Back to School
What a Pediatrician and Mom Wants You to Know About School This Fall
On her Instagram, @adviceigivemyfriends, mom and pediatrician Dr. Kelly Fradin answers the questions about parenting and kids' health she gets over and over again. Naturally, many of those questions have recently centered around the Covid-19 pandemic. To help parents navigate this tough and unprecedented time, she wrote Parenting in a Pandemic, which is full of her signature practical, evidence-based advice. In celebration of its release, we caught up with Dr. Fradin about what’s on parents’ minds most right now: back to school.
- Interview By
- Marnie Schwartz
Tell us a little bit about yourself and your family.
I grew up in North Carolina and met my husband at Harvard. I followed him to NYC where I got my medical degree from Columbia. I finished my training in pediatrics at the Children’s Hospital at Montefiore in the Bronx. Shortly after finishing my training, we started our family and my son is 6.5 and my daughter 2.5! We live on the Upper East side in Manhattan. I work in school health in the South Bronx.
What inspired you to start Advice I Give My Friends?
I saw so much advice out there about raising children, without much from pediatricians! I have a lot of ideas based on my knowledge and experience as a doctor about what parents should know, not all of which is medical. Doctor visits are short so most pediatricians don't have a chance to deliver all the nuanced information we want parents to know. I thought I could bridge the gap by sharing the sort of information I share with my friends. I focus on pediatric health problems, parenting tips, safety, development, advocacy and recently a lot of coronavirus information.
The coming school year is weighing heavily on parents’ minds right now. You’ve written about your support for reopening schools. What are some of the most important reasons you think kids should be going
back to school this fall?
I worry most about the children who stand to lose the most from school closures. Children with special healthcare needs depend on therapies and educational resources only available through school. Some children from vulnerable communities don’t have safe places to be without school and will miss out on remote education opportunities. So I think it’s important that we prioritize safely opening schools.
In-person school is really good for kids. They learn, see their friends, move their bodies, and have opportunities to try new challenges. School also provides food, medically necessary therapies, mental health services and other services for children. So when I consider the issue from the child's perspective, I want kids going back to school!
However, that said, I think it’s important for parents to know that at an individual level, remote schooling may be a great option. Some children have thrived in these settings with fewer distractions and more time. I hope in-person education can be available, but in-person education this fall isn’t necessarily the right choice for everyone. And, I do think it's possible for children to thrive at home. We all worry about social and language development, but if parents are able to engage with their children, home can be a rich environment for learning. The youngest kids will have more challenges connecting with teachers or friends through a screen and will rely on caregivers at home to meet their needs.
What are some of the risks associated with
kids staying home?
I worry about children being less active and snacking more away from school. We want to make sure to keep children's bodies physically healthy through time at home. With children out of school, ensuring their safety and adequate supervision is also important. Young children may get into dangerous situations at home quickly when parents are distracted or overstretched. All children are spending more time than ever on screens, so we need to monitor and plan to keep the content safe.
Older children and teens are at higher risk for mental health issues such as anxiety and depression. During this time, coping with stress and disappointment while separated from their friends, we need to be careful to stay connected with tweens and teens to make sure they are supported through these challenges.
What are the most important things schools need to do to reopen safely? Do you think that realistically they will be able to do it, at least in some parts of the country?
Schools need a lot of money to open responsibly. Cohorting groups require smaller class sizes and more teachers. Ventilation systems can decrease transmission and should be upgraded. More busses are required to facilitate social distancing. Hand washing or sanitizing stations need to be available. Masks and face shields need to be available for school staff or students who don’t have one. All of these interventions require funding and we’ve seen public budgets slashed due to the economic impact of the pandemic.
Big picture: We need community buy-in. School can be as safe as possible, but in areas where there is rampant transmission, we can't screen out potentially infected people from the community since people infected with coronavirus can show no symptoms. We need big groups of people to embrace and prioritize controlling the spread of coronavirus so that schools can reopen safely. We need teachers to feel confident that our leaders have plans that
prioritize their safety.
Realistically, I have doubts about some of the planned school openings. But it’s important to keep in mind that various parts of the country are seeing different levels of transmission. I am hopeful for some schools
to open successfully.
Many families are currently deciding whether or not to send their kids back in-person or stick to remote learning. What are some things parents should think about when
making this decision?
Families should consider what would happen if their child got sick and infected their household. Parents need to consider their age and health conditions to determine how high risk they are for severe coronavirus infection. We have to think about the level of current transmission in a community. The best proxy is to see what percent of test results are positive. Also, parents should evaluate the school policies to understand what’s being done to decrease risk.
Each child’s needs should be considered independently. Some children can get a lot out of remote schooling while others less so. Their temperament and educational goals for the school year should be considered.
Also, don’t forget to fully think through the virtual plan. I can imagine families choosing play dates or enrichment activities that have virtually the same level of exposure. So if your goal is to decrease exposure, school is not
the only variable.
Some of this correlated with age. Remote schooling before third grade falls heavily on parents. And teenagers do seem at higher risk of catching and transmitting infection.
Obviously things could change in the next four to six weeks, but as of now… what are your plans for your own kids
come September?
I am sending my kids to school in the fall provided we have the opportunity. Two things enable me to feel comfortable and confident doing so. 1) My family is healthy and low risk. I wish we had grandparents we saw frequently, but they live out of town. While there have been severe cases of coronavirus in people like my family, they are very rare. 2) Our community is taking COVID-19 seriously. Everywhere we go people are masking and distancing. Our rates indicate low transmission, and our schools have comprehensive plans. If we were high risk or if we felt our schools weren’t appropriately cautious, it would be a much
more difficult decision.
What does a successful school reopening look like to you? What differences in school settings or school days would be needed for success?
A successful school reopening would be a school that’s able to stay open! Many schools will have cases and some classrooms will need to close. If a family with three children infects three classes in a small school, that will knock a significant portion of the school into a 14-day period of isolation at home. We should anticipate that cases will happen, whether due to school exposure or community exposure, and be prepared to continue the education plan remotely when needed.
School will look different for children and it’s important for us to discuss this with our kids before sending them. The cafeteria, auditorium and other areas where children congregate will need to be closed or repurposed. Groups of children will likely move around the school building less, for example no longer rotating through art or library. Some activities like indoor band or choir practice may be very difficult. Sports like wrestling and football where there is a lot of close contact will also be nearly impossible to do responsibly.
Schools will also be different for parents. There will be less socializing at drop off and fewer after school activities, sporting games, and birthday parties. We'll all have to adjust to our new normal.
I grew up in North Carolina and met my husband at Harvard. I followed him to NYC where I got my medical degree from Columbia. I finished my training in pediatrics at the Children’s Hospital at Montefiore in the Bronx. Shortly after finishing my training, we started our family and my son is 6.5 and my daughter 2.5! We live on the Upper East side in Manhattan. I work in school health in the South Bronx.
What inspired you to start Advice I Give My Friends?
I saw so much advice out there about raising children, without much from pediatricians! I have a lot of ideas based on my knowledge and experience as a doctor about what parents should know, not all of which is medical. Doctor visits are short so most pediatricians don't have a chance to deliver all the nuanced information we want parents to know. I thought I could bridge the gap by sharing the sort of information I share with my friends. I focus on pediatric health problems, parenting tips, safety, development, advocacy and recently a lot of coronavirus information.
The coming school year is weighing heavily on parents’ minds right now. You’ve written about your support for reopening schools. What are some of the most important reasons you think kids should be going
back to school this fall?
I worry most about the children who stand to lose the most from school closures. Children with special healthcare needs depend on therapies and educational resources only available through school. Some children from vulnerable communities don’t have safe places to be without school and will miss out on remote education opportunities. So I think it’s important that we prioritize safely opening schools.
In-person school is really good for kids. They learn, see their friends, move their bodies, and have opportunities to try new challenges. School also provides food, medically necessary therapies, mental health services and other services for children. So when I consider the issue from the child's perspective, I want kids going back to school!
However, that said, I think it’s important for parents to know that at an individual level, remote schooling may be a great option. Some children have thrived in these settings with fewer distractions and more time. I hope in-person education can be available, but in-person education this fall isn’t necessarily the right choice for everyone. And, I do think it's possible for children to thrive at home. We all worry about social and language development, but if parents are able to engage with their children, home can be a rich environment for learning. The youngest kids will have more challenges connecting with teachers or friends through a screen and will rely on caregivers at home to meet their needs.
What are some of the risks associated with
kids staying home?
I worry about children being less active and snacking more away from school. We want to make sure to keep children's bodies physically healthy through time at home. With children out of school, ensuring their safety and adequate supervision is also important. Young children may get into dangerous situations at home quickly when parents are distracted or overstretched. All children are spending more time than ever on screens, so we need to monitor and plan to keep the content safe.
Older children and teens are at higher risk for mental health issues such as anxiety and depression. During this time, coping with stress and disappointment while separated from their friends, we need to be careful to stay connected with tweens and teens to make sure they are supported through these challenges.
What are the most important things schools need to do to reopen safely? Do you think that realistically they will be able to do it, at least in some parts of the country?
Schools need a lot of money to open responsibly. Cohorting groups require smaller class sizes and more teachers. Ventilation systems can decrease transmission and should be upgraded. More busses are required to facilitate social distancing. Hand washing or sanitizing stations need to be available. Masks and face shields need to be available for school staff or students who don’t have one. All of these interventions require funding and we’ve seen public budgets slashed due to the economic impact of the pandemic.
Big picture: We need community buy-in. School can be as safe as possible, but in areas where there is rampant transmission, we can't screen out potentially infected people from the community since people infected with coronavirus can show no symptoms. We need big groups of people to embrace and prioritize controlling the spread of coronavirus so that schools can reopen safely. We need teachers to feel confident that our leaders have plans that
prioritize their safety.
Realistically, I have doubts about some of the planned school openings. But it’s important to keep in mind that various parts of the country are seeing different levels of transmission. I am hopeful for some schools
to open successfully.
Many families are currently deciding whether or not to send their kids back in-person or stick to remote learning. What are some things parents should think about when
making this decision?
Families should consider what would happen if their child got sick and infected their household. Parents need to consider their age and health conditions to determine how high risk they are for severe coronavirus infection. We have to think about the level of current transmission in a community. The best proxy is to see what percent of test results are positive. Also, parents should evaluate the school policies to understand what’s being done to decrease risk.
Each child’s needs should be considered independently. Some children can get a lot out of remote schooling while others less so. Their temperament and educational goals for the school year should be considered.
Also, don’t forget to fully think through the virtual plan. I can imagine families choosing play dates or enrichment activities that have virtually the same level of exposure. So if your goal is to decrease exposure, school is not
the only variable.
Some of this correlated with age. Remote schooling before third grade falls heavily on parents. And teenagers do seem at higher risk of catching and transmitting infection.
Obviously things could change in the next four to six weeks, but as of now… what are your plans for your own kids
come September?
I am sending my kids to school in the fall provided we have the opportunity. Two things enable me to feel comfortable and confident doing so. 1) My family is healthy and low risk. I wish we had grandparents we saw frequently, but they live out of town. While there have been severe cases of coronavirus in people like my family, they are very rare. 2) Our community is taking COVID-19 seriously. Everywhere we go people are masking and distancing. Our rates indicate low transmission, and our schools have comprehensive plans. If we were high risk or if we felt our schools weren’t appropriately cautious, it would be a much
more difficult decision.
What does a successful school reopening look like to you? What differences in school settings or school days would be needed for success?
A successful school reopening would be a school that’s able to stay open! Many schools will have cases and some classrooms will need to close. If a family with three children infects three classes in a small school, that will knock a significant portion of the school into a 14-day period of isolation at home. We should anticipate that cases will happen, whether due to school exposure or community exposure, and be prepared to continue the education plan remotely when needed.
School will look different for children and it’s important for us to discuss this with our kids before sending them. The cafeteria, auditorium and other areas where children congregate will need to be closed or repurposed. Groups of children will likely move around the school building less, for example no longer rotating through art or library. Some activities like indoor band or choir practice may be very difficult. Sports like wrestling and football where there is a lot of close contact will also be nearly impossible to do responsibly.
Schools will also be different for parents. There will be less socializing at drop off and fewer after school activities, sporting games, and birthday parties. We'll all have to adjust to our new normal.