Children’s Orthopaedic Center and director of the Scoliosis and Spinal Deformity Program at Children’s Hospital Los Angeles. “There is no limit or recommended weight, other than common sense.”

Select a backpack that is ergonomically correct for your child’s size. However, Skaggs adds, “There is no evidence that using one or two straps makes a difference, nor is their evidence that pulling a wheeled bag behind them is better. It is highly unlikely that carrying a backpack does any permanent harm to posture, or there would be generations of ex-boy scouts and infantry with poor posture.”

Oftentimes, a child’s excitement for action and adventure supersedes discretion in playing safely. Every year in the United States, according to the Centers for Disease Control and Prevention, emergency departments treat more than 200,000 children ages 14 and younger for playground-related injuries that include severe fractures, internal injuries, concussions, dislocations and amputations.

• Ensure all playground equipment is in functional, stable condition and bears no signs of rust or excessive wear and tear (broken bars on jungle gym, cracked support bars on a swing set).

• Teach children to properly use the equipment and to not engage in risky behavior like going down a slide headfirst or hanging upside down on the jungle gym.

• Talk to your child’s school or daycare facility to ensure that your child’s playtime will be properly supervised.

• Keep children hydrated during the hot summer weather.

At school, your child will interact with many more kids than they did over the summer. This means they will encounter many different germs.

“The easiest, most basic thing your child can do to avoid contracting illness or spreading germs is to practice effective hand washing throughout the school day,” says Juan Espinoza, MD, general pediatrics at Children’s Hospital Los Angeles.  This means before school, before and after lunch, after recess time and after using the toilet. Children should also get into the habit of brushing their teeth after they get home from school and before bedtime.

Make sure your child’s vaccinations are current, and make sure that everyone in the family gets an annual influenza vaccine.

“It’s plain and simple, vaccinations save lives. Not only do they protect your child and your family, they help prevent the spread of disease in schools and in the community,” says Grace Aldrovandi, MD, chief of the Division of Infectious Diseases at Children’s Hospital Los Angeles.

Having good eyesight and hearing is essential to academic success. If left undetected, vision and hearing problems can hamper a child’s ability to learn in the classroom and can be misdiagnosed as a learning disability.

“Preschool and elementary school-aged kids should get vision screenings at well child visits, which can identify crossed eye or lazy eye conditions,” says Mark Borchert, MD, director of the Eye Birth Defects Institute and Eye Technology Institute in The Vision Center at Children’s Hospital Los Angeles.

Headphone usage at unsafe volumes can contribute to hearing impairment and potentially to hearing loss. “Follow The American Auditory Society’s 60/60 guidelines and listen at no more than 60 percent of maximum volume and not more than 60 minutes at a time,” says Children’s Hospital Los Angeles pediatric otolaryngology specialist Debra Don, MD.

At least one week before school starts, parents should start scaling back bedtime for kids and start waking them earlier to start their day. When getting back into a new schedule, factor in extra time each morning to allow for kids to get dressed, gather their belongings and eat breakfast before heading out the door. For working parents, time management and an established morning routine is essential to minimize stress.

• Each night before school, place your child’s belongings (homework, books, backpacks) at a convenient and consistent location so that all they have to do is grab and go.

• Clothing can be laid out the night before in the child’s room so that getting dressed in the morning is not an ordeal.

• Talk with children about how school is going. “Parents should listen more than talk or correct, and ask open-ended questions,” says Stephanie Marcy, Ph.D and pediatric psychologist at Children’s Hospital Los Angeles. Marcy says.

When it comes to bullying, “children should be encouraged to demonstrate advocacy for themselves and others, and have a specific plan that they work out with their parents in case they find themselves the victim of bullying, or witness another child being bullied.”

If your child is the bully, it’s important not to respond with anger. “Parents need to approach their child with concern and support rather than anger,” Marcy explains. “Help them to develop a healthy sense of self.”

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