Is Your Child Ready to Learn?

A surprising array of health issues can get in the way of school success. Bring this checklist to your next checkup.
Little girl wearing glasses

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When most of us think about helping kids succeed in school, we zero in on things like reading to them early and often, and making sure that schools are safe and staffed by talented teachers.

The vision of pediatrician Irwin Redlener, M.D., goes further. As a professor at Columbia University's Mailman School of Public Health, Dr. Redlener knows that being physically and mentally healthy is essential for getting a good education. So 25 years ago he teamed with musician Paul Simon to found Children's Health Fund, a national organization dedicated to providing quality health care for kids who don't have access to it. "Undiagnosed, untreated medical problems can profoundly affect a child's ability to learn," says Dr. Redlener, a Parents advisor. If your daughter's frequent ear infections prevent her from hearing her teacher, she's going to have trouble understanding the addition lesson. If your son's classmate can't focus because he was coughing all night from asthma, he won't remember the spelling words no matter how hard he studied. "My goal is to raise awareness of the connection between health and education," says Dr. Redlener. The key is to prevent or properly manage physical and psychological problems, and catch developmental delays early.

We believe that every parent can take a page from his playbook, so Parents has partnered with Children's Health Fund to get the word out. (See "Give Every Child a Chance," on page 3.) By making sure you know what to expect at the next checkup -- and which red flags to wave if the doctor doesn't address one of your concerns -- you will give your child a firm foundation for school success. Ask yourself these questions:

How well can my child see?

Kids with vision problems lose interest in learning, explains pediatrician Lisa Gwynn, D.O., medical director of Children's Health Fund in Miami-Dade County, Florida. "They can't follow what's going on in class, so they zone out, fall behind, or misbehave. Often, they're labeled problem learners or misdiagnosed with a learning disability."

Between 5 and 10 percent of preschoolers and 25 percent of school-age children have a vision problem, says the American Optometric Association. Yet less than a third have their vision tested before they start school.

Teachers witness these problems every day. Aileen Umholtz, an elementary-school teacher in Easton, Pennsylvania, recalls a third-grader who never paid attention during lessons and was "totally lost" when he had to complete assignments on his own. "He thought he just wasn't smart, and he stopped trying." All that changed when he was finally fitted for glasses. "Suddenly, school was exciting. He started participating in class, he handed in homework on time -- in every way, he was a happier kid," she says.

What your doctor should look for By age 3 or 4, when your child can read an eye chart, he should be screened yearly for nearsightedness, farsightedness, astigmatism (the eyeball is not perfectly round, resulting in distorted vision), color blindness, and strabismus (eye misalignment). If he can't read yet, he may be shown shapes or pictures of animals.

When to speak up Does your child hold books and toys very close to his eyes, turn or tilt his head to one side, or cover one eye when reading? Does he sit unusually close to the TV or computer screen? Squint even though the light is not bright or complain of headaches? Ask for a referral to an ophthalmologist or an optometrist.

Could she have a hearing problem?

Hearing is vital to speech and language development but problems are often undetected or misinterpreted. They range from mild impairment to profound loss, and a child can suffer regardless of how serious the problem is. "If kids are only hearing every other word, they don't pick up on social cues and miss out on social interactions with their parents, friends, and the world at large," says Denise Roeder, a kindergarten teacher in New York City.

Two or three kids out of every 1,000 suffer from a severe hearing loss, according to the American Academy of Pediatrics. Congenital problems are usually identified before a baby leaves the hospital, but others can develop throughout childhood as a result of head injury, genetic factors, diseases such as measles, antibiotics taken for serious infections including meningitis, even exposure to very loud noise. Temporary hearing loss, which can last three or more months, can occur when repeated ear infections lead to fluid buildup.

What your doctor should look for The pediatrician will examine your child's ears for infection, but she should also have a yearly audiometric screening by age 3 (4 at the latest). During this test, your child will wear headphones and be asked to raise her hand to indicate in which ear she hears tones. If she fails the exam, ask for a referral to a pediatric audiologist or to a pediatric ear, nose, and throat specialist (ENT) for a more comprehensive evaluation.

When to speak up "One of the first signs of hearing loss is speech delay," says Dr. Gwynn. "Most children will say single words by 15 months and two-word sentences like 'Mama bye-bye' by age 2. By 3, strangers should be able to understand what she's saying." Other red flags: Does she seem to ignore you when you call her name, or blast the volume on the TV? Is it hard for her to understand others? Does she tell you her ear hurts or that she hears noises in her ears? A specialist can determine the extent of hearing loss and work with you and the school to develop an intervention plan.

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