BHIPP Bulletin

Volume 8, Issue 2

August 2022

This month's BHIPP Bulletin is a contribution from

Rick Ostrander, EdD, Associate Professor in the Department of Psychiatry and Behavioral Sciences at Johns Hopkins School of Medicine,

Founder of Pediatric Medical Psychology Program at Johns Hopkins Children's Center and BHIPP Consultant.

Entering Kindergarten is an exciting time for children and their parents. The school experience allows children a unique opportunity to learn new concepts, acquire new skills and engage with new friendships; in the process, it also allows children to take the first steps towards increasing independence. However, parents may worry about a child’s ability to prosper as a happy and involved member of this new learning environment. But what does it mean for a child to be “ready for school” and what can be done to prepare a child for this important transition? Successful entry into kindergarten is the result of a combination of a child’s capabilities and needs as well as the settings in which a child resides. Indeed, children’s adaptation to a new school experience is strongly influenced by interactions between the child, family, school, and the larger community. Important considerations and recommendations for helping a child’s transition into school are provided below (Pretti-Frontczak et al., 2016). 

RECOMMENDATIONS

The following recommendations will help prepare children for a successful transition into kindergarten. They are organized into three general domains: language and cognition, social–emotional learning, and personal self-help skills. Developing these domains requires guidance and practice, and it is important to note that individual children develop such skills over time and the best way to develop and reinforce such skills is when they are integrated with daily family interactions (Pretti-Frontczak et al., 2016). 

Language and Cognition

To increase your child’s language and cognitive abilities, it is important to focus on activities that improve listening, speaking, attention, vocabulary, memory (recall of information), and comprehension. Such skills have been directly linked to early success in reading and math and to higher rates of academic success and school completion (Duncan et al., 2007).

1. The development of language skills can be accomplished when caregivers restate and expand upon a child’s statements and by using more complete sentences with added descriptive vocabulary. This can be accomplished by attending, commenting, asking questions and encouraging comments by the child around everyday activities and child play. 
2. Reading books with the child will build vocabulary and foster an interest in reading. Engagement in reading can be fostered when children are encouraged to ask questions about what might be happening in the story and then helping the child to expand on their comments. During these discussions it is also important to point out differences between single letters, whole words, and sentences. Finally, it is important to provide models of fluent, expressive reading by either reading with or letting the child listen to a recording of the storybook.
3. Caregivers can increase communication and interactions with children during everyday family routines. This might include providing quick encouragement and check-ins on a child’s progress and needs (e.g., “I appreciate how you are putting away your toys now so we can get ready to leave.”) These simple comments can not only illustrate that caregivers are actively listening to the child but also provide an opportunity for the child to expand about their needs and wants.
4. Playing games and daily activities provide opportunities to develop pre-academic skills. The early linkages between letters and words can be fostered by helping children to recognize, spell, and write his or her name and to find objects that begin with similar sounds and letters. Games such as I Spy also can encourage vocabulary development and early literacy skills (e.g., “I spy something that starts with the sound /a/ or starts with the letter ‘t’.”). 

Social–Emotional Learning

To foster social–emotional learning it is important to teach children to express and control their emotions and to recognize that their emotions can differ from others’. Such understanding is the basis of many important social relationship and interpersonal skills, such as the ability to take turns, share materials, and resolve conflicts with others (Tominey, O’Bryon, Rivers, & Shapses, 2017).

1. A child’s emotional vocabulary can be developed by associating words with feelings. Reading books with a child offers an opportunity for adults to discuss and label emotions and talk about pictures of people expressing different emotions. Also, adults can model and label their own emotions as they encounter different situations (e.g., “I am frustrated [mad, sad, scared] right now because …”).
2. Adults should support a child’s ability to control and regulate their behavior. One way to do this is to model and reinforce effective coping strategies, such as deep breathing (i.e., “I am going to take a deep breath and count to 10”) and positive self-talk (e.g., “I will find something else to do until I can play with the toy I want.”). Self-regulation also can be fostered through the use of social stories, in which the characters use important skills to face problems or situations. For example, one well-known author of such stories is Julia Cook, who wrote the children’s book, I Just Don’t Like the Sound of No. 
3. Helping children to accept transitions. Children are sometimes unwilling to stop an ongoing activity and move onto another. Helping children in these transitions can be accomplished by giving clear warnings that a change is going to happen. For example, a caregiver might say “We have 5 more minutes left to play. Then we must clean up so we can go to the Doctor’s.” Having a visual schedule of daily family transitions may help with routine transitions. The schedule should be placed in a prominent spot and used as a reminder of what is coming next. Teachers often use similar practices in classrooms to prepare students for upcoming transitions.
4. Engage in games or activities that require cooperation and turn taking. Games such as Chutes and Ladders, Go Fish, or Musical Chairs use these skills. When children lose a game, it is also important for caregivers to model language and coping strategies for when things don’t turn out the way a child would like (e.g., “That was a fun game even though you didn’t win.”).

Personal Self-Help Skills

To promote a child’s self-help skills, it is important to ensure that the child develops personal competencies for eating, toileting, dressing, putting items away, and sharing important information in an emergency, such as his or her own and family members’ names, address, and phone numbers (Rosenkoetter & Knapp-Philo, 2006).

1. When caregivers prepare children to put on and take off their own outdoor gear and shoes, they develop important self-help skills and make classroom transitions easier. In the process, caregivers can help to strengthen small and large muscles through playing games or singing songs that require starting and stopping specific movements such as balancing, hopping, jumping, running, or skipping. 
2. Encourage personal responsibility by giving children opportunities to practice related skills. Children are better prepared for the classroom if they have already learned to clean up after themselves at meals, pack up their own school materials in the morning, and unpack them in the afternoons. 
3. Caregivers should make it a point to have conversations with their child weeks in advance about what to expect on the first day of school. This should include expected steps of the day, which may include taking a bus, getting dropped off or picked up by another parent, and attending a before- or after-school program. 
4. Once a child begins school, it is often helpful to keep home routines consistent and provide extra rest time. Children may need plenty of rest and consistency to adjust to the new demands and expectations of school. Set up a consistent bedtime and after-school routine to ensure children have the necessary sleep to function at their optimal capacity. Children ages 3 to 5 years require 11–13 hours of sleep, and school-age children require 10–11 hours of sleep.

Other important considerations

To further prepare for and enhance a child’s entry into school, it is important for caregivers to build a relationship with the child’s teacher; understand important school policies, rules, and expectations; and identify differences and continuities between home and school values, expectations, and routines (Pianta & Kraft-Sayre, 2003).

As always, if you have questions about the behavioral health needs of your patients, we encourage you to call the BHIPP consultation line at 

855-MD-BHIPP (632-4477), open 9am-5pm Monday-Friday, for resource/referral networking or consultation support.

We will keep you informed about all our services and training events through our website (www.mdbhipp.org) and monthly e-newsletters. Additionally, BHIPP is on LinkedIn, Twitter, and Facebook. We invite you to follow us there to stay up-to-date on upcoming training events, pediatric mental health research, and resources for providers, families and children.

RECOMMENDED RESOURCES

Websites

http://csefel.vanderbilt.edu/

The website for the Center on the Social and Emotional Foundations for Early Learning provides resources to support social–emotional learning for young children, including social stories, book lists, and practical strategies.

https://developingchild.harvard.edu/

The website for the Center on the Developing Child at Harvard University provides research on child development and presents the information through videos and briefings.

Books for Parents

Elovson, A. (1993). The kindergarten survival handbook: The before school checklist and guide for parents. Santa Monica, CA: Parent Education Resources.

This book provides parent-friendly information about ways in which parents can use every day experiences to help their child be ready to learn and enjoy school. Specific strategies and simple suggestions for use in the home are provided.

Siegel, D. J., & Payne, T. (2011). The whole-brain child: 12 revolutionary strategies to nurture your child’s developing mind. New York, NY: Bantam Books.

This book provides parents with practical information about their child’s developing brain, with specific ideas and language to foster healthy problem solving with toddlers through teenagers.

Books for Children

Danneberg, J. (2000). First day jitters. Watertown, MA: Charlesbridge.

Harris, R. H. (2003). I am not going to school today.

New York, NY: Margaret K. McElderry Books.

Henkes, K. (2010). Wemberly worried. New York, NY: Greenwillow Books.

Millis, D., & Finlay, L. (2001). Sam’s first day. Aurora, IL: Mantra Lingua.

Penn, A. (2009). The kissing hand. Indianapolis, IN: Tanglewood.

REFERENCES

Cooper, H., Allen, A. B., Patall, E. A., & Dent, A. L. (2010). Effects of full-day kindergarten on academic achievement and social development. Review of Educational Research, 80, 34–70. https://doi.org/10.3102/0034654309359185

Duncan, G. J., Dowsett, C. J., Claessens, A., Magnuson, K., Huston, A. C., Klebanov, P., & Japel, C. (2007). School readiness and later achievement. Developmental Psychology, 43, 1428–1446. Head Start Center for Inclusion. (n.d.). Social stories.

Miller, E., & Almon, J. (2009). Crisis in the kindergarten: Why children need play in school. College Park, MD: Alliance for Childhood. 

Pianta, R. C., & Kraft-Sayre, M. (2003). Successful kindergarten transition: Your guide to connecting children, families, and schools. Baltimore, MD: Brookes.

Pretti-Frontczak, K., Harjusola-Webb, S., Chin, M., Grisham-Brown, J., Acar, S., Heo, J., & Zeng, S. (2016). Three mistakes made worldwide in “getting children ready” for school. Young Exceptional Children, 19, 48–51. https://doi.org/10.1177/1096250616629591 

Rosenkoetter, S. E., & Knapp-Philo, J. (2006). Learning to read the world: Language and literacy in the first three years. Washington, DC: Zero to Three Press.

Tominey, S. L., O’Bryon, E. C., Rivers, S. E., & Shapses,

S. (2017). Teaching emotional intelligence in early childhood. Young Children, 72, 6–12.

The new cycle of BHIPP TeleECHO^TM Clinics will begin in September! We highly encourage pediatric primary care providers and their care teams to join our learning community to increase your skills in managing child mental health concerns. Read more in the flyer below and register for the upcoming cycle!

Mark your calendar for the upcoming BHIPP TeleECHO^TM Clinics this cycle!

Check out our BHIPP Resilience Break for September.

It's not too late to sign up!

The BHIPP Mental Health Crisis Training Series begins in Fall 2022 with a session on Maryland's mental health system of care. Register for this session and all others in the series through the link below!

Ensure your healthcare services are entered fully in TelehealthLocator ~ a Telehealth Resource Center program that will provide a single point of access to view and overlay gaps in access to care, broadband, and telehealth availability by service type.

Follow this link to complete an online form to identify the services your facility offers in-person and via telehealth. For questions, contact Anita Browning, MATRC Outreach Coordinator, [email protected]