As children prepare for in-person school, OHSU Doernbecher experts suggests "good information and good communication" as the keys to a successful transition. (Getty Images)

After months of virtual learning, many students across the state are transitioning their studies to in-person classroom settings. While this step may be exciting for some learners, others may have mixed feelings.

Ajit Jetmalani, M.D.

"We have strong evidence that supports the safe return to in-person school when science-based infection control practices are in place,” says Ajit Jetmalani, M.D., Joseph Professor and Director of Child and Adolescent Psychiatry in the OHSU School of Medicine and OHSU Doernbecher Children’s Hospital. “At the same time, we will not have complete certainty, which creates a feeling of caution and worry for many. This is perfectly natural for students, and adults alike.”

The key to overcoming these challenges, says Jetmalani:  good information and good communication.

“With support, we know that many children and adolescents are capable of managing stress and change. Depending on the age of the child or adolescent, stressors can come in many forms, from separating from family after a long period of at-home learning, to social interactions and academic challenges, or worries about the future. Adjusting to a ‘new normal’ at school – complete with masks and physical distancing - is also likely to contribute to a heightened angst for some children,” he says. “When children feel their concerns are heard with empathy, they are more likely to navigate major life transitions with parental support.”

Jetmalani suggest the following tips to help effectively engage your student before heading back to school in person:

• Stay calm: Children can sense feelings of stress, anxiety or anger in adults. Before having a conversation with your child, be sure that you are in a calm state of mind: listen first, and then help correct misperceptions about what to expect and provide reassurance when needed. 
  
  Parents know their children best. Yet it can be surprising how often a parent’s worries may differ from a child’s concern.
   
• Set the stage:  Parents should first inform themselves about what return to in-person school might entail. If provided by your school district, watch preparation videos and review written materials and communications. Then, ask your student what they may already know about in-person school, and how they are feeling about it. 
  
  By doing this together, gaps in a child’s understanding may be realized and mitigated in advance.
  
  “Schools understand that this transition may be challenging for some students, and are prepared to offer support,” Jetmalani says. “Reach out to your teacher or principal’s office with any questions that may not be answered by available resources. Getting answers ahead of time may alleviate anxiety and help set your child up for success.”
   
• Acknowledge barriers: While necessary to limit the spread of COVID-19, some safety precautions – such as face coverings – may also make communication difficult, causing increased frustration. 
  
  Remind your student not to assume the worst when challenges or poor interactions with others take place. Instead, encourage them to take a pause and calmly ask for clarification.
   
• Recognize signs: While communication may be a viable solution for some students, others may require additional intervention. Children or adolescents who become withdrawn or show signs of increased irritability, difficulty sleeping or anger may be at higher risk for serious mental health or behavioral challenges. In such an instance,  Jetmalani recommends consulting with the child’s primary health provider, and/or using community resources.
  
  “To prevent accidents or impulsive acts of self-harm, all households should also lock away medications, firearms or other dangerous products, especially during this time of elevated stress,” he says.

• Be realistic: The shift to a new learning environment, schedule and social interaction can be a lot to process for some students. To help limit increased anxiety, parents should feel comfortable temporarily lowering academic or other expectations of their student and prioritizing kindness, understanding and a sense of calm to help aid in a more successful transition. 

According to Jetmalani, the most important thing to remember is that the return to in-person school will not be perfect. “Not only are students transitioning to a ‘new normal’ but so are principals, teachers, bus drivers and school administrators,” he says. “As we venture forward, it is OK to stumble. Embrace the challenges and take comfort in the idea that everyone is in this together.”

 

Queries from the clinic: OHSU Doernbecher experts respond to the five most common questions about the return to in-person learning

Q: How can I make sure my child wears their mask and stays physically distanced at school?
This really depends on the child and their ability to follow instruction. To help improve masking and physical distancing practices, talk to your child about the importance of following safety rules to protect their teachers and classmates.

Some children have challenges with emotional, motor or learning abilities that might make safe practices difficult and we need to find ways to build their skills or modify expectations. 

Practice wearing masks, and washing hands at home. Children should use hand sanitizer or wash their hands with soap and water before and after touching, adjusting, or putting on their masks. 

Remember that teachers will be available to help if children struggle, or forget what to do.

Q: Is it safe for students to be 3 feet apart while at school, as opposed to 6 feet?
A growing amount of evidence suggests that some schools have been able to successfully reopen with a distance of 3 to 6 feet between students without increasing community spread of COVID-19.

The practice of the 3-foot physical distancing rule should be limited to in-person school classroom settings where all children are properly masked in elementary school. In middle and high school, 3-feet between students can occur unless the community rate of virus is extremely high (as defined by local public health guidance).
 
Outside of the classroom, the 6-foot rule should be followed.

Q: Should I send my child to school with hand sanitizer?
First, check in with your school’s administration office to see if they allow students to bring hand sanitizer from home. If allowed, and your child has demonstrated the ability to safely use hand sanitizer independently, then you may consider placing a small bottle of sanitizer in your student’s backpack.

Schools and school buses will have plenty of hand sanitizer, or water and soap, available as a part of their health and safety plans.

Q: How do I keep unvaccinated members of our family safe?
Oregonians have done a good job of limiting the spread of COVID-19 overall. We know that wearing masks, washing hands, keeping physical distance and avoiding large gathering works. If we continue to do these things, in addition to getting vaccinated, we will continue to limit COVID-19 transmission.

Available research suggests that children, in general, are not as likely to get the virus as adults are, and do not transmit the virus as frequently. Additional evidence indicates that pediatric symptoms of COVID-19 are less severe.

Currently, COVID-19 vaccines are not  approved for children younger than age 16. We are hopeful this may change soon.

Q: How do I tell the difference between a cold, the flu, allergies and COVID-19?
Unfortunately, it is very difficult to differentiate the coronavirus from other cold viruses and influenza. Therefore, it is recommended that any child with any cold or flu-like symptoms – such as nasal congestion, cough, sore throat and/or fever - get tested for coronavirus and isolate away from other people until the test results indicate a negative diagnosis.

Allergies are not associated with fever, and have symptoms of itching nose, sneezing, and watery eyes. If your child has known allergies, try their usual treatments to see if the symptoms go away. If they don’t, or additional symptoms develop, COVID-19 testing should be considered.


While we prepare to ensure health and safety against COVID-19, OHSU Doernbecher reminds parents and caregivers to not forget about other common return-to-school preparations such as well-child checkups, transportation safety and successful sleep routines. Learn more here.


The following OHSU Doernbecher physicians contributed expertise: Hayes Bakken, M.D., associate professor of pediatrics, Dawn Nolt, M.D., M.P.H., professor of pediatrics (infectious diseases), Ben Hoffman, M.D., professor of pediatrics and medical director of the Tom Sargent Safety Center, and Alex Foster, M.D., assistant professor of pediatrics.