Bullying, although not a new problem in and around schools, has increasingly become a bigger issue with children, having negative impacts for all involved. With the increase in online formats (social media, gaming, etc.) this can feel like an issue that is difficult to get ahead of. The Centers for Disease Control and Prevention (CDC) define bullying as” any unwanted aggressive behavior(s) by another youth or group of youths…. that involves an observed or perceived power imbalance, and is repeated multiple times or is highly likely to be repeated.” Bullying can come in the following forms:

• Physical such as hitting, kicking, and tripping
• Verbal including name-calling and teasing
• Relational/social such as spreading rumors and leaving out of the group
• Damage to property of the victim
• Online (Cyber-bullying) which includes verbal threats and harassment over online platforms (cell phone, text messages, social media, gaming, emails)

Bullying can produce long term effects for children, resulting in physical injury, social and emotional distress, self-harm, and even death. It also increases the risk for depression, anxiety, sleep difficulties, lower academic achievement, and dropping out of school. 

Talking about bullying can be difficult for everyone. However, research suggest that children often look to parents/guardians for advice/help on difficult decisions. Spending even 15 minutes a day talking with your child can reassure them that they can talk to you if they have a problem. Start conversations about daily life and feelings with questions like these:

• What was one good thing that happened today? Any bad things?
• What is lunch time like at your school? Who do you sit with? What do you talk about?
• What is it like to ride the school bus?
• What are you good at? What would do you like best about yourself?

It is important to talk to your child about bullying so that they understand what it means to bully someone and what to do if it happens to them. If you suspect that your child is being bullied at school or on the bus, please contact the school. If you suspect that your child is being bullied somewhere outside of school please consider discussing the following tips/options with your child:

Don’t give the bully a chance. As much as you can, avoid the bully. You can’t go into hiding or skip class, of course. But if you can take a different route and avoid the mean kid, do so.

Stand tall and be brave. When you’re scared of another person, you’re probably not feeling your bravest. But sometimes just acting brave is enough to stop a bully. How does a brave person look and act? Stand tall and you’ll send the message: “Don’t mess with me.” It’s easier to feel brave when you feel good about yourself. See the next tip!

Feel good about you. Nobody’s perfect, but what can you do to look and feel your best? Talk to your child about ways to increase self-esteem.

Get a buddy (and be a buddy). Two is better than one if you’re trying to avoid being bullied. Plan to walk with a friend or two on the way to school, recess, lunch, or wherever you think you might meet the bully. 

Ignore the bully. If you can, try your best to ignore the bully’s threats. Pretend you don’t hear them and walk away quickly to a place of safety. Bullies want a big reaction to their teasing and meanness. Acting as if you don’t notice and don’t care is like giving no reaction at all, and this just might stop a bully’s behavior.

Stand up for yourself. Pretend to feel really brave and confident. Tell the bully “No! Stop it!” in a loud voice. Then walk away, or run if you have to. 

Don’t bully back. Don’t hit, kick, or push back to deal with someone bullying you or your friends. Fighting back just satisfies a bully and it’s dangerous, too, because someone could get hurt. You’re also likely to get in trouble. It’s best to stay with others, stay safe, and get help from an adult.

Don’t show your feelings. Plan ahead. How can you stop yourself from getting angry or showing you’re upset? Try distracting yourself (counting backwards from 100, spelling the word ‘turtle’ backwards, etc.) to keep your mind occupied until you are out of the situation and somewhere safe where you can show your feelings.

Tell an adult. If you are being bullied, it’s very important to tell an adult. Find someone you trust and talk about what is happening to you. 

Remember, children often learn by watching adults. When adults treat others with kindness and respect,  it demonstrates to children that there is no place for bullying. Children watch how the adults in their lives manage stress and conflict, how they treat those around them and how they allow others to treat them. For more information regarding bullying, the effects of bullying, and how to make a positive impact in our communities, please visit the following websites:

https://www.stopbullying.gov/bullying/what-is-bullying

https://www.stopbullying.gov/prevention/how-to-prevent-bullying

https://kidshealth.org/en/kids/bullies.html

The American Academy of Child  & Adolescent Psychology (AACAP) offers the following information regarding screen time and children:

Children and adolescents spend a lot of time watching screens, including smartphones, tablets, gaming consoles, TVs, and computers. On average, children ages 8-12 in the United States spend 4-6 hours a day watching or using screens, and teens spend up to 9 hours. While screens can entertain, teach, and keep children occupied, too much use may lead to problems.

Parents may not always know what their children are viewing, or how much time they are spending with screens. Children may be exposed to:

• Violence and risk-taking behaviors
• Videos of stunts or challenges that may inspire unsafe behavior
• Sexual content
• Negative stereotypes
• Substance use
• Cyberbullies and predators
• Advertising aimed at your child
• Misleading or inaccurate information

Too much screen time may lead to:

• Sleep problems
• Lower grades in school
• Reading fewer books
• Less time with family and friends
• Not enough outdoor or physical activity
• Weight problems
• Mood problems
• Poor self-image and body image issues
• Fear of missing out
• Less time learning other ways to relax and have fun

Managing a child’s screen time is challenging for families. Your child is never too young for a screen-time plan. Consider the following as a guideline:

• Until 18 months of age limit screen use to video chatting along with an adult (for example, with a parent who is out of town).
• Between 18 and 24 months screen time should be limited to watching educational programming with a caregiver.
• For children 2-5, limit non-educational screen time to about 1 hour per weekday and 3 hours on the weekend days.
• For ages 6 and older, encourage healthy habits and limit activities that include screens.
• Turn off all screens during family meals and outings.
• Learn about and use parental controls.
• Avoid using screens as pacifiers, babysitters, or to stop tantrums.
• Turn off screens and remove them from bedrooms 30-60 minutes before bedtime.

Screens are here to stay and can offer many positives. It’s never too early to develop a screen-time plan with your family. Let your children share their ideas and concerns. Some additional tips to keep in mind are:

• Familiarize yourself with programming to make sure it is age-appropriate.
• Talk to your child about what they are seeing. Point out good behavior, such as cooperation, friendship, and concern for others. Make connections to meaningful events or places of interest.
• Be aware of advertising and how it influences choices.
• Encourage your child to learn other activities such as sports, music, art, and hobbies that do not involve screens.
• Set a good example with your own safe and healthy screen habits.
• Teach children about online privacy and safety.
• Actively decide when your child is ready for a personal device.
• Encourage using screens in ways that build creativity and connection with family and friends.
• Consider your child or teen’s maturity and habits. The right plan for one family may not be a good fit for another.

Positive and healthy screen use is possible with proper guidance and consistency.

If you are concerned about your child’s screen time, talk to your pediatrician or family physician.  If problems persist, ask for a referral to a qualified mental health professional.

The American Academy of Pediatrics (AAP) recommends developing a media plan that helps you set media priorities that best fit the needs of your family. Use the following link to learn more about this useful tool:  https://www.healthychildren.org/English/fmp/Pages/MediaPlan.aspx

Sleep plays an important role in the health and development of children. Research shows that sleep can impact a child’s mood, attention, cognitive performance, learning and memory. Sleep can also affect your child’s physical health as it plays an essential part in the immune system’s ability to heal and defend itself against pathogens.

When children aren’t getting enough sleep you may find that they have trouble paying attention, mood swings, behavior problems, and leaning problems. Insufficient sleep can also leave your child at a higher risk of illness and infection. Making sure that your child has adequate sleep is extremely important for their physical and emotional health, as well as their academic success!

How much sleep do kids need?

How much sleep kids need varies by age. While every child is different, experts recommend:

• infants (0–3 months): 14–17 hours, including naps 
• infants (4–12 months: 12–16 hours, including naps
• toddlers (1–2 years): 11–14 hours, including naps
• preschool (3–5 years): 10–13 hours, including naps
• school-age (6–13 years): 9–12 hours
• teens (14–17 years): 8–10 hours

Sleep Tips for Kids

Daytime habits also affect sleep. You can promote restful slumber in your children by following basic rules for good sleep:

• Arrange a balanced schedule with interspersed periods of rest and play
• Set a regular bedtime
• Make the bedroom a no-screen zone, even during the day 
• Provide a healthy diet
• Set the thermostat to a slightly cooler temperature  
• Use dark curtains to block out light, or a nightlight if they’re scared of the dark
• Keep the bedroom quiet, or use a white noise machine to mask outside sounds
• Avoid caffeine, large meals, and sugary treats before bedtime, opt for a healthy bedtime snack if necessary

Children and Sleep

https://kidshealth.org/en/parents/sleep.html

Regular physical activity is one of the most important things you can do for your health! Being physically active can improve brain health, manage weight, reduce the risk of certain diseases, strengthen bones and muscles, and improve your ability to do everyday activities.

Exercising with your child can better your own health while helping your child develop exercise habits. You are a role model, and your child is more likely to be physically active if you make physical activity a family priority. Take a family bike ride or walk together, or play catch in the yard. Plant a family garden, and watch vegetables and flowers grow over time. Limit screen time on devices and think of ways to get active with your child instead.

The amount of physical activity that children should have depends on their age:

Recommendations for Children Ages 3 Through 5 Years

• Be physically active throughout the day for growth and development.
• Adult caregivers should encourage children to be active when they play.

Recommendations for Children and Adolescents Ages 6 Through 17 Years

• 60 minutes or more of moderate-to-vigorous intensity physical activity each day.
  • Aerobic activity: Most of the daily 60 minutes should include activities like walking, running, or anything that makes their hearts beat faster. At least 3 days a week should include vigorous-intensity activities.
  • Muscle-strengthening: Includes activities like climbing or doing push-ups, at least 3 days per week.
  • Bone-strengthening: Includes activities such as jumping or running, at least 3 days per week.

https://www.cdc.gov/physicalactivity/basics/children/index.htm

https://www.mayoclinic.org/healthy-lifestyle/fitness/expert-answers/kids-and-exercise/faq-20058336

Healthy eating is an important part of your child’s growth and development. Research suggest that health habits, including healthy eating, begins at the earliest stages and helps to build positive foundational practices for lifelong health and wellness. Schools are uniquely situated to partner with parents in providing opportunities to learn about and practice healthy eating behaviors. 

Eating a healthy breakfast is associated with improved cognitive functions, reduced absenteeism, and improved moods in children. Please refer to our schools health and wellness policy when packing lunches and providing snacks for children. Please avoid sending sugary snacks and beverages to school with your child. These items often cause an increase in energy followed by a sluggish, depressed mood making it difficult for children to focus during the school day. Instead consider sending water for hydration, 100% fruit or vegetable juices, and snacks high in protein. 

A healthy eating routine is important at every stage of life. It can have positive effects that add up over time. It’s important to eat a variety of fruits, vegetables, grains, protein foods, and dairy or fortified soy alternatives. When deciding what to eat or drink, choose options that are full of nutrients. Make every bite count.

MyPlate is a great way to ensure you and your children are eating nutritious foods from all 5 of the food groups and has great tips on keeping your family healthy!

https://www.myplate.gov/life-stages/kids

https://www.nutrition.gov/

Understanding the Risks of Choosing Not to Vaccinate

If You Choose Not to Vaccinate Your Child, Understand the Risks and Responsibilities – Information from the CDC

If you choose to delay some vaccines or reject some vaccines entirely, there can be risks.  Please follow these steps to protect your child, your family, and others.

With the decision to delay or reject vaccines comes an important responsibility that could save your child’s life or the life of someone else.

Anytime that your child is ill and you:

• Call 911;
• Ride in an ambulance;
• Visit a hospital emergency room; or
• Visit your child’s doctor or any clinic

You must tell the medical staff that your child has not received all the vaccines recommended for his or her age.  Keep a vaccination record easily accessible so that you can report exactly which vaccines your child has received, even when you are under stress.

Telling health care professional your child’s vaccination status is essential for two reasons:

• When your child is being evaluated, the doctor will need to consider the possibility that your child has a vaccine-preventable disease. Many of these diseases are now uncommon, but they still occur.
• The people who help your child can take precautions, such as isolating your child, so that the disease does not spread to others. One group at high risk for contracting disease is infants who are too young to be fully vaccinated.  For example, the measles vaccine is not usually recommended for babies younger than 12 months.  Very young babies who get measles are likely to be seriously ill, often requiring hospitalization.  Other people at high risk for contracting disease are those with weaker immune systems, such as some people with cancer and transplant recipients.

Before an outbreak of a vaccine-preventable disease occurs in your community:

• Talk to your child’s doctor or nurse to be sure your child’s medical record is up to date regarding vaccination status. Ask for a copy of the updated record.
• Inform your child’s school, childcare facility, and other caregivers about your child’s vaccination status.
• Be aware that your child can catch diseases from people who don’t have symptoms. For example, Hib meningitis can be spread from people who have the bacteria in their body, but are not ill.  You can’t tell who is contagious.

When there is vaccine-preventable disease in your community:

• It may not be too late to get protection by getting vaccinated. Ask your child’s doctor.
• If there are cases (or, in some circumstances, a single case) of a vaccine-preventable disease in your community, you may be asked to take your child out of school, childcare, or organized activities (for example, playgroups or sports).
• Your school, childcare facility, or other institution will tell you when it is safe for an unvaccinated child to return. Be prepared to keep your child home for several days up to several weeks.
• Learn about the disease and how it is spread. It may not be possible to avoid exposure.  For example, measles is so contagious, that hours after an infected person has left the room, an unvaccinated person can get measles just by entering that room.
• Each disease is different and the time between when your child might have been exposed to a disease and when he or she may get sick will vary. Talk with your child’s doctor or the health department to get their guidelines for determining when your child is no longer at risk of coming down with the disease.

Be Aware:

• Any vaccine-preventable disease can strike at any time in the U.S. because all of these diseases still circulate either in the U.S. or elsewhere in the world.
• Sometimes vaccine-preventable diseases cause outbreaks, that is, clusters of cases in a given area.
• Some of the vaccine-preventable diseases that still circulate in the U.S. include whooping cough, chickenpox, Hib (a cause of meningitis), and influenza. These diseases, as well as the other vaccine-preventable disease, can range from mild to severe and life-threatening.  In most cases, there is no way to know beforehand if a child will get a mild or serious case.
• For some diseases, one case is enough to cause concern a community. An example is measles, which is one of the most contagious diseases known.  This disease spreads quickly among people who are not immune.

If you know your child is exposed to a vaccine-preventable disease for which he or she has not been vaccinated:

• Learn the early signs and symptoms of the disease.
• Seek immediate medical help if your child or any family members develop early signs or symptoms of the disease.

IMPORTANT: Notify the doctor’s office, urgent care facility, ambulance personnel, or emergency room staff that your child has not been fully vaccinated before medical staff have contact with your child or your family members. They need to know that your child may have a vaccine-preventable disease so that they can treat your child correctly as quickly as possible.  Medical staff also can take simple precautions to prevent diseases from spreading to others if they know ahead of time that their patient may have a contagious disease.

• Follow recommendations to isolate your child from others, including family members, and especially infants and people with weakened immune systems. Most vaccine-preventable diseases can be very dangerous to infants who are too young to be fully vaccinated or children who are not vaccinated due to certain medical conditions.
• Be aware that for some vaccine-preventable diseases, there are medicines to treat infected people and medicines to keep people they come in contact with from getting the disease.
• Ask your health care professional about other ways to protect your family members and anyone else who may come into contact with your child.
• Your family may be contacted by the state or local health department who track infectious disease outbreaks in the community.

If you travel with your child:

• Review the CDC travelers’ information website (http://www.cdc.gov/travel) before traveling to learn about possible disease risks and vaccines that will protect your family. Diseases that vaccines prevent remain common throughout the world, including Europe.
• Don’t spread disease to others. If an unimmunized person develops a vaccine-preventable disease while traveling, to prevent transmission to others, he or she should not travel by a plane, train, or bus until a doctor determines the person is no longer contagious.

https://www.cdc.gov/vaccines/hcp/patient-ed/conversations/downloads/not-vacc-risks-color-office.pdf

Pennsylvania law allows for the following exemptions:

Medical Exemptions

By law, only licensed medical doctors, doctors of osteopathy or their designees can sign for medical exemptions. Chiropractors’ certifications for medical exemptions are not acceptable. A medical exemption for a specific antigen(s) should be documented in the statement of exemption. All other immunizations are still required.

Religious/Moral Exemptions

Statements of religious or strong moral or ethical conviction opposing immunization must be submitted in writing and signed by the parent, guardian or emancipated child. A space on the Certificate of Immunization is provided for this purpose. This exemption does not need to be renewed yearly.

Vaccines are an important part of the health and wellness of not only the individual, but also our larger global community. There are now vaccines to prevent more than 20 life-threatening diseases, helping people of all ages live longer, healthier lives. Immunization currently prevents 3.5-5 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles (World Health Organization, 2023). 

Vaccines work with your child’s immune system to help them fight various diseases. They work by introducing a very small part of these germs into your child’s system so that their immune system can better recognize and fight against these illnesses. The American Academy of Pediatrics (2023) strongly recommends on-time routine immunizations for all children and adolescents in order to protect the health and safety of children and communities. 

If you have any questions regarding the safety and efficacy of vaccinations or to find out if your child is up to date, please contact your health care provider or the school nurse. You can also visit the following websites for evidence based information: 

American Academy of Pediatrics

https://www.aap.org/en/patient-care/immunizations/

Centers for Disease Control and Prevention

https://www.cdc.gov/vaccines/parents/why-vaccinate/index.html

The following vaccinations are required for PA schools:

What are the immunization requirements for all grade school students?

• Four doses of tetanus, diphtheria and acellular pertussis (one dose on or after the fourth birthday) *
• Four doses of polio (fourth dose on or after fourth birthday and at least six months after previous dose given) **
• Two doses of measles, mumps, rubella (MMR)
• Three doses of hepatitis B
• Two doses of varicella (chickenpox) or evidence of immunity

*usually given as DTP or DTaP or DT or Td
**A fourth dose not necessary if the third dose was administered at age 4 years or older and at least six months after the previous dose.

What are the seventh grade school immunization requirements?
In addition to all other required grade school immunizations:

• One dose of tetanus, diphtheria, acellular pertussis (Tdap) on the first day of seventh grade
• One dose of meningococcal conjugate vaccine (MCV) on the first day of seventh grade

Note: If a child gains entrance to school in any succeeding year, the same immunizations are required on the first day.

What are the 12th grade school immunization requirements?
In addition to all other required grade school immunizations:

• One dose of meningococcal conjugate vaccine (MCV) on the first day of 12th grade. If one dose was given at 16 years of age or older, that shall count as the 12th grade dose.

https://www.health.pa.gov/topics/programs/immunizations
World Health Organization (2023). Vaccines and immunization. https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1

• PHYSICAL EXAM RECORDS: A copy of a physical exam done by your child’s Healthcare provider dated within 4 months of school entry is required for Kindergarten. 

• DENTAL CERTIFICATE: Pennsylvania law (28 PA Code )* states “Dental examinations shall be required on original entry into school and in grades 3^rd and 7^th. If you do not have a family dentist or are having difficulty getting an appointment, please contact the school nurse for assistance.

• IN SCHOOL SCREENINGS: Pennsylvania School Code requires that the following screenings be done in schools: 

Growth Screenings: 28 PA Code, Chapter 23.7 states “Height and weight measurement shall be conducted at least once annually and preferably twice annually. Every effort shall be made to determine the pattern of growth for each child so that his weight and height can be interpreted in light of his own growth pattern rather than those of his classmates.” 

Vision Screen: 28 PA Code, Chapter 23.4 requires vision screenings and examinations.  Additionally, regulations specify that “vision screening tests shall be conducted annually by a nurse, teacher or medical technician.” 

Hearing Screenings: 28 PA Code, Chapter 23.5 states that each year, students in kindergarten, special ungraded classes and grades 1^st, 2^nd, 3^rd, 7^th and 11^th shall be given a hearing screening test administered by either the school nurse or trained medical technician.

All results will be available for parents/guardians and failed vision/hearing screenings will require a follow-up.

• IMMUNIZATIONS: Please provide the school nurse with a copy of your child’s most recent immunization record showing the following immunizations-given at the appropriate ages per current PA DOH recommendations: 

• 2 chicken pox (varicella) 
• 4-5 DTaP/DTP containing vaccinations with last dose between ages 4-6 
• 3-5 polio vaccinations (IPV) with the last dose between age 4-6 
• 1 Measles, 1 Mumps and 1Rubella vaccinations (must have 2 of each by age 7) 
• 3-4 Hepatitis B vaccinations appropriately spaced 

*For additional immunization information, please see:*  https://www.health.pa.gov/topics/Documents/School%20Health/SIR8.pdf

Immunization waivers are allowed for medical and/or religious/moral exemptions. Please see “Choosing not vaccinate” for the appropriate information and form regarding this issue.

https://docs.google.com/forms/d/13mUAPR3ds-cc2ukwMzdRqX5kD7Ov_7t6-_GzA_zJuio/edit?ts=641c3684