Bill Klaproth (Host): This is the PedsPod by Le Bonheur Children's Hospital. I'm Bill Klaproth. And with me is Delana Pence, a behavioral health consultant at Le Bonheur Pediatrics. And today, we're talking about school readiness and the big transitions into kindergarten, middle school, and high school. Delana, welcome.

Delana Pence: Thank you for having me.

Host: Yeah, it's great to talk with you. This is a big topic. So, let's start with this. From a behavioral health perspective, why are school transitions such important milestones in a child's development?

Delana Pence: Well, each one of these come with their own set of expectations and changes, and it requires a lot of adaptability. And lots of things are happening at the same time. So, it requires children to adapt across multiple domains at the same time. So, like, we're at different stages emotionally, socially, cognitively. And so, kids are having to manage a lot of competing demands at the same time. And so, each milestone transition comes with its own set of challenges that you have to overcome and adapt to.

Host: Yeah, it's always a nerve-wracking thing. And for us adults, we've all been through it. So, trying to help our kids get through it as best as possible is so important. So, I'd like to walk through all three of these, starting with kindergarten, then we'll move to elementary school to middle school, then middle school to high school. So, let's start with kindergarten. When people hear kindergarten readiness, they often think about academics. But what does school readiness actually include, particularly from a social-emotional standpoint?

Delana Pence: Yeah, I think you're right. Like, often we do think about like the academics, do they know their name? Do they know their address? Like those kind of things. But there's so much more that goes into being ready for kindergarten. There's a level of developmentally appropriate independence. Are they fully potty trained? Are they able to say when they need to go to the restroom? Are they able to say when they like or don't like food? Beause you think they're in the cafeteria or they're bringing their lunch. Can they speak up for themselves when they need something? A lot of separation anxiety happens around kindergarten as well. How do they handle their emotions? Are they able to manage those emotions? Can they share? Can they work in a group? And so, when we think about kindergarten readiness, we need to have them ready for that level of independence that's required for kindergarten as well.

Host: I remember that separation anxiety. That is a hard one. Okay, final thought on kindergarten.

Delana Pence: I think for me with kindergarten is just making sure that we've established some routines like early on and we're getting kids ready for kindergarten with those routines, like sleep routines, because, you know, they're not going to nap in kindergarten anymore. Something to help parents prepare a little bit would be like there's lots of books or YouTube videos out there about this is what kindergarten looks like. I drove my own son by the school like, "This is your school," even before we did the kindergarten pre-camp thing. And so, just getting them ready and make this a celebration like, "Oh my goodness, you're going to kindergarten. This is so exciting." So, that they get excited about the transition too.

Host: I think that is a great tip, really preparing them, doing that drive, "Here's your school, here's what's going to happen." I think that is so important. Okay, let's move on elementary school to middle school. So, why is the transition to middle school often considered one of the most challenging educational transitions? And what developmental changes are children experiencing during this time?

Delana Pence: I think this one is so difficult for multiple reasons. One, we go from a very encouraging, playful, hands-on kind of environment in elementary school to a stark change with middle school. Often demands are much higher. The type of teaching changes. A lot of times it turns into more lecture style. Also, kiddos have a lot going on in their bodies at that point. We are hitting puberty or have already started puberty. We are developing more complex emotions. I think of the movie "Inside Out 2," which I love so much, that introduces Boredom and Embarrassment and Anxiety. That's really what's happening in our body at those times. We start to recognize our peer influence. And we start to formulate what is our identity, where are we going from here? It, combined with those academic challenges, that's a lot for someone to deal with at one time.

So again, when you go back to adaptability, some children struggle more than others, especially depending on what stage of development you're in, like, when you are hitting puberty and the maturity level. And so, it's just really difficult because everyone hits puberty at a different stage, and so you also have multiple children in different stages of development.

Host: So true. And this is really the kind of the real deal school where expectations are a lot higher on you as well, so you have that going on too. Give me one final thought on elementary school to middle school.

Delana Pence: I think for parents in that moment is just being very aware of how your child is doing. Look for warning signs because this is a very tough transition, and middle schoolers are tough. If I had to teach someone, it would not be middle schoolers because they are going to be so brutally honest with you and they have so much going on.

And we need to remember that as parents, that they are navigating so much. And so if we start seeing an increase in emotions, not beyond normal puberty emotions or withdrawal or we're not wanting to hang out with our friends or we've had like stark changes in who we are, having those conversations, checking in on our kids, figuring out what's going on. And if we don't feel like we know, because I'm a parent too, take them to somebody else. There's no shame in being like, "Hey, if you won't talk to me, can you talk to somebody else? I want to make sure you're doing okay."

Host: Yeah, that is another great tip. So, all right, we started them in kindergarten. We've got them through middle school. Now middle school to high school, and that is often a time when students really are figuring out who they are. So, how can identity development, greater academic demands, and social pressures, all that stuff that comes with high school, affect a teenager's behavioral health?

Delana Pence: There's a lot of pressure going into high school. I feel like I'm old, but like it's beyond even what I met. There's a lot of need for extracurriculars, right? So, in order to get into a good school, you feel like you have to have all these things on your plate. So not only are you balancing these higher academic demands, you're also balancing band, sports, clubs, debate, all the things that would get you into what you want to see in your future.

But then, you also have this expectation of, like, you're supposed to know what you want to do with the rest of your life. But who at, like, 15 knows what they want to do for the rest of their life? But there's this pressure to have this plan and to follow that plan through high school. And so, all of that competing demands along with identity formation, your brain is still developing those executive functioning skills, and we all develop at a different level. Like, all that can be very, very stressful, and you're getting it from multiple facets, right? You're not just getting it from school. It's your parents too, and then your peers, and everyone's kind of at a different level with that. And so, you will see an increase of those stress responses. And so, you'll see more kiddos with anxiety and depression symptoms. And sometimes we write those off, because we're like, "You're a kid, what do you know?" But the demands are really high.

Host: Yeah. That is so true. And you're not old, by the way. I'm just saying. It's so true though about the different multiple pressures in high school. So, give me one final thought on high school as well.

Delana Pence: I think for this, with the tips with parents, honesty with your kids, and then get to know your children. I think at this stage of life, they are changing so much, and they are becoming independent and seeking that autonomy. And you'll see some of that, what we think sometimes is defined through rebellions, but it's really them trying to figure out who they are and grow some of that autonomy.

So really getting to learn about your child at each stage, and high school looks so much different than middle school and looks so much different than kindergarten. But it's almost like getting to know your child at each of those levels and stages I think goes a long way with building communication.

Be interested in what they're interested in. If you care less about whatever it is, that's fine. But still ask questions, be interested, show up for them, and it will build that communication so you will be able to see the warning signs when they might need a little extra help.

Host: The more you know your child, the better parent you can be. Okay. So, Delana, across all of these age groups, and I think this is important, what warning signs might indicate that a child is having more than the usual difficulty adjusting and may need additional support?

Delana Pence: When I think of particularly around kindergarten or even middle school, that increased emotionality, so you might have more tantrums than normal for the younger kids. For middle school and high school, you may start to see more withdrawal or you might even hear them talking like those spiraling thoughts or like that self-defeating comments or things like that. And there is a level of isolation in a sense with teenagers not wanting to be with their parents all the time. But being able to really kind of see, "Okay, are we withdrawing or are we hanging out with our friends? What are we doing?"

I would look for appetite changes, sleep disturbances, not wanting to do things that they would normally want to do. Like you don't see them talking to their friends or hanging out or being passionate about something that they were once passionate about. So, those are some of the typical warning signs that I would look out for.

Host: And if you do see one of those warning signs, Delana, what should you do next?

Delana Pence: Talk to your pediatrician. I work with Le Bonheur Pediatrics, and so I work in an outpatient, pediatric clinic, right? So here, the parents talk to the pediatricians, and then they link them with someone like me. So there's one of us in each of the clinics, which is a great, great benefit of being with Le BonHeur.

But when you talk to your pediatrician, they can help you know, are these part of where we are in development, or are these warning signs, things we should be concerned about? And then they can lead you to resources, whether it's with Le BonHeur or somewhere else, we can definitely get resources to help support you and help support your child. But I think starting with your pediatrician, noting the concerns, and go from there.

Host: So, it sounds like if you feel something's not right, don't hesitate, don't be afraid to go ask for help. See your pediatrician.

Delana Pence: Absolutely not.

Host: Okay, so final question, Delana, and thank you for all of this. What are maybe one or two things parents can do before the new school year to make the transition easier and to help their child feel more confident and really prepared for this next step?

Delana Pence: I think routines are the most important. So before school starts, like a couple weeks out, we start getting our sleep routine back in order, because we know we're all on summer brain and it's not the same. So, being able to establish those bedtimes and the morning time get up, because we know that sleep impacts the body so much and our ability to concentrate and absorb and comprehend, as well as healing the things that our body needs. So, establishing those routines. establishing a set of, like, communication at each developmentally appropriate level. I think sometimes we are like, "How was your day?" And we might get a, "Fine," "Good," whatever, right? But being able to ask more intentional questions like, "What was your favorite thing today? What was the worst thing about today? What's something you might have learned today? What'd you have for lunch today?" Just opening up those lines of communication at each stage so that you can continue to build on the communication. And for each stage in development, giving a set of expectations, so getting them prepared for what it looks like. Not in a fearful Oh my gosh, this is how it's going to go," but in a, "Hey, this is what you can kind of expect from the upcoming school year. You might see these changes. You're probably going to have this amount of classes and this amount of teachers." Just being able to help them adjust into that transition.

Host: I think that is such good advice. I know that I always used to ask my kids instead of, "How was your day?" And then, you get, "Fine." You get the one-word answer. It's like, "Tell me something today good that happened. What was your favorite part about today?" So, they're forced to answer. They can't just go, "Fine." So, really good advice. Delana, this has really been great. Thank you so much for your time today. We really appreciate it.

Delana Pence: Oh, thank you.

Host: Yeah. Once again, that is Delana Pence. And be sure to subscribe to The Peds Pod on Apple Podcasts, Spotify, or wherever you listen to your podcasts. And of course, you can always find more information at lebonheurpediatrics.com. That's lebonheurpediatrics.com. And if you found this podcast helpful, please share it on your social channels. This is The Ped Pod by Le Bonheur Children's Hospital. Thanks for listening.