Sunday, September 2, 2012

Back to School Morning Battles

Transitioning from summer to school is never easy. Getting all of the kids out of bed, ready for school, and out the door on time can be a challenge. While we’d all like to start the day with a “good” morning, if you have school-aged kids, mornings can often turn into battlegrounds. Of course, no one solution will work for every child or every family, but here are some tools that you may find useful.

Get Enough Sleep

Make sure you child is getting enough sleep. Pre-school and elementary aged kids need 11 to 12 hours of sleep. Middle and high school aged kids need 10 hours of sleep. Set their bedtimes accordingly. A well-rested child won’t be difficult to get out of bed, and they are much more likely to be cooperative and move faster than a sleepy child.

Maintain a Consistent Sleep/Wake Routine

Try to have consistent sleep and wake times seven days a week. Having different weekend schedules can make falling asleep and waking up difficult during the week.

Try Melatonin

If your child is having difficulty shifting to a school time sleep/wake schedule, and in particular, is having difficulty falling asleep at the appropriate time, you might consider melatonin supplementation. Melatonin is a hormone naturally produced by the body that helps regulate the sleep/wake cycle. Some studies show that taking melatonin 30 to 60 minutes before you want to fall asleep can help you fall asleep and help adjust your sleep schedule. (It is often used to treat jet lag.) Clinically, I have seen good results with melatonin. To help adjust your child’s sleep schedule, give them melatonin 30 to 60 minutes before the time you want them to fall asleep. Make sure they are comfortable, relaxed, and in bed when you want them to fall asleep. Melatonin will not knock them out, it just makes them feel sleepy and less alert. If they are watching television, playing video games, texting, etc., you might miss the boat. I recommend a melatonin dose of 0.5mg to 9mg. I would start with a low dose and increase by 0.5 to 1mg every few nights until you notice it working well. Some kids will respond at low doses and others may need high doses. I would not give this supplement to any child under 7 years of age. I recommend short term use of a couple weeks to a few months to help adjust your child’s sleep cycle. If you have any concerns about taking a supplement, consult your doctor. Melatonin is available as an over-the-counter supplement. Stick with a reputable brand.

Use a Dawn Simulation Light

Another tool to help change your child’s sleep/wake schedule and help kids wake up in the morning is a dawn simulation light. Light triggers a hormonal response which naturally ends the sleep cycle and triggers the body to wake up.  A dawn simulation light gradually brightens over the course of 30 minutes to 2 hours, depending on the light and the setting, simulating sunrise and triggering the end of the sleep cycle. You awaken gradually and gently unlike a jarring alarm clock with can leave you groggy. Be sure and use this every morning at the same time including weekends.  At first, your child may not be fully awake at the set wake up time, but they should at least be in a lighter stage of sleep more prepared to wake up for the day. Over time, if your child is getting a sufficient number of hours of sleep, they should be able to wake up at the desired time using the light.

Allot an Appropriate Amount of Time for Getting Ready

Figure out the right amount of time for your child to get ready in the morning. Pre-schoolers and early elementary kids don’t know how to “rush”. They won’t really understand time-pressure and can be easily distracted by other things. Trying to hurry them can often backfire. Conversely, teen-agers may be willing to forego “primping” time and a hot breakfast to get 20 minutes more sleep. Also consider the full array of personalities—some kids are easily distractible and require more time, some kids care more about their appearance and will require more time, some kids don’t care that much about appearance and would rather sleep more, etc. Know your child and set their wake-up times thoughtfully.

Be Ready Early

If you have pre-school or elementary aged kids, I recommend that parents be fully ready (showered, dressed, etc.) before their kids wake up. Preschool and early elementary kids aren’t going to necessarily plow through their morning routine on their own in a timely fashion. Be prepared to help them every step of the way to keep them on track, and to deal with those meltdowns or burst of uncooperativeness that all kids seem to exhibit whenever you’re watching the clock. For older elementary aged kids, be available if they need you.

Write Down the Morning Routine

For pre-schoolers and early elementary, have a written morning routine for your kids. This is basically a list of all the things they need to do in the morning. Use pictures if your child can’t read. This list helps set mutual expectations and provides a reference for your child. You can even turn this into a check list or sticker chart to help motivate your child and create something tangible in which they can take pride.

Give Your Child Responsibility

By the time your child is in 2nd or 3rd grade, you should take yourself out of the morning battle and put the responsibility with your child. Agree upon a “morning contract”. The contract should include wake up time, morning tasks, completion time, and clear consequences for not being ready on time. It should also define clear consequences for not being ready on time. Set your child up for success by giving them plenty of time to complete their tasks. If possible, have logical consequences such as going to bed earlier that night so they have energy and can concentrate in the morning, or a monetary fine (your time is money and they are wasting it). Make sure there are clocks or timers in their bedroom and bathroom so they can keep track of time. Then, step back and let them take responsibility for their own morning routine. Make sure you hold up your end of the bargain and give consequences consistently.

Practice on the Weekend

If your child repeatedly demonstrates that they can’t get ready on time, you can try a weekend practice session. When they get up on Saturday morning, they can do their morning routine, then put their pajamas back on, get back in bed, and do it all over again and again. Up front, specify the number of times they will have to repeat the routine. Use a stopwatch so you can see their progress and how long it takes if they are truly motivated (but don’t expect average weekday times to come close to their fastest Saturday practice session time). Sometimes children are uncooperative with their morning routine because of strong anxiety about going to the school.

Arrive at School On Time Regardless

Younger children need to learn that they need to be there when school starts. If you are allowing enough time and providing enough support for your pre-schooler or early elementary child, and they are still being uncooperative and are making themselves late for school, don’t let it happen. Bring your child to school on time regardless. Drop them off in their pajamas with their outfit in a bag. Be sure and let them know of this plan ahead of time so they have the opportunity to correct the situation. Your child may start kicking and screaming (literally) when they figure out that you really plan to bring them to school in their pajamas. Stick to your guns. Get help getting them in the car if necessary and be prepared to hand off a screaming child to the school. It is a good idea to coordinate with the school ahead of time so they are not surprised by your pajama-clad child. Most kids will not arrive at school in their pajamas more than once.

Get Help From the School

If your older child is consistently late for school despite your best efforts, talk to the school about their tardiness policy. See if they will implement special measures for your child such as detention or curtailment of extra-curricular activities based on tardiness. The school wants your child to arrive on time, so you may find them very willing to help. Having the school get involved takes some of the burden off of you and puts more responsibility with the child.

Deal With Anxiety Head On

All kids have some anxiety about going back to school. Some kids experience moderate to high levels of anxiety that can cause real problems.  Kids can demonstrate high anxiety a number of ways. Some kids will be completely uncooperative with the morning routine while trying to stall and delay (in which case, many of the tools above won’t work), some will have stomach aches or other “illnesses”, some will throw a tantrum when it is time to walk out the door or leave your side, or you may find them literally kicking, screaming, and clinging to door frames as they refuse to go to school.  

The first step is to talk with your child about their anxiety and find out what worries them.  As a parent, try to validate their feelings. Don’t try to talk them out of their feelings or solve their problems. In other words, do say things such as “I understand”, “having a new teacher can be worrisome”, “being away from mommy can be scary”, etc. Don’t say things such as “there is nothing to worry about”, “you’re just being silly”, “don’t be a baby”, etc. Your child may have anxiety about something you can address. For example, you might find out they are scared of the school bus, they are bullied in the lunchroom, or they are confused about classroom procedures. Most of the time, however, they will need to work out their anxieties themselves.

As a parent, you need to validate their feelings but make them go to school. Allowing them to stay home for a couple days to “get over it” does not work and will probably make the problem worse. Your child needs to deal with their anxieties as soon as possible. Get them to school by whatever means necessary and be prepared to hand off a crying child to the school. This advice holds true for preschoolers as well as older children. Preschoolers often cry with varying intensity when being dropped off at school but usually snap out of it shortly after you leave. Try to make your goodbye short and sweet. Long drawn out emotional goodbyes will only make it harder for them and you. Older kids can have a variety of reactions including physical refusal, angry desperate crying, and silent tears. Leaving them at school in distress can be incredibly hard, but know that in the long run you are making the best decision for them. Obviously, you will need to work with the school to monitor their progress. If your child continues to be in distress, you can try a graduated plan where they go to school for a short amount of time and them come home. Each day you send them to school a little longer. Make sure that when they are home, they are doing schoolwork during school hours. Don’t let them watch tv to do something fun during school hours. If your child seems extremely anxious (i.e., freaking out) prior to the start of the school year, you can try this graduated plan from the beginning.  The only way to get over anxieties is to deal with them. You have the difficult job of forcing your child to do this.

Social Anxiety Causing School Anxiety

One cause of school anxiety is social anxiety. Social anxiety is significant emotional distress or fear about interacting with others or about being watched or judged. This type of anxiety runs deeper than school and is likely to have broad impacts on your child’s life beyond going to school. It can impact your child’s ability to make and keep friends, it can hold your child back from trying activities and having new experiences, and it can ultimately impact their self-esteem. If you believe your child suffers from social anxiety, I recommend that you seek help from a qualified mental health professional.

Other Medical Issues Impacting Sleep

There are a few medical issues than can impact a child’s ability to get up and get ready for school. If you feel your child may suffer from one of these conditions, please consult your doctor.

POTS, or Postural Orthostatic Tachycardia Syndrome, is a condition in which the blood vessels don’t respond properly to changes in gravity resulting in rapid jumps in heart rate. As a result, most kids with this problem will experience lightheadedness when going from sitting or laying to standing, standing for a prolonged period of time, or taking a hot shower. Children with this condition may also be prone to fainting, complain of frequent headaches, have low energy, and have difficulty waking up in the morning. This problem tends to occur more often in girls and most commonly begins during the teenage years. If your child is experiencing some of these symptoms you should check with your pediatrician. A referral to a pediatric cardiologist for a simple non-invasive test may be necessary to help diagnose this condition.

Delayed Phase Sleep Syndrome is a sleep disorder in which people have a delayed sleep-wake schedule. They aren’t able to fall asleep until very late at night (typically about 2am or later) but can then sleep a normal amount of time and get restful sleep. This condition is problematic because school and starts at about 7am, not noon. This problem typically starts around puberty when there is a natural shift in the sleep-wake cycle. Obviously, kids with this sleep disorder have a terrible time waking up for school. They are just too exhausted from having fallen asleep just a few hours prior to you waking them. In general, the treatment will require use of a light box, melatonin and other means to help shift the sleep-wake schedule to an earlier bedtime. Once a normal sleep/wake schedule is achieved, these teens will need to very strictly adhere to the schedule seven days a week to main the timing of the sleep cycle. Please consult your doctor if you feel you child is suffering from this condition.

Sleep Apnea is a condition in which children (or adults) wake multiple times during the night due to breathing obstructions. Usually, people with this condition are not aware that they are waking up. In kids, this condition is often due to enlarged tonsils or adenoids partially blocking their airway. Children with this condition do not get a good night’s sleep despite having slept for an appropriate duration. They will consistently be difficult to wake up and be tired throughout the day. One way to tell if your child is experiencing this problem is to watch and listen to them while they sleep. If they snore loudly, if their breath seems to “catch” while snoring, or if they are snoring and don’t seem to be sleeping soundly, they may have this problem. Consult your pediatrician if you think your child suffers from sleep apnea. Consider making an audio or video recording of your child sleeping and bring it with you to the doctor.

Unfortunately, there is no silver bullet to get you through the morning routine peacefully and efficiently. Every child and family situation is different and no single strategy works for everyone. I hope you will find some of my suggestions helpful. Just remember that kids are kids, so don’t expect perfection. If you try out a new approach, be sure and explain it to your child, apply it consistently, and give it time to work. Good luck!

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