Taking a Mental Health Day Off from School

Taking a Mental Health Day Off from School: A Pediatrician-Mom’s Perspective by Hansa Bhargava, MD, FAAP

“I’m exhausted. Can I please have a day off from school?” My first instinct when one of my kids asks a question like this is to push them to get out of bed and get going. But when my daughter woke up last Friday and asked this question, I hesitated. My daughter has had a crazy month. Along with her usual load of 6th grade quizzes, tests, and homework, she’s had to stay at school until 7pm almost every day for rehearsals for the school play. After that, it’s a long drive home through traffic, and then dinner. She’s not able to sit down and start her load of homework until 8:30pm.

As a working mom and pediatrician, I’ve had weeks like these. The only difference is that I don’t have homework, studying, and projects to do when I get home after a very long day. And even without all of that, I will honestly admit, I have felt the need for a “mental health day.”

Kids and Stress

What I’m seeing as a pediatrician is that more and more kids are incredibly stressed. Not only have their academics been ramped up, but they are expected to do higher-level sports, high-level arts, and be on the go constantly. For many children, the lazy, after school, neighborhood playtime is long gone―as are the long summers of being bored.

What Parents Can Do

All kids are different and some can handle more than others. But as parents, we need to listen to our kids and know their limits. Studies have actually shown that boredom and long periods of unscheduled time can actually spur creativity and out of the box thinking, as well as reset the emotional needle. We ALL need this―and the kids do, too.

So, let’s all take time regularly to have that break. Reset and recharge by staying home, by being with family, or by just simply taking a walk and looking at the trees and the spring flowers. It will calm our soul and give us the “mental break” we need to recharge ourselves.

That day, I gave my daughter what she asked for. I did let her stay home and just be. And the next day, she was ready to go full force again.


Source: Copyright © 2018 Hansa Bhargava, MD, FAAP. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Talking to Children About Tragedies & Other News Events

After any disaster, parents and other adults struggle with what they should say and share with children and what not to say or share with them.

The American Academy of Pediatrics (AAP) encourages parents, teachers, child care providers, and others who work closely with children to filter information about the crisis and present it in a way that their child can accommodate, adjust to, and cope with.

Where to Start – All Ages

No matter what age or developmental stage the child is, parents can start by asking a child what they’ve already heard. Most children will have heard something, no matter how old they are. After you ask them what they’ve heard, ask what questions they have.

Older children, teens, and young adults might ask more questions and may request and benefit more from additional information. But no matter what age the child is, it’s best to keep the dialogue straightforward and direct.​

Avoiding Graphic Details & Exposure to Media

In general, it is best to share basic information with children, not graphic details, or unnecessary details about tragic circumstances. Children and adults alike want to be able to understand enough so they know what’s going on. Graphic information and images should be avoided.

Keep young children away from repetitive graphic images and sounds that may appear on television, radio, social media, computers, etc.

With older children, if you do want them to watch the news, record it ahead of time. That allows you to preview it and evaluate its contents before you sit down with them to watch it. Then, as you watch it with them, you can stop, pause, and have a discussion when you need to.

Children will generally follow good advice, but you have to give them some latitude to make decisions about what they’re ready for. You can block them from seeing the newspaper that comes to the door, for example, but not the one on the newsstand. Today, most older children will have access to the news and graphic images through social media and other applications right from their cell phone. You need to be aware of what’s out there and take steps in advance to talk to children about what they might hear or see.

Talking to Very Young Children

The reality is that even children as young as 4 years old will hear about major crisis events. It’s best that they hear about it from a parent or caregiver, as opposed to another child or in the media.

Even the youngest child needs accurate information, but you don’t want to be too vague. Simply saying, “Something happened in a faraway town and some people got hurt,” doesn’t tell the child enough about what happened. The child may not understand why this is so different from people getting hurt every day and why so much is being said about it. The underlying message for a parent to convey is, “It’s okay if these things bother you. We are here to support each other.”

Talking to Gradeschool Children & Teens

After asking your child what they have heard and if they have questions about what occurred during a school shooting, community bombing, natural disaster, or even a disaster in an international country, a parent can say something such as:

“Yes. In [city], [state]” (and here you might need to give some context, depending on whether it’s nearby or far away, for example, ‘That’s a city/state that’s pretty far from/close to here’), there was disaster and many people were hurt. The police and the government are doing their jobs so they can try to make sure that it doesn’t happen again.”

A parent can follow-up as needed based on the child’s reactions and questions.

Talking to Children with Developmental Delays or Disabilities

Parents who have a child with a developmental delay or disability should gear their responses to their child’s developmental level or abilities, rather than their physical, age. If you have a teenage child whose level of intellectual functioning is more similar to a 7-year-old, for instance, gear your response toward her developmental level. Start by giving less information. Provide details or information in the most appropriate and clear way you can.
Talking to Children with an Autism Spectrum Disorder (ASD)

What’s helpful to a child with an ASD may be different. For instance, the child may find less comfort in cuddling than some other children. Parents should try something else that does calm and comfort their child on other occasions. Ask yourself, “Given who my child is, his personality, temperament, and developmental abilities, what might work for him?”

Signs a Child Might Not Be Coping Well

If children don’t have a chance to practice healthy coping, a parent may see signs that they’re having difficulty adjusting. Some of things to look for are:

  • Sleep problems: Watch for trouble falling asleep or staying asleep, difficulty waking, nightmares, or other sleep disturbances.
  • Physical complaints: Children may complain of feeling tired, having a headache, or generally feeling unwell. You may notice your child eating too much or less than usual.
  • Changes in behavior: Look for signs of regressive behavior, including social regression, acting more immature, or becoming less patient and more demanding. A child who once separated easily from her parents may become clingy. Teens may begin or change current patterns of tobacco, alcohol, or substance use.
  • Emotional problems: Children may experience undue sadness, depression, anxiety, or fears.

Sometimes it can be hard to tell if a child is reacting in a typical way to an unusual event or whether they are having real problems coping, and might need extra support. If you are concerned, talk to your child’s pediatrician or a mental health professional or counselor.


Source: Adapted from an eHealthMD interview with David Schonfeld, MD, FAAP, Director of the National Center for School Crisis and Bereavement and member of the AAP Disaster Preparedness Advisory Council. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

How to Make Your Home into a Workable School

In these unprecedented times, nearly 55 million students nationwide are now expected to continue their education at home while schools are closed – some indefinitely – to slow the spread of coronavirus. Parent across the country are looking for ways to adjust.

Last week, USA Today columnist Jennifer Jolly investigated, “Remote learning during coronavirus: How to make your home into a workable school.”

CLICK HERE to read her full article.

Positive Parenting & COVID-19: 10 Tips to Help Keep the Calm at Home

Calmly teaching your child good behavior can become more difficult, though no less important, during stressful times. The American Academy of Pediatrics (AAP) offers these tips for families facing long periods of time isolated at home during the COVID-19​ outbreak.

With schools closing and many parents working at home or facing job uncertainty, it’s more important than ever to use positive parenting and healthy approaches to discipline. Some examples:

1. Prevent boredom. Bored or frustrated children are more likely to act out. Many U.S. children have had their lives disrupted–they are out of school, and they can’t play with their friends. Try to keep kids busy with a healthy and productive schedule at home.

2. Address fears. Children who are ​old enough to follow the news may be afraid, for example, that they or their parents are going to die. The medical research about COVID-19 shows that healthy people under 60 are unlikely to get very sick or die. Talk with children about any frightening news they hear.

3. Use time-outs. This discipline tool works best by warning children they will get a time-out if they don’t stop. Remind them what they did wrong in as few words―and with as little emotion―as possible. Then, remove them from the situation for a pre-set length of time (1 minute per year of age is a good guide).

4. Redirect bad behavior. Sometimes children misbehave because they don’t know any better and need some guidance. Find something else for your child to do.

5. Know when not to respond. As long as your child isn’t doing something dangerous and gets plenty of attention for good behavior, ignoring bad behavior can be an effective way of stopping it. Ignoring bad behavior also can teach children natural consequences of their actions. For example, if your child keeps dropping food on purpose, there will be nothing left to eat.

6. Praise success. Children need to know when they do something bad—and when they do something good. Notice good behavior and point it out, praising success and good tries. This is particularly important in these difficult times, when children are separated from their friends and usual routines.

7. Allow time for attention. The most powerful tool for effective discipline is attention—to reinforce good behaviors and discourage others. When parents are trying to work at home with children who are out of school or child care, this can be tough. Clear communication and setting up expectations, particularly with older children, can help with this.

8. Avoid physical punishment. The Academy reminds parents that spanking, hitting, and other forms of physical or “corporal” punishment risks injury and isn’t effective. Physical punishment can increase aggression in children long-term, and fails to teach children to behave or practice self-control. In fact, research shows it may harm the child and inhibit normal brain development. Corporal punishment may take away a child’s sense of of safety and security at home, which are especially needed now.

​​​The Academy reminds parents and caregivers never to shake or jerk a child, which could cause permanent injuries and disabilities and even result in death. Tips for calming a fussy baby and advice for caregivers who have reached a breaking point can be found here. If you have a friend relative or neighbor with the new baby at home, think of ways you can ​​reach out to provide support during the ​isolation period.

9. Take care of yourself. Caregivers also should be sure to take care of themselves physically: eat healthy, exercise and get enough sleep. Find ways to decompress and take breaks. If more than one parent is home, take turns watching the children if possible.

10. Remember to take a breath. In addition to reaching out to others for help, the AAP recommends parents feeling overwhelmed or especially stressed try to take just a few seconds to ask themselves:

  • Does the problem represent an immediate danger?
  • How will I feel about this problem tomorrow?
  • Is this situation permanent?

In many cases, the answers will deflate the panic and the impulse to lash out physically or verbally at children.


Source: American Academy of Pediatrics (Copyright © 2020). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.