THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 542.5 Guest: Dr. Harold Shinitzky, psychologist, Johns Hopkins Pediatric Center Topic: Helping Kids with school changes Producer/Host: Steve Girard

NEMA: When a child sees change is coming...anxiety soon follows. We're with Dr. Harold Shinitzky, a psychologist and instructor with Johns Hopkins Hospital Pediatric Center. What kinds of things are youngsters feeling when going into school for the first time, or changing to a higher grade?

SHINITZKY: Children who are entering into the pre-kindergarten classes and kindergarten classes are exposed to something new...and novel experiences frequently, for a youngster, are pretty threatening. Little boys and girls are used to a certain routine at home, and predictability is really something that allows children to feel a sense of comfort. For these children, what's really important for us to look at is to see their reactions. Some children look at new situations with some anxiety, and others seem to adjust to it quite well. But it's important for us to be aware that even if a child seems to be well-adjusted and at ease with this transition, it's a lot of new experiences, and it's important for us to be pro-active, and to talk with the children ahead of time, to share with them some of the expectations, and to get them actively involved in looking toward this new experience. There's many different ways you can do that: I think what's really important is introducing them to the school environment, getting them familiar with the classroom where they're going to be situated throughout the day. Those are all very important, and it's important to be pro-active about that.

At this age, most children are dealing with specific developmental tasks...two of which are separation anxiety, and stranger anxiety. So coupling this kind of change in their entire routine, we have these normal, developmental tasks these children are going through. and it's difficult for them to be able to pull away from the family, that's a sense of security for them, and it's also difficult for them to understand who these new people are, and they feel comfortable with them. Again, some children seem to be very at ease with that, and other children, just by temperament, seem to have much more difficult time. So, again, it's important to talk with your children, emphasize that this is something that's coming up, and make it something to look forward to.

NEMA: How about the situation where there's a youngster not going to school, when his siblings are...and he's left behind.....

SHINITZKY: It's kind of interesting, because a lot of the youngsters that we work with who are, let's just say, middle school and adolescence, it doesn't have to, necessarily just apply to younger children. When their older siblings go off to school....there's often a sense of abandonment, a feeling of being left behind. A lot of children feel the sense of envy, of wanderlust, of being able to watch their older siblings move on. But there's a fear that their relationship is going to be discontinued. It's rather important, at that point, to be able to recruit the older child, who is now old enough and mature enough to go off to college, to be able to develop new routines, and kind of new traditions with the child who's left behind. and there are many different ways to do that...the older children can leave some type of a prized possession of theirs behind for the younger child to hold on to. Or the younger child can be asked to see if there's something they can do...I'm sorry, the older child can do something with the younger child, to initiate some kind of new routine, be it every month, or every week..."I'm going to call you", and on the other times you call me. Visitation, it's rather important to be able to schedule things in advance...it allows the child that is now remaining at home to have that sense of continuity, that the relationship will continue.

NEMA: With the school year just getting into full swing, having a talk with your youngsters about the changes going on in their lives can be an important step in lessening any anxiety they may be feeling, and to enjoy more fully the challenge of new experiences. Our thanks to Dr. Harold Shinitzky of the Johns Hopkins Hospital Pediatric Center. I'm Steve Girard.