Navigating Back-to-School Anxiety

For many children, heading back to school means buying new supplies and meeting a new teacher. But for children returning with a new prosthetic limb, brace, wheelchair or other visible medical device, the first day can also bring anxiety about unwanted attention, difficult questions and bullying.

Shriners Children's St. Louis social worker Bryan Berger, MSW, LCSW, said returning to school after the break can make children feel self-conscious, especially if they have new medical equipment that they didn’t have the previous year. Shriners Children’s patients might go back to school with assistive devices or orthopedic equipment that look different than what their peers are familiar with. Berger teaches patients to turn their differences into something positive.

“I try to give them talking points to help other kids understand what their medical device is,” Berger said. “They can say something along the lines of, ‘This is a new part of me that I’ll be living with and it’s something that makes me different in a good way.’ If they’ve had an amputation or revision surgery, I encourage them not to shy away from that and let other children know this is the new normal. Many kids will look and say things with curiosity, not with an intent to hurt. We try to explain that to our patients.”

Berger also encourages parents to prepare their children for questions and looks from their peers. He said parents should reinforce positive messaging and even practice scenarios kids might find themselves in at school. If Berger does hear from a patient who’s struggling with bullying, he has discussions with them and connects them with different resources, including school counselors.

“I want our patients to take pride in their physical differences,” Berger said. “Here at Shriners Children’s, we do our best to provide and empower patients and their families with knowledge to succeed when they leave the building from both an emotional and physical standpoint. Our patients’ physical differences should not be a burden.”

Shriners Children’s finds that patients tend to be most self-conscious between 10 and 14 years old, especially through puberty and the early high school years. Shriners Children's outlined some tips for parents with children returning to school this fall:

• Start the Conversation Early: Talk openly with your child about their physical differences and/or changes following an injury.
• Role Play Common Scenarios: Practice how to respond to questions or stares calmly and confidently.
• Empower Choice: Reinforce that it’s up to your child to decide how much to share.
• Create a Routine: Establish back-to-school habits a few weeks ahead of time to ease transitions.
• Collaborate with Educators: Contact teachers or school counselors early with any accommodations or concerns.
• Focus on Strengths: Encourage activities that build your child’s confidence and celebrate their talents.

Resource for Parents