Healthy Kids. Supported Families. Strong Communities.

Category: Teens

How can my child get help at school?

There are lots of reasons a child may need extra help at school. Some have school-based needs from the first day. A teacher may raise concerns about learning or behavior. A student could have a new diagnosis that interferes with daily activities. No matter the reason, there are basics that can help families start on this journey.

School-based services can be complicated and ever-changing. As a pediatrician, I still sometimes struggled with getting kids what they needed in school. Having a plan and understanding some of the terms can give families a little more confidence.

Where to start?

How the process begins will differ depending on each family and child. For some children, their needs are known before they even start school. Other students’ needs may not be known until they struggle. In any case, the first place to start is information gathering and presenting. Get as much information as you can and put it all in one place.

Talk to your doctor

The doctor’s office is one good place to start. For many school services, children need a diagnosis to qualify. If your child does not yet have a documented diagnosis, the doctor can help with that. Sometimes the doctor can make a diagnosis that day. Often, they will have questions for you and/or your child’s teacher or specialists. And they may decide to make a referral. To save time, bring any info you have to the visit- report cards, prior testing or school evaluations, teacher’s notes, names of specialists, etc.

If your child already has a diagnosis or known reason for needing services, the doctor can help with information gathering. They can give you a list of diagnoses, prior test results, medications, durable medical equipment and even ideas for services that may be helpful. As a doctor, I would put all of this info in a letter that the parents could bring to the school. This was easier for the parent and school than sifting through years of paperwork.

Talk to the teachers

Many parents start with talking to the teacher. At the beginning of the year, ask the teacher the best way to reach them: email? phone? a note in your child’s folder? Don’t wait for parent-teacher conferences. Teachers can let you know how your child is learning. They can also tell you what has worked or hasn’t worked so you know what to ask for. And they notice parts of your child’s day-to-day that other people might miss. Is your child unsteady in a crowded hallway? Are they squinting at the board? Teachers want the same thing you do- to see your child succeed in class.

Talk to the school

Okay, you’ve talked to your child’s doctor. Maybe you’ve talked to the teacher. You’ve decided your child needs support at school. The next step is to go to the school or district. Your child’s teacher, school counselor, nurse or principal may be able to help you depending on what your child needs.

Don’t hesitate to contact the school district, especially if this is a long-term issue that will span grades. Every district has a Department for Special Education. Many also have a department for “student services” or “student support.” You can find these on your school district’s website, or your school’s counseling office can give you the phone number.

Be Specific

When you talk to the school district, be very specific. Tell them what problems your child is having in school (or what problems they would have without support). This could include getting around the school, hearing/seeing the teacher, learning, staying safe and healthy in school, etc. The school district is interested in how your child does in a school setting. If your child has a specific diagnosis or has results of testing or studies, let them know. It may help to provide the district with any letters or information you have from the doctor, teachers, prior schools, testing, etc. Remember to keep a copy for yourself!

I almost always recommend writing a dated letter to the school district with your concerns and needs. Keep a copy of the letter for yourself. If you talk to the district on the phone, ask them what the next step is and take notes of who you talked with and when.

If there is something specific that your child needs, let the school district know 1) What school-based problem needs solving- e.g. “My child will not be able to carry their books around school or take the stairs” 2) Why (if you know why)- “They have cerebral palsy which causes poor balance” and 3) The solution- “They need an elevator pass, longer time between classes and someone to carry their backpack.” The people at the school district want your child to do well in school. However, they are not doctors so something that may be obvious to you may need to be stated clearly.

If you don’t know what your child needs, it is still important to be specific. E.g. “My child is in 3rd grade and reads below a 1st grade level. When the teacher asks a question, my child knows the answer but doesn’t understand when it is written down. This started in first grade. My doctor did a vision test and it was normal.”

School evaluations

If your child does not have a diagnosis, sometimes a school evaluation can be helpful. You can ask the school for an evaluation as part of the IEP process (see below for more information about IEPs). An evaluation is usually done at the school by an outside expert. It can include observations, teacher and parent questionnaires and tests that your child completes. These tests may look at how your child learns, how your child speaks or moves, and your child’s social/emotional development. The school cannot usually make a diagnosis. However, the results may help your doctor make one. They can guide the school to which services your child needs.

Your child can be evaluated by the school even if they are also being evaluated by a specialist or their own doctor. Sometimes the school testing provides a different kind of information.

The meeting

Some services can be provided very easily. Often, just talking to a teacher, counselor or nurse can get a child the help or support they need.

However, sometimes the school and family will need to sit down together to make a clear plan for support moving forward. Parents may hear about different types of plans for their child including an IEP (Individualized Education Plan) or 504 Plan. The following sites explain 504 Plans and IEPs and how they are similar and different.

IEP vs 504 at

What is an IEP? at Additude Magazine

504 Plans at

No matter what type of plan your child has, there are a few things to know before the meeting:

  • You can make changes to what the school suggests. The first meeting is the easiest time to ask for what your child needs and tell the school what changes you want. However, you can also revisit the plan later if it isn’t working.
  • Don’t be afraid to be creative. You may have ideas that the school hasn’t thought of. There is no real limit on what can be in the plan if you and the school agree.
  • If you don’t understand something, ASK. There are a lot of new words, acronyms and abbreviations. Parents are not expected to understand all of it.
  • Remember to bring copies of everything even if you’ve already given it to the school.

My best advice for the meeting itself is: bring someone with you. As someone who has been through a meeting, I know how much it can feel like you are in a different country where everyone is speaking a language you don’t know. Many school districts allow you to request a parent peer who has been through this before. They know the acronyms and how the system works. If not, bring a friend. Some doctor’s offices have care coordinators or social workers who can attend with you.

Through this process, you will deal with experts in medicine and experts in education. Remember, you are the expert in your child!

How do I start a reading routine?

I love books. One of my favorite parts of my job as a pediatrician is giving out books. And reading with my kids is one of my favorite parts of being a parent. I won’t say books can fix everything, but I rarely find a part of parenting that isn’t improved by books.

Sleep trouble? Reading can be part of a bedtime routine. Behavior issues? A few minutes snuggled up reading is positive one-on-one time. Potty training? Ask my kids about “poop stories.” Boredom? Check. Unsure how to bring up a tough topic? Yup. Jitters over starting something new? Struggling with feeling different? Dealing with a loss? There’s a book for that. And of course, there are other benefits of reading. Books can reflect children’s own experiences and give them insight into the experiences of others. Reading can help improve language skills, vocabulary and school performance. It can teach kids how to cook, draw and create online virtual worlds. Reading has the potential to bring kids comfort, joy and adventure.

Of course, there are many other times parents joyfully connect with their children, whether through cooking, worshipping, shooting hoops or singing. There are infinite ways families enrich their children’s lives with their own meaningful traditions. If you would like reading to be one of those but are not sure when or where to start, any time is the right time.


It is never too early to start reading together (just like it’s never too late!) Newborns recognize and are soothed by their mother’s voice even before they are born. And while infants don’t understand the story, early reading can help their language development. Plus, as a parent, I found it broke up the boredom that can come from spending all day with a newborn.

Babies tend to like simple books about other babies and animals. Once babies are 6-12 months old, they start to grab at, chew and throw books. That’s great! It’s normal baby curiosity and experimentation (and teething). At this age, it can be tough to get through a whole book or even a whole page. That’s okay. “Reading” to your baby may mean pointing at a picture of a cow and making moo sounds. Or saying “where’s the baby?” as you close and open the book to the same baby picture. Or even asking “Is this my hat?” as you balance a book on your head. All of this counts! You’re reading together!


Reading to toddlers is where things start to get fun, until the hundredth time reading the same book. While toddlers may still like babies and animals, they also enjoy books that have rhymes and repetition. Toddlers are pretty tough, so stick with board books if you can. Kids this age may have a favorite book that they want read again and again. They may also be able to finish the last word of their favorite sentences or rhymes. So pause every once in awhile to give them a chance, or throw in a wrong word and see if they notice. (Note: to break up the monotony, “Is this my hat?”- still a hit.)

Some toddlers are always moving, so it can be hard to find calm time for reading. But parents usually know those few minutes in the day when their children are finally still, maybe around nap-time, during a snack or after their bath. Or throw a book in your bag to read waiting for an appointment or in line. Remember, reading together is supposed to be fun; if it’s stressful, put the book down and try again later.

School age

Just like it’s never too early to start reading to your child, it is never too late to read aloud. Once kids learn how to read, you can both gain a lot from reading out loud together. When kids hit school-age, reading can be relaxing way to re-connect and maybe sneak in some snuggles. It also helps kids develop interest in books when they are sharing them with someone they love. At the same time, “Is this my hat” stops working and you may have to try a little harder to make reading fun.

As I’ve said before, reading should be enjoyable for both of you. That means finding some time to read that doesn’t put pressure on your child to read to you. If your child is a reluctant reader or struggling to read, there will be other times to work on those skills. In fact, it is important for children who are reading behind grade level to read books that are just a small stretch for them to read independently and to BE READ books at their grade level. This allows them to work on their own reading at a steady pace while gaining the vocabulary, comprehension and joy in reading that come from hearing grade level stories.

At this age, kids’ interests will drive what books you read. Kids love having some control and independence so going to the library and letting them choose the book can be a big hit. Do they like unicorns? sports? video games? a super-hero movie? Chances are, there’s a book about it. And don’t limit yourselves to books. Maybe they’d like a graphic novel, magazine, book of jokes? Go for it. This time doesn’t have to feel educational to be worthwhile. The point is to enjoy reading and each other (with a focus on the latter).

Tweens and teens

Reading together with older kids can sometimes feel like a hard sell. But secretly, most adolescents still want their parents’ attention. So while they may not admit it, behind those eye rolls is appreciation that you are interested.

This age group takes a bit of creativity. Some kids will still be interested in reading aloud together. Some kids like being the one who reads, so try taking turns. Kids may want to choose the book themselves and can get a kick out of having their parents read potty humor or horror stories. But if you find a book you think your kid will love, try it out; they might be impressed.

Sometimes reading together means reading the same book separately. If there’s a genre, series or subject that your child is interested in, grab 2 copies of the same book. Or buy an extra copy of a book they’re already reading. You can each read separately and discuss, e.g. “Did you get to the part where ______?” “Who do you think is going to end up together?”

Maybe reading together at this age is saying “check out this magazine article I just read about [insert pop culture reference here].” Maybe it’s listening to an audiobook together in the car. All of this counts! You’re reading together!

What’s Your Back-up Plan?

(If you are thinking about suicide or need emotional support, the Lifeline is available 24/7: 1-800-273-8255)

Lately, I’ve been seeing a lot of teenagers struggle emotionally. Many of these are kids who have never had issues with mood in the past. It’s a reminder that just because a kid HAS always handled things easily doesn’t mean that they WILL always handle things easily. It has also led to lots of conversations around strategies for dealing with stress, anxiety and depression.

At some point during these conversations, I ask “If those strategies don’t work, what’s your back-up plan?” or “If you’re feeling really badly, maybe even so badly you think about hurting yourself, what are you going to do?” And, most of the time, the answer I get is “I don’t know.”

What is a back-up plan?

If a teen is struggling with their mood, stress level or bad thoughts, their parents should talk to their pediatrician or find a therapist or counselor. They can help develop strategies for handling those tough feelings. A back-up plan is a plan for if you are feeling worried, sad, overwhelmed or out-of-control and your stress relief strategies aren’t working or you can’t use your strategies. It’s a way to reach out to other people so you don’t have to handle things alone. It’s knowing that asking other people for help is a smart, responsible way to help ourselves.

Everyone should have a back-up plan. You never know if or when you are going to need it. But if you do, you want to have one ready. In the middle of a car accident is no time to install an airbag; in the middle of a crisis is not a great time to make a back-up plan. Most drivers will never need an airbag, but if we do, we’re glad it was installed before-hand!

(Some people know the term “crisis plan” from behavioral health. However, when people hear crisis plans, they tend to imagine something very formal and written that can only be used in a crisis. A back-up plan can be simple and easily changed and can be used whenever you want. )

How do you make a back-up plan?

A back-up plan will be different for everyone but each has a few key components. 1) When will you use it? 2) Who are you going to reach out to? 3) How are you going to reach out? 4) What’s your back-up to your back-up?

We discuss when to use the plan below, so we’ll start here with the “Who.” Some people already have an adult they feel comfortable talking to about tough issues. Some people feel more comfortable talking to someone they don’t know, like a confidential hotline. Some prefer to text. The most important thing is that you choose a method that you will actually use. If you choose an adult you know, it may be helpful to let them know ahead of time so they know how to help you. (It’s important that an adult is part of the back-up plan. Teen friends can be very helpful in stressful situations, but it is unfair to have friends take on this kind of responsibility. It can also put a strain on a friendship if they feel torn between keeping your feelings private and wanting to help you by sharing your situation with another adult.)

How are you going to reach this person? In-person? Call? Is their number memorized? Maybe you can discuss a code word with them ahead of time so they know to drop what they’re doing. If it’s a hotline, is it programmed into your phone? The National Suicide Prevention Lifeline is 1-800-273-TALK (8255).

And make sure you have a back-up to your back-up. If someone doesn’t answer the phone, what then? If you’re super-annoyed at your person and don’t want to talk to them, what will you do instead?

When do you use a back-up plan?

There is no down-side to using your plan. Don’t worry about not feeling “bad enough” to need it. If anything, the sooner you use your back-up plan, the better it usually works.

That being said, it can help to identify times when you might need it. Maybe there are triggers that are upsetting- a specific person, a reminder about a bad event, trouble with school/sports/work. When those triggers come up, you can use some of your other strategies right away and think about whether you need your back-up plan.

Most of the time, we know it’s time to use a back-up plan by how we feel. If you are thinking about hurting yourself, it’s time to use the back-up plan. If you are having thoughts that scare you, it’s time to use the back-up plan. Pay attention to your body and emotions. Are you feeling hot and tingly? Panicked? Tight all over? Hopeless? Low-energy? Heavy? Any of these may be signs to start using some of your stress-relief strategies and think about whether it is time to use your back-up plan.

Back-up plan examples

Back-up plans will be very individualized. They can be simple or more detailed. Remember, the best plan is the one that you’ll use. Here are a couple examples to get you started:

When I start to feel down, I’ll go for a run and listen to music. If that doesn’t work or if I have any scary thoughts, I will call my aunt. If she doesn’t answer, I’ll call the National Suicide Lifeline. Both phone numbers are in my cell phone.”

“If I start to panic, I’ll try a breathing exercise. If I can’t do that, I’ll hand my dad a piece of paper that says “panicked”. We’ve already talked about this and he knows that’s a sign that I am having a hard time and need extra help. If it’s during the school day, I will go to the school counselor. If those don’t work, I’ll text the Crisis Textline.”


National Suicide Lifeline 1-800-273-8225 : 24/7 Confidential Line. Anyone can call for emotional support whether or not you’re thinking about suicide)

Crisis TextlineText HOME to 741-741 : 24/7 Confidential Chat for any crisis or anyone who needs support)

The Trevor Project 1-866-488-7386 or Text START to 678-678 : Suicide prevention, crisis intervention and support for LGBTQ young people

Mental Health is Health: Website with resources, education and support for young people who want to take care of their own mental health or help a friend with mental health concerns