Because we recognize the importance of schoolwork for our patients, Cook Children’s partners with Fort Worth Independent School District to provide school services to eligible patients while in the hospital setting. Our teachers work specifically with children and teens who have a chronic or complex diagnosis, are experiencing an extended hospitalization, or have sustained a life-threatening injury.

Whether they’re attending a session at the bedside or in the patient classroom on the first floor of the Fort Worth medical center, students receive one-on-one services to help them keep up with their schoolwork.

Get to know each of our incredible teachers, Marissa Glasschroeder, Laura Ralston and Nicole Rogers, by watching the videos below.

The school nurse has long offered an escape from the classroom… and as many Band-Aids as a kid could need. But the responsibilities of a school nurse stretch far beyond their tiny office walls. They are the keepers of care for hundreds, if not thousands, of students. Their duties range from administering CPR to managing insulin pumps and blood sugar levels. In between all of that, there is another heavy responsibility they are tasked with: recognizing and reporting suspected abuse and neglect.

“We want our nurses to have the updated knowledge, skills and resources they need to keep our kids safe and to do their job effectively,” said Cindy Parsons, Director of Health Services at Keller ISD. “The school nurse has an important role in education about child abuse. Teachers and other school staff members may not be as familiar with subtle signs of neglect, and the school nurse is often the person who helps to educate them.”

According to a lawsuit filed by the American Civil Liberties Union (ACLU) on Monday, the deputy violated the rights of two children when he shackled the kids around their biceps in the fall of 2014. The boy and a 9-year-old girl had both been diagnosed with attention deficit hyperactivity disorder (ADHD). The lawsuit alleges that both children were being punished for behavior related to their disabilities.

ADHD is a common challenge in classrooms across the country. So what should parents and teachers do to prevent a child from becoming too unruly to handle? Lena Zettler, director of Psychology at Cook Children’s, suggests the following:

• Have a plan
• Have a team
• Have an advocate

“What are the steps that will be taken and who are the key people involved? These things should be understood before an emergency happens,” Zettler said. She says it’s important to remember that kids with ADHD most likely aren’t acting up for attention.

“Education is the first step for treatment for ADHD. It’s is a neuro-developmental disorder. It is not a disorder of bad parenting,” says Zettler.

Students with disabilities make up 12 percent of the student population nationally. According to the U.S. Department of Education, they account for 75 percent of the students who are physically restrained by adults in their schools. To prevent such drastic measures from being taken, parents who have a child with ADHD should have a conversation with their child’s teacher about the condition before the school year begins.

Together, parents and school officials need to put a team in place to assist in the child’s education and plan out what will happen when the child acts out.

Parents and school officials also need to designate an advocate, someone the child can turn to for help. The advocate could be an assistant teacher, a counselor or even a principal. By putting a team together and a plan in place, parents can help ensure ADHD children and their classmates get the most out of the school year.

“Taking these steps will not only benefit a child with ADHD, they will help the entire class,” says Zettler.

Surprised? Lisa Elliott, Ph.D., clinic manager of Cook Children's Behavioral Health in Denton, Texas, isn't. Elliott, a licensed psychologist, says parents and teachers often have an outdated view of what a victim looks like.

"The general public has always perceived that children who are vulnerable to bullying have some sort of social deficit, physical handicap or learning disability," Elliott said. "While this is true, socially adept kids are equally vulnerable to bullying, especially when they attempt to climb the social ladder."

Last year, the American Sociological Review published the "Casualties of Social Combat" study, which examined more than 4,200 middle- and high-school students and found that the more popular students became, the more vulnerable they were to bullying.

Snakes and (Social) Ladders

For several years, Elliott has given presentations on bullying to the local community. She says parents are surprised when they hear a popular student can be both a bully and a victim at the same time. According to Elliott, the danger comes when a child tries to gain more status in a social clique that is emotionally aggressive or manipulative. Signs of this nonphysical bullying can be subtle and easily mislabeled as "drama."

Jockeying for position

According to the study, bullying is more likely to occur within a social group, between two "friends" who are on the same level in social heirarchy. On the outside, this may simply look like typical relationship drama. What's actually happening may be subtle but serious bullying.

How to Stop the Cycle 

No child is bully-proof. According to Elliott, the key is to to make sure your child can spot an unhealthy friendship before it goes too far.

"We should communicate to our children what true friendship is, and what it isn't," Elliott said. "This will help them discern which peers they can trust and which ones are trying to manipulate them."

Elliott offers parents the following talking points when speaking to their child about bullying:

• Even people who say they're your friends, can bully you.
• You should confront your friends when they're being hurtful to you or others.
• Retaliating may feel good temporarily, but refusing to stoop to the bully's level will win you more popularity in the long run.
• When you hear a false rumor, just ignore it and be yourself.
• You're most likeable when you respect yourself and others.
• Bullies usually have their own insecurities. Returning meanness with kindess is the best way to break down their defense.

Warning signs

If you worry your child is being bullied, look for the following signs:

• Sudden change in friendships.
• Unexpected drop in grades.
• Irritability or moodiness.
• Reluctance to go to school.
• Avoidance of social situations.
• Faked illnesses or complaints of feeling sick.

The screaming-leg-hanger-on-er

I know there are parents who are terrified of how their child will do on their first day of school. They are picturing their children crying and hanging on to a leg shouting, “Mommy! Don’t leave me here!” My heart goes out to those families because that must be really difficult. It seems painful for the child and is probably the most painful on mom or dad who is attempting to pry themselves away. Then, they have to spend the whole day worrying if their child is OK or building a need for therapy from their mounting sense of abandonment.

Here are some tips:

1. This behavior might be demonstrating some separation anxiety Talk through the drop-off period and the day with your child until you are both sick of talking about it. One of the best methods for combatting anxiety is to be prepared.
2. If possible, send the parent who is less likely to cause this reaction early on. Sometimes it’s mom and sometimes it’s dad. If your child can make an easy break with one, but not the other, let that parent try to help during those early days until the child sees that school isn’t such a terrible place.
3. Make a quick break. Trying to coerce children to say they love you and give you 1,000 kisses only makes things worse. A quick goodbye and we’ll see you soon should suffice.

A quick note of support: Ultimately, you may do everything right and this may still happen to you. Try to remember that their behavior at this extremely stressful moment does not define your ability as a parent. Teachers are used to seeing this. Most of them probably see it every single year in a child or two.

The quiet, but compliant child

I would bet that many kids fall into this category. They aren’t exactly sure what to think about school. They are a little annoyed about their first day of school outfit and a little more annoyed about the fact that they had to take pictures wearing it, holding a sign that says “First Day of School.” (What’s Instagram mom?) They are not openly upset about you leaving them, but they may seem a little anxious.

Here are some tips:

1. They might appreciate it if you walk them into class the first few days and see what they have been up to for a minute or two.
2. Let them know what they are feeling is normal. “It’s OK to be afraid. But every day you go, it will get easier.”
3. This is another instance where a quick, clean break is good. After the child is settled in, say goodbye and leave. No need to make every drop off day sappy … just treat it like it is no big deal.

The “see you later, dad; or not. Whatever it’s cool” child

My child might fall into the previous category, but I have a pretty strong feeling he will fit here. He seems really excited about school and I hope that is actually the case on the day of. I plan to give him lots of latitude to change his mind that day because with 5 year olds, you never know what to expect.

For this child, these tips are more for mom and dad:

1. Keep it together yourself, if you can. Your big boy or girl is growing up and independent. That is actually the goal of parenting. No one wants their college age child to be holding onto their leg at the dorm so you can check that off your parenting accomplishment list.
2. Don’t take it personally. They still love you (for now) and still want you around (occasionally).

There are many more first day of school personalities that your child could show, these are just a sampling. The best advice I can give from hearing back to school stories for years is to be flexible. Come back next week to see if I can follow my own advice. I’ll try not to cry the first day he asks me to stay in the truck while he walks in …

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.