Along with this goal of each child’s attendance, we have to balance the goal of keeping others safe from infectious diseases. Our contagious students need to stay home when they are sick to keep the rest of their classmates safe. (This is why I don’t really care for perfect attendance bike raffles. I prefer responsible attendance.)

Balancing these tensions is often hard for the parent, the school and the pediatrician because we often don’t know exactly when a child is no longer contagious. This is why I got so geeky excited last week to see a new study released in the Pediatric Infectious Disease Journal about the contagiousness of strep throat.

The study looked at 111 children with strep throat over two days.

Day 1: Children who tested positive for strep were given their first dose of amoxicillin before 5 p.m. (They also had cultures taken which allow to see if bacteria will grow from a swab of their throats.)

Day 2: Children were retested and cultured for strep in the morning to determine if they still carried the bacteria in their throats.

Here is what they found:

• 101 children tested negative for strep on the morning of day 2.
• 7 children had significantly decreased growth of bacteria from their throat cultures.
• 2 children continued to have high loads of bacteria.

The author’s conclusion: “all children treated with amoxicillin for streptococcal pharyngitis (strep throat) by 5 p.m. can, if afebrile (fever free) and improved, may be permitted to return to attend school on day 2.”

I’m pretty sure you’re not as excited as I am, but THIS IS HUGE!

Based on current guidelines, children must be treated for 24 hours before being allowed to return to school. If we treated according to the results of this study, it would allow for the child to be back in school and for the parent to be back at work a whole day earlier.

I feel like there is a lot of work to be done in this area and this type of study, along with other models of health care delivery, are good examples of the work that will be necessary.

Because I value education and our school districts so much, I want to be constantly thinking about ways we can do this better. As a general pediatrician, I can really boil down the goals of my job to these:

1.Keep kids growing and healthy.

2.Keep kids developing and learning.

Early in your baby’s life, this looks like frequent checkups for preventing illness, monitoring growth (and talking about diet) and teaching ways that parents can help their child with development. (Read: Everyone should homeschool.)

As your child gets older and starts school, my role changes a little bit. I don’t ask my elementary age patients about fractions or my high school students about “The Great Gatsby.” Instead, I might ask, “How is school going?” “Any problems I need to know about?” “Any way I can help?”

On a practical level, this means offering school aged children after school appointments when possible. It means getting sick kids in the same day so that we can start treatment and get them back in their desks as soon as possible.

In the future, this may mean totally different modes of delivering health care and working with the school and school nurses in order to decrease missed class time.

But I’m getting ahead of my geeky self again. I’ll save that discussion for later.

Part 2 - Elementary and Middle School

I'd guess the titledidn't fool as many of you as it did in Part 1. I probably would've clicked angrily on the link and went to disprove the fact that homeschooling is for everyone too, but I assume that the rest of you who clicked on today are actually interested in how you can help your child learn. Remember these posts are all about the fact that despite the fact that we delegate a lot of our role of educating our children to the school we choose to send them to, the responsibility of their education still falls on us, the parents.

I thought of two different things to post about. First I considered writing about feeding your child breakfast. Several studies show that doing so will increase their grades and especially their ability to pay attention throughout the morning. So, feed your child breakfast. Moving on.

One of the major predictors of success in school and in the future for our children is our involvement in their school and their education.

The school will do what they can, but they are limited by many factors:

1)   Your child is not the only child in class. Vying for the teacher's attention can be difficult.

2)   Your child may learn faster or slower than the average person in class and adjustments are often difficult.

3)   Schools have limited financial and personnel resources that don't allow for curriculum to be differentiated for each student.

So, how do we compensate for each of the above deficiencies? We get involved. More specifically, we get involved in the right way. A study done at the University of New Hampshire showed that it would take $1,000 per student per year of extra spending for the school  to achieve the same results as parent involvement.

A comprehensive review of parent involvement was released by the National Center for Family and Community Connections with Schools in 2002 called "A New Wave of Evidence." I know it's 10 years old, but it's so comprehensive, I couldn't imagine using anything else.

So, how does parental involvement improve performance?

Here are just a few of the ways (New Wave of Evidence-pg 13):

•      Earn higher grades and test scores, and enroll in higher-level programs.
•      Be promoted, pass their classes, and earn credits.
•      Attend school regularly.
•      Have better social skills, show improved behavior, and adapt well to school.
•      Graduate and go on to postsecondary education.

But, how do you do it right?  As with anything, you can even mess up being involved in your child's school and education if you don't think about what you're doing.

Here's what studies say actually works (New Wave of Evidence-pg 87):

     1) Provide a stimulating literacy and material environment.

     2) High expectations and moderate levels of parent support and supervision.

     3) Monitoring of TV viewing and homework completion.

     4) Joint learning activities at home.

     5) Emphasis on effort rather than ability.

     6) Promoting of independence and self-reliance.

Let's go through each for a little discussion:

1) Provide a stimulating literacy and material environment - Have stuff around that stimulates your child to want to learn. This is simple in all stages of life but you just have to be careful to provide it. Keep books easily accessible in the current reading level and one reading level above your child so that they can explore what’s next. Read in front of them (no child is going to read in the room where you are watching TV). Keep art supplies, building toys and other items easily accessible and limit screen time so that your kids have time to play with them.

2) High expectations and moderate levels of parent support and supervision - Don't hover over their shoulder the whole time they are doing homework but check in frequently to make sure they are on task and don't have questions for you. I usually get my son started on something and then walk away and come back a few minutes later. He gets a lot more done when I'm not standing there and he doesn't rely on me to help him along the way.  My favorite thing to see him do is when I come back and he says, "I had a little trouble with this one so I moved on to the next one till you could help me." “Awesome, bud, let’s do it.”

3) Monitoring of TV viewing and homework completion - Set a rule for the TV and homework completion.  I guess it doesn't have to be, but I would think that having the same rule for all the children in the house would be helpful.  You could choose to have no TV until homework is complete or maybe one show (15-30 minutes) before you start.  Sometimes that break can be a refresher for a kid who is worn out from a long day at school but for other kids is impossible to get them back on task.  You need to decide what works best for your family and stick to the plan.

4) Joint learning activities at home - This is where you get to be creative. You can read my post called: Your Child is Gifted to get more advice on how to do this well.

5) Emphasis on effort rather than ability - You can see my entire post about this: You're So Smart.

6) Promoting of independence and self-reliance  -Remember that your goal is to get your child to be independent and ready to move off and do something else when they finish high school. It's hard to remember to think about it when they are young but giving them opportunities to be independent now when you are still close by is a great way to teach them to make better decisions later.

While we're at it, here are some things you should not do whenever it comes to being involved with your child's education:

1) Don't do their homework or projects for them. It's OK to help them if they are choosing wisely but it's also OK to let them make a bad grade if they are relying on you to do it all for them.

2) Don't ever tell you child's teacher that they are "bored" because the class is to easy. It may be completely true, but after saying it, you have eliminated almost any chance you had of working to get a solution to the problem.  Some other things you could say: How can we challenge him/her? Is there some way we could change x/y?

3) Don't go above your child's teacher to the principal unless you've tried to work with the teacher first. It actually causes a problem for everyone involved. The principal doesn't like it, the teacher doesn't like it and you're unlikely to get the results you desire.

4) Don't reward solely for grades. Everyone handles grades a little differently. Some families dole out huge money for good grades, some none and others everywhere in between. Rewarding for grades alone sets them up to choose easier classes and cut corners (cheat?) to get better grades.

Let’s be involved with our kids’ schools, but do it in the right way. The results could be amazing!

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.

Ok,so everyone who knows me already knew that I wasn't actually advocating home schooling in the traditional kinder-twelfth grade manner. I believe that parents should school their kids however they feel they works best for their family and their child. I know families who have chosen to home school some of their children while putting the others in public and/or private schools.  They chose what they thought was best based on their individual child and I applaud that.

One thing I would stress is to make sure you don't do anything out of social pressure. People who hang out with people who home school will get tremendous pressure to home school, but some parents simply aren't made in the mold of the home school teacher (especially me). People who hang out with people who do private school will insist that you can't get a good education anywhere else, and that's simply not true. So, weigh your options carefully and make a decision and go with it. Ok, soap box rant over...

However, it's important to remember that educating your child does not start with your decision of where they start kindergarten and it doesn't end when you make the decision and send them off to their first day of school.

You may have seen the following study or heard glimpses of it before, but I don't believe that there is a more powerful study regarding child development so I am going to go over it again:

Observing kids in a preschool, 2 researchers from the University of Kansas, Dr. Todd Risley and Dr. Betty Hart, noticed a difference in the development of vocabulary between the professors' kids and other children in the preschool.  They tried several strategies to get the other children talking, but nothing that they did at the day care enabled them to catch up to the professors' kids in increasing their vocabulary. Interestingly, they were able to get the children talking more, but not with a broader vocabulary. They realized that something must be happening before age 4 that was causing the difference between the two group.  So, they decided to do a study.

They enrolled children in the study by calling people out of the birth announcements in the Kansas City newspaper and then they "began recording what the people were saying to each other, to the child, (and) to each other in the child's presence." Once a month an observer would go to the home and audibly record, as well as make observations about what was going on in the home while they were there.  They followed the children from 9 months to 36 months.

There were 2 big discoveries:

1. The children who had bigger vocabularies had families who talked A LOT. There wasn't a lot of fancy teaching going on or flash cards, just talking. The difference was striking: 2100 words per hour in the professional families vs 600 words per hour in lower socioeconomic settings. This resulted in a 50 percent higher vocabulary and a higher IQ for those children at age 3.

2. Children who had bigger vocabularies had parents who used more "rich language" and not all "business talk." There is a certain amount of instruction that needs to happen with a toddler: "Sit down," "Eat your carrots," “Get your finger out of your nose” and "Don't hit your brother" are common phrases around our house. But it's not those words that lead to language development. The better phrases incorporate phrases like "what if," "shouldn't you" and "remember." These phrases came naturally as the number of words spoken increased because you get past the necessary business talk and into the rich language as your speech quantity increases.

The amazing things about the study is that they were looking to compare socioeconomic groups, but what they found is that if they stripped everything down the only remaining factor in predicting success in vocabulary was the quantity of words spoken and had nothing to do with the child's background.

There are so many interesting aspects of this study and you can read more about it here in an interview with Dr. Risley:

Where Vocabulary Growth Comes From 

Here's how you can use this research to start your child "home-schooling" early.

1. Talk to your baby/toddler.  It seems weird and awkward because early on you get nothing back, but they are soaking up every syllable into a construct in their brain that will likely come spilling back at you at some point when they are ready. Get in front of them and let them see you form the words with your mouth.  Use "parentease." Parentease is that higher pitched, sing-songy style of talking that anyone else listening would make fun of you for, but babies do understand and hear it better.

2. Talk with rich language. Explain things to them. Describe things. I've told this before, but my wife and I like to call our speech with our kids "narrating their world." When we can, everything they touch gets a noun label.  Then we will move on to adding an adjective or a verb when time allows and when they are becoming more developmentally advanced.

Here's an example of how that goes in our house:

"Hannah did you find a ball?"

"Ooohhh, look at that red ball.  And here's a blue ball too, Hannah."

"Hannah, are you going to throw that ball?  Yeahhh, you threw it."

We use our children's names all the time. In fact, we had to reconsider our list of baby names after our first because we realized what sounds cute once doesn’t always sound so cute the thousandth time you say it. It gets their attention in a way that isn't threatening in the way that, "Hey you, listen to me!!  (Sweet transition) Is that a red ball?" is.

3. Pretend they say stuff. It's OK. Using the above example, the first time Hannah said anything that even remotely sounded like ball, we got so excited. "That's right Hannah, it is a ball." I'm pretty sure she didn't even know what happened, but all the smiling and excitement was positive reinforcement and she was trying to say ball over and over again. Now, it's her favorite word.

Language development is such a critical component to the overall success of your child. There is nothing else that you can do that has a bigger impact on their future, so get to talking and talking and talking.

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.