My Doctor Online The Permanente Medical Group

Types of School Problems

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School problems may be caused by a variety of social and academic challenges.

General academic problems may include poor academic performance, trouble keeping up with the increasing amount of homework, and a lack of interest in school. Other problems might involve fear of attending school, either because the child is young or the school environment is not safe. Other children may experience problems with a specific teacher.

Social pressure might also increase once your child enters the school system, and this can have an impact on your child's school performance. As children age, they want to be accepted by their peers and not be seen as different. Gaining acceptance from peers can be particularly difficult if your child has a chronic health condition and must receive medication during the school day.

Behavioral problems could also occur, causing problems at school. As your child develops, especially during puberty, they can be the subject of unkind behavior from other children, including bullying. Or your child may feel pressure to behave inappropriately toward other children.

Symptoms

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General signs that your child may be experiencing problems at school can start as early as elementary school. Children of all ages, but particularly younger children, may pretend to be sick to avoid attending school. They may become anxious on a Sunday evening, before their school week begins. They may have trouble sleeping or eating during the school week.

Your child may suddenly begin to perform poorly in school or to struggle with certain subjects or increased homework expectations. Some children become frustrated by their poor academic performance and may become aggressive, angry, depressed, anxious, or withdrawn.

If social pressures are the culprit, your child may no longer interact with friends or be invited to after-school activities. If the problem stems from being bullied, your child may be afraid to walk to school or ride the bus, or he or she may begin to lose items or money. During puberty, many children change friends, become moody, and struggle with academic subjects as they try to fit in or be a part of the crowd.

Diagnosis

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Poor school performance and behavior problems at school could signal a health problem. Many children with behavioral problems are diagnosed with attention deficit hyperactivity disorder (ADHD or ADD). Others who get poor grades may have problems with their vision and not know it, or they may possibly have a learning disability.

We can help identify these and other common school-age conditions. Be sure to schedule an appointment so we can evaluate your child if they suddenly begin having behavior problems at school.

Other conditions that can affect school performance during childhood and adolescence include depression and anxiety. We diagnose these conditions by performing a physical examination and by talking with you and your child. 

If your child develops symptoms that concern you, such as sleeping too much or too little, loss of interest in activities they once enjoyed, or gaining or losing a significant amount of weight, be sure to call us to schedule an appointment.

Prevention

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Build your child's self-esteem. Provide positive discipline, and ensure that your child is involved in appropriate activities to help him or her through these challenges.

Keep communication open with your child, even when he or she begins to look to peers for advice during puberty. Support your child and their interests, even if they choose activities that you would not choose. Treat your child with love and respect, even if they don't always treat you this way, especially during adolescence. Provide boundaries for acceptable behavior and reasonable consequences that are age-appropriate.

Stay involved with your child's school. Try to volunteer regularly at the school, even as your child gets older. Stay in touch with your child's teachers and make sure they know to contact you if they have any concerns.

Supporting Your Child

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The best way to stay in tune with children is to listen to them, so that they feel comfortable talking with you about school problems. Even if you think the issue at hand is small, it is important to listen and provide empathy, or your child may not come to you with the bigger issues later on.

Social problems

Your child needs to know that you are on their side, no matter what. If they caused the problem at school, talk with them about possible solutions, letting them come up with a few.

If they are the victim of social problems at school, such as bullying, avoid criticizing the other children and help your child explore solutions. It might help to role-play with your child, practicing what your child might say when faced with the upsetting situation.

Encourage your child to focus on their good qualities and the qualities they look for in friends. If needed, get your child involved in an activity where they can meet new children and make new friends.

If the social problem is significant, such as bullying or cyber bullying, be sure to alert school officials. Your child deserves to attend school in a safe environment.

If the problem is with a teacher, talk directly with the teacher, school counselor, and principal to develop a successful plan to resolve the situation.

Academic problems

The intensity of homework and expectations for academic performance increase as your child ages, and your child may have difficulty adjusting to the new demands.

If your child begins to do poorly in school, talk with your child and with their teacher to understand the problem. Provide your child with a quiet, comfortable area to do homework each day. Let your child participate by agreeing on a set time for homework. If needed, make sure you also have a list of assignments due each week so that you can check to ensure your child completes all required homework.

If your child is struggling with a particular subject, it might help to provide them with a tutor, such as a math tutor. Minimize extracurricular activities and other distractions until your child's grades improve. However, be careful not to punish a child for an average grade if they are putting forth effort to improve.

If your child struggles with several classes, including reading, we may recommend an evaluation for learning disabilities, including dyslexia. Don't assume it is your child's lack of effort when most of their grades are below average.

Chronic health issues

If your child must take prescribed medicine or other treatment during the day but is embarrassed to do so in front of their peers, meet with their school nurse, counselor, teacher, and principal to work together to develop a plan. For instance, your child can quietly leave the classroom at the same time each day to privately take their medication.

If other children ask questions, work together to develop an answer that your child is comfortable giving and help younger children practice the answer. You can also educate their friends about your child's health condition so they understand why your child must take medication.

If you become concerned, call us to schedule an appointment to discuss your child's physical or emotional well-being.

Your Child's Care with Me

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If you are concerned about your child's symptoms, and your concerns are urgent, please contact our Appointment and Advice line, which is available 24 hours a day, 7 days a week.

Our advice nurses can give you immediate advice, and our telephone staff can send me a message or schedule an appointment for your child.

Depending on your child's symptoms and medical history and your preferences, the nurse may:

• Provide advice about how to care for your child at home.
• Send me a message so I can follow up with you directly.
• Offer you a telephone appointment with me or a trusted colleague.
• Make an appointment for your child to be seen in person.
  

Whether by phone or in person, we will discuss your child's symptoms and medical history, and address your concerns. Together we will create a treatment plan to help your child feel better.

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You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.

• For nonurgent questions or concerns, you can e-mail me using this site, once you have registered to use the Act for a Family Member feature. You can also schedule an appointment online to see me in person.
• If your concerns are immediate, or you simply prefer to use the telephone, please call our Appointment and Advice line, which is available 24 hours a day, 7 days a week. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or schedule an appointment for your child.
• Depending on your child’s symptoms, you may also have the option to schedule a telephone appointment – with me or another pediatrician, if I am unavailable. Please let the telephone staff know what you prefer and what is convenient for you.

Coordinating Your Child's Care

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Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting care for your child easier.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your child’s care to stay current on your child’s health status and to collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your child’s condition, care is safer and more effective.

If you come to an office visit

• At the beginning of your child’s visit, you will receive information about when he or she is next due for a well child visit (checkup) and immunizations. We can discuss and schedule any preventive tests that may be needed. 
• At the end of your child’s visit, you may receive a document called the “After Visit Summary” that will summarize the issues we talked about during the visit. You can refer to it if you forget what we discussed, or if you just want to recheck your child’s height, weight, or vital signs. (If your child is under age 12, you can also view these summaries online, under Past Visits.)

If you schedule a telephone appointment

• In addition to in-person visits, we now offer the option of telephone appointments for certain common pediatric concerns. Depending on your child’s symptoms, you may have the option to schedule a telephone appointment with me or another pediatrician, if I am unavailable. We will call you at an agreed-upon time, at whichever phone number is most convenient for you.
• Many parents like this new option, but if you prefer to be seen in person, it’s always your choice. Just let the telephone staff know what type of visit you prefer.
• Telephone appointments are not appropriate for all health concerns. The advice nurse can help you decide what type of care is best for you and your child.

If I prescribe medications

We will work together to monitor and assess how your child’s medications are working and make adjustments as needed. 

Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically, in advance.

• Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
• Have them delivered to you by mail at no extra cost. Or you can pick up your child’s medications at the pharmacy.
• If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.

If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, such as X-rays, we will schedule an appointment with the Radiology Department. 

When the results are ready, I will contact you with the results by letter, secure e-mail message, or phone. In addition, you can view most of your child’s laboratory results online, along with any comments that I have attached to explain them.

If I refer your child to a specialist

My specialty colleagues are readily available to assist me if I need additional advice about your child’s condition. In some cases, I may contact them during your visit, so we can discuss your child’s care together. If we decide your child needs a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.

Convenient Resources for You

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My goal is to provide high-quality care and to offer you choices that make your child’s health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available to help you manage your child’s care at any time that is most convenient for you. From my home page you can:

Manage your child’s care securely

You can begin to manage your child’s care online by requesting access through our Act for a Family Member feature. Once you have added your child to your account, you can:

• View and compose secure e-mail messages.
• Manage your child’s prescriptions and refills.
• Schedule well visit and nonurgent appointments.
• View your child’s Preventive Services to see whether your child is due for any immunizations or well visits.
• If your child is under 12, you can also view most lab test results and review information about past visits.

Learn more about your child’s condition

• Read about causes, symptoms, treatments, and procedures.
• Find interactive health tools, videos, and podcasts to help you manage your child’s condition.
• View programs to help you decide on or prepare for a surgery or procedure.

Help your child stay healthy

• Sign up for our online newsletters for parents, customized to your child’s age.
• Locate health education classes and support groups offered at our medical center.
• Explore interactive programs, videos, and podcasts that focus on helping you keep your child healthy.
• Check to see when your child is next due for immunizations and a well visit (checkup).