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Where To Turn After a Poor Parent-Teacher Conference

It’s that time of year…. Parent-Teacher Conferences. Some parents love hearing about their child’s successes, but some parents don’t have that experience. Instead they receive a troubling report.

If you’re reading this, you probably sat in the tiny chair in front of your child’s teacher and absorbed the classroom your child occupies five days a week.  You scoured the walls looking for your child’s artwork and reminisced on your own school days for a minute.

You were a little excited and a little nervous to get the scoop on how your brilliant child is excelling in school but the teacher spent about 30 seconds on your child’s strengths and the rest was about how he’s struggling.

Struggling to grasp academic concepts…
Struggling to stay focused…
Disrupting the class…
Not performing well on tests…
Or even struggling socially…

Struggling just enough to be cause for concern and just enough to not make sense. You know your child is brilliant and you experience it at home, but your child’s teacher isn’t quite accessing it. It can feel like your child’s brain is turned off at school or amped up so high that they can’t learn.

Regardless of the teacher’s feedback you left the conversation puzzled and not really understanding how to get your child up to speed. Maybe this type of parent teacher conference isn’t new to you, but you’re not seeing changes and you weren’t given any direction on how to create change.

Here’s some valuable information for you to look into. Many children are experiencing sensory challenges that are going unidentified in schools or are being incorrectly diagnosed as behavioral issues, ADHD, or even autism spectrum disorder. Sensory challenges are 5 times more likely than autism spectrum disorder yet most professionals your child is encountering are not trained to spot it.

Sensory challenges just mean that a child’s brain responds to sensory input differently and some sensations may create an over-responsive action, like hitting back when being lightly touched. Other times a sensation like touch or someone trying to get the child’s attention may go unnoticed because the brain is under-responsive. There are many other variations of sensory challenges that can prevent your child from entering “the learning zone”.

Sensory challenges show up differently in each individual and most doctors are trained to respond to sensory concerns from parents as if the child will “grow out of it”.  Teachers are rarely trained to understand what sensory challenges are so they are often looked at as behavioral issues or laziness. For many children, the sensory challenges continue and even get worse without treatment as they grow.

Once a sensory issue is identified, the child can receive the direction they need to enter “the learning zone” they haven’t been able to access at school.

If you think your child may be experiencing a sensory challenge visit the STAR Center resource page. STAR Center is equipped to assess children who are experiencing sensory challenges so you can be clear on how to get your child in the learning zone. In partnership with Mile High Mamas.

 

 

What You Need to Know About Vaginal Birth After Cesarean Delivery (VBAC)

Mothers who have given birth via cesarean delivery (C-section) are not automatically reserved to deliver the rest of their children in the same way. Many of my patients come to me asking about vaginal birth after cesarean (VBAC) as an option for their next delivery. I often field a number of questions from my patients regarding the viability and safety of VBAC. Here are a few of the most popular:

Do I qualify for VBAC?

Many of my patients who gave birth via C-section qualify for VBAC. Perhaps the most important qualification for VBAC is the type of incision made on the uterus during your previous delivery. Moms wanting to give birth vaginally after a C-section must have given birth with the assistance of a low transverse incision. Performed in a majority of C-sections, a low transverse incision uses a horizontal cut made across the lower part of the uterus. In opposition, if a vertical incision on the higher, thicker part of the uterus was used in your first C-section, VBAC is not an option.

Additionally, patients who had their first C-section due to breech or fetal distress have a better chance of VBAC success as opposed to moms who had to have their C-section after failure to progress.

What are the risks?

For patients who qualify for VBAC, the risks are minimal. In fact, only .5 – 1 percent of patients have complications. However, this does not mean that all mothers who go into labor planning on VBAC are able to deliver vaginally. The American College of Obstetricians and Gynecologists estimates between 60-80 percent of women who try to have a VBAC succeed.

Because labor is different for every mother, difficulty progressing, breech or fetal distress may necessitate a second C-section to ensure the health of both you and your baby. For this reason, every mother planning on VBAC delivery must deliver in an approved hospital with 24-hour obstetric coverage and full access to anesthesia and surgical capabilities.

What are the benefits?

Patients who deliver vaginally spend less time in the hospital than those who deliver via C-section. Because C-section deliveries require major abdominal surgery, hospital stays afterward tend to be longer. VBAC also allows for more mother participation in the labor and delivery process. If you plan on having more children, VBAC delivery helps avoid the risks of multiple surgeries, which can cause the development of scar tissue within the abdomen and pelvis.

There are risks and benefits of each method of delivery, and often times the best approach depends on each individual’s unique case. As I tell my patients, my job is to guarantee the safety of you and your child no matter the method of delivery. If you have any concerns or questions about VBAC, your OB/GYN is a fantastic resource and partner in helping you make the right decision for your family. (476)

drlane** This blog post was written to serve as suggestions for VBAC and should not be taken as concrete medical advice, nor do the views above reflect the views of Women’s Care of Colorado or the HealthONE organization. As with any medical questions or concerns, please make an appointment with your physician to discuss your own personal situation and treatment options.

Dr. Lara Lane has more than 15 years of experience as an OB/GYN physician and is the former chief resident in obstetrics and gynecology at Kaiser Permanente Medical Center in Santa Clara, Calif. As a member of the Women’s Care of Colorado team, Dr. Lane is primarily focused on childbirth and gynecological needs and is dedicated to helping women better manage their health. In partnership with Mile High Mamas.

Is Minimally Invasive Surgery the Right Choice for You?

Women have a lot of choices when it comes to their reproductive health. However, when faced with a condition that affects their reproductive system, it can sometimes be difficult to know the right choice to make.

As a specialist in minimally invasive gynecologic surgery, I frequently find myself counseling patients about the technical advancements that are available to treat their conditions. For many patients, these options, which include minimally invasive surgery, can provide better treatment experiences with better outcomes.

Robotic surgery is the most advanced type of minimally invasive surgery available today, and can be extremely effective in treating a variety of women’s health conditions.

Here are some of the benefits:

Just as the name implies, it’s less invasive.

Minimally invasive surgical procedures require smaller incisions, which mean faster recovery, less pain and a quicker return to normal activities.

Its outcomes are better.

Minimally invasive surgery offers great benefits. Robotic surgery is currently in its third generation and continues to achieve greater outcomes for patients. Additionally, it is a safe, technically advanced surgical option that has a small chance of complications.

It can be the best option to treat a variety of gynecologic conditions.

Conditions such as uterine fibroids, endometriosis and a variety of other ailments may require surgical intervention. In the case of treating uterine fibroids, hysterectomy (removal of the uterus) or myomectomy (surgical removal of fibroids from the uterus) may be the best option. When performed using robotic surgery, these procedures are less invasive and have excellent outcomes.

It’s one of the best ways to diagnose endometriosis.

Nearly 1 in 10 women of childbearing age have endometriosis, however, according to the Endometriosis Foundation of America, it can take an average of 10 years for women to be diagnosed with this condition. Because of this, underdiagnosis is extremely common. One of the best ways to definitively diagnose endometriosis is via robotic laparoscopic surgery; this procedure uses a camera to detect signs of endometriosis and enables quicker removal of endometriosis implants and scar tissue.

V.Dabelea.pMedical advances have allowed OB/GYN providers to offer safer, more effective alternatives to major surgery. As with any medical procedure, minimally invasive or major, it is always best to consult with a physician who has expertise in the care of a specific condition before seeking treatment. If you have any questions or concerns regarding minimally invasive robotic surgery as it relates to you or a loved one’s gynecologic care, your OB/GYN physician or specialist can provide further advice and guidance.

Victor Dabelea, MD, is a gynecologic surgeon at Consultants in Obstetrics and Gynecology, which has offices across the Denver metro area. He has been designated by the American Association of Gynecologic Laparoscopists (AAGL) as a Center of Excellence in minimally invasive gynecology. Dr. Dabelea attended medical school and completed his residency in general surgery at the University of Medicine and Pharmacy in Timisoara, Romania. He completed his residency in obstetrics and gynecology at St. Joseph Hospital in Denver. In partnership with Mile High Mamas.

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Q&A: Top reasons for a “C-Section”

Childbirth is physiology of the human body at its best. While the weeks are counted down, pregnancy books are perused and nursery items are assembled, when it comes time for the birth, labor and delivery do not always go as planned.

Dr. Shan Shan Jiang, an OBGYN specialist at Consultants in OB/GYN, sheds light on important elements of labor that are vital for keeping both mother and baby healthy and safe.

 Why should expecting mothers strive toward a vaginal birth when possible?

There are a number of potentially positive consequences from a vaginal birth, including:

  • Less risk of internal organ damage to the mother.
  • Breastfeeding may be more effective.
  • Mother is much less likely to require a C-section delivery in subsequent pregnancies.

What are the top medical indications for a C-section?

  • If you have had a prior C-section.
  • If you have had prior surgery on the uterus.
  • The baby is breech.
  • Signs of fetal distress.
  • Failure or lack of progression of labor.

What is “failure to progress?”

women-group-pregnantIn active labor, you can have an arrest of dilation. Once you start pushing, you can have arrest of descent.

When the cervix is 6 cm dilated, it is considered active labor. If you have strong and adequate contractions for four hours without a dilation change of your cervix, it is considered “arrest of dilation.”

When the cervix is 10 cm dilated, your provider will ask you to start pushing. If the baby hasn’t been delivered after four hours of pushing, it’s time to think about assisting the birth with birthing forceps or vacuum, versus C-section. This is considered “arrest of descent.”

A C-section is recommended in these situations to minimize health risks for mom and baby.

 If my cervix does not dilate on its own, what are some ways to help my labor progress toward a vaginal delivery?

Your provider may recommend breaking your water by starting oxytocin to help strengthen your contractions.

When my doctor or midwife asks for “internal monitors,” what does it mean?

There are two types of internal monitors. One is called an intrauterine pressure catheter (IUPC), which is a catheter placed between baby’s head and the uterine wall that measures the strength of contractions. This is used to prevent a C-section by making sure your contractions are strong enough to dilate your cervix.

The other is called a fetal scalp electrode. It is like placing an acupuncture needle on baby’s scalp during labor to better monitor baby’s heart rate. It is typically used when the baby needs to be repositioned to improve oxygenation to the baby.

Does getting an epidural increase my chance of needing a C-section?

Epidurals increase the average amount of time from start of labor to delivery but don’t significantly increase the risk for having a C-section.[1]

 If I had a C-section before, does it mean I will always need a C-section for my subsequent pregnancies?

No, a trial of labor after C-section (TOLAC) can be a very safe option for expecting moms who have had a previous C-section. In fact, you can consider a TOLAC even with two previous C-sections. Talk to your doctor or midwife for more details on the risks and benefits.

Combining her passion for the social sciences and expertise in obstetrics and gynecology, Dr. Jiang strives to provide highly personalized, comprehensive care to women of all ages. Dr. Jiang and the Consultants in OB/GYN team specialize in obstetric and gynecologic care. Call 303-322-2240 or visit www.consobgyn.com to make an appointment.

 [1] The College of Family Physicians of Canada. Does epidural analgesia increase rate of cesarean section? 10 April 2006. In partnership with Mile High Mamas

Permanent Sterilization for Birth Control: Exploring Your Options

Is your family complete and you are considering a permanent form of contraception? Depending on each patient’s preferences and individual case, one of two options for permanent sterilization is available: the Essure® Tubal Occlusion or laparoscopic tubal ligation surgery.

As I tell my patients at at Women’s Care of Colorado, both forms are viable means to achieving the same result.

Essure® Tubal Occlusion

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Essure Tubal Occlusion

Over the last 10 years, Essure Tubal Occlusion has grown in popularity thanks to its ease of performance through minimally invasive surgery outside the operating room. Women who choose Essure as an option for permanent sterilization are not anesthetized, only require a few medications for pain management during the procedure and are out of the office in about an hour.

With the assistance of a hysterscope, small coils are inserted into the fallopian tubes through the vagina. Once inserted, the body develops scar tissue over the coils, effectively blocking sperm from reaching the egg.

After three months, the patient will have an HSG, an x-ray dye test to determine if the scarring has completely blocked the fallopian tubes. Because the scarring takes time, addition birth control is still needed during these three months.

Many women prefer the Essure procedure over a laparoscopic tubal ligation because it can be performed in the office without general anesthesia and with no abdominal incisions. Some women complain of cramping (the medicine is designed to alleviate this), but are able to resume normal activity the following day.

After the procedure, placing anything in the vagina and sexual intercourse are strongly advised against for two weeks. 

Laparoscopic Tubal Ligation/ Removal

Performed by an OB/GYN physician in the operating room, a laparoscopic tubal ligation is an out patient surgery administered under general anesthesia. The surgery itself takes less than an hour, with two to three small incisions (about 1cm) made on the abdomen.

During the procedure, the physician will either completely remove the fallopian tubes or use what is called a Filshie® Clip to obstruct the tubes, preventing eggs from traveling from the ovaries to the uterus.

As is the case with any surgical intervention, a laparoscopic tubal ligation carries with it increased risk of complications and a more painful recovery time than the Essure procedure. After surgery, we advise limited activity for one-two week and no sexual intercourse for at least two weeks.

Even though surgery is slightly more risky than the Essure procedure, the fallopian tubes are completely blocked upon completion, and additional birth control is unnecessary as it is after the Essure Tubal Occlusion.

Choosing the Right Option

Both procedures have their own benefits, and choosing the right option for you and your family is your decision alone. As partners in your OB/GYN care, we are here to help you navigate through your options and decide on the right fit for your family.

womenscarecoloradoPermanent sterilization is a complex subject not only for mothers, but the entire family. I always advise thoughtful consideration when families come to my practice to start the conversation about sterilization as a permanent birth control solution.

While many sterilization options can be reversed, these two are permanent, and should not be pursued if you have any doubt about whether or not you will want another little one joining the family. No matter your decision, we are dedicated to helping you make the right choices for your family’s future.

leman Dr. Juliet Leman is a Colorado native who returned to the Mile High City after completing her residency in obstetrics and gynecology in Michigan. An OB/GYN physician at Women’s Care of Colorado, her areas of interest include obstetrics, gynecologic surgery and caring for women in all stages of life. Dr. Leman enjoys spending time outdoors with her family and friends and “tries” to enjoy running.

What Colorado Parents Need to Know About This New Youth Marijuana Education and Prevention Campaign

When retail marijuana became legal for adults 21+ in Colorado on January 1, 2014, Mile High Mamas had a huge surge in traffic. I didn’t make a connection until I realized the reason: people were finding out how to get stoned and thought our name Mile “High” Mamas was funny.

No matter where you stand on the issue, our kids + drugs = no laughing matter.

brainpotentialIn the state of Colorado, preventing and deterring youth use has never been more important. That’s why I feel so strongly about Good to Know, a new campaign from the Colorado Department of Public Health and Environment. It helps parents so we are prepared to have informed, open and honest conversations that will help our youth make healthy decisions.

I’ve assumed most people would be opposed to exposing our kids to this drug but I’ve been surprised by some of the feedback I’ve received that includes “Kids will be kids,” “It’s a rite of passage and everyone’s doing it” or “It’s OK because the tax money will go back to our schools.”

We know that the brain is still developing until age 25 and that marijuana, as well as other substances, impacts brain development. The most recent Healthy Kids Colorado Survey (HKCS) data indicates that in 2013, one in five high school and middle school students reported using marijuana in the last 30 days.

The bad: one in five students is using. The good: four out of five students are not so let’s hope that number has not risen since its legalization in 2014.

Talking to youth about marijuana can be challenging for many adults. With this in mind, the health department’s new resource portal, GoodtoKnowColorado.com/Talk, gives adults the information and resources they need to feel confident talking about marijuana with the young people in their lives. This tremendous resource includes information on the following:

  • Health Effects – Information about how underage marijuana use can impair learning and memory,   coordination, judgment and brain development.
  • Legal Consequences – Details on the legal consequences of underage marijuana use including potential loss of financial aid, job or driver’s license.  
  • Marijuana 101 – Information on common slang terms for marijuana, methods of consumption and   details on safe storage
  • Talking Tips for Parents and Youth-Serving Professionals – Age-specific recommendations on how to   talk to youth about marijuana.(Click to Enlarge)

Take Action

Please become a part of Good to Know’s important campaign that takes on the task of speaking to youth directly, empowering adults to inform and give our youth the tools they need to succeed. Our kids are smart and have promising futures so let’s give them all the tools they need to succeed!

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This post is Sponsored by Single Edition Media on behalf of the Colorado Department of Public Health & Environment. Opinions are our own.

 

My Breastfeeding Chronicles and How to Support NICU Moms

I was prepared for a lot of things when I became a mom. I had read practically every baby book published and my baby was more stylin’ than the Kardashians thanks to Grandma who’d been buying clothes for years in anticipation of her first grandchild. What I was not prepared for: Guantanamo Bay-level sleep deprivation and The Breastpump (in caps).

I’d planned to breastfeed my kids but hadn’t anticipated what a roller-coaster ride it would be. Despite countless lactation consultations in and out of the hospital, neither of my kids ever latched on and I was left feeling frustrated and defeated that I’d never have those tender moments of my child nuzzling up to me.

breastpumpEnter: The Breastpump (still in caps). While in the hospital, I was presented with Medela’s latest innovation in hospital-grade electric double pumps that remove as much milk as a breastfeeding baby. If you’ve ever overproduced milk, you know engorged breasts are detention-camp-level-torture (as you can tell, my transition to motherhood with my colicky daughter was not a smooth one).  

I took one look at the breastshields, valves, bottles, membrances, tubes and bottles and incredulously asked “You want me to do what with those?” Though overwhelming at first, pumping breast milk became a daily ritual. I rented a pump from the hospital but also bought a smaller electric Medela Breastpump that was more portable. 

I also supplemented my daughter with formula and one of my first lessons in motherhood is that there is no ideal. Ditch the guilt and do what feels right for you and your child.  

Medela Recycles: How to Donate

When both of my kiddos were ready to wean, I had no idea what to do with my pump and found myself attached to what had allowed me to provide sustenance to my babes for so many months. I didn’t have any friends who were nursing and I worried about donating it for sanitary reasons so in the end, it probably ended up in a landfill.

The good news? Thanks to the “Medela Recycles” program, you may now properly recycle your personal-use pumps while positively impacting another mom’s breastfeeding journey.  All pumps recycled through the Medela Recycles program will go toward a donation of hospital-grade Medela Symphony Preemie+™ Breastpumps and breastfeeding supplies to the Ronald McDonald House Charities (RMHC). The goal is to provide moms with the same high-quality equipment they use at the hospital during their stay at a Ronald McDonald House. The Symphony Preemie+ Breastpump help infants’ mothers establish a milk supply to provide their own breastmilk to their premature babies.

To kick off the campaign in Colorado, I was honored to tour the RMHC’s spacious 47-room facility in Aurora. This home-away-from-home for so many families whose children are being treated at the hospital is brimming with beautiful, touching artwork, zerbras, dinosaurs, a trainset, a playhouse, Broncos-themed room for teens and a play area for younger kids. Add a computer room, library, kitchen, family rooms and “a store” where they can checkout games and videos for free and it’s tough not to get choked up over this facility that is 100 percent powered by donations and love.  

Volunteer Diane gave us the tour and when I asked how she became involved, she confided, “Not to sound weird or anything but I felt like I was called to be at the Ronald McDonald House. I passed by it on my way to work every day and knew this is where I needed to be.”
Laura Hatch Photography
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Some families stay for only a couple of nights. Others are there for months on end.  I was even more committed to help spread the word about Medela Recyels when I learned that nearly nearly 40 percent of the families served by RMHC are caring for babies in the NICU. By making Symphony pumps available at Ronald McDonald Houses, mothers have the ability to pump while resting to restore the energy needed to focus on their baby in the NICU and give families caring for a baby in the NICU one less thing to worry about.Laura Hatch Photography
Following Medela’s presentation of hospital-grade Medela Symphony Preemie+™ Breastpumps and breastfeeding supplies, a mom of five approached us. “I’m pregnant with my sixth baby and I have to tell you how much this donation means to me,” she shared. “I had a difficult time and couldn’t breastfeed because it was too painful. I was relieved to have access to Medela’s breastpumps. For my last baby, I pumped for six months and was able to feed her with my milk for 12 months. I’m so grateful.”

Medela hopes to recycle 12,000 Medela breastpumps through this initiative that also reduces solid waste and helps protect the environment.  Moms that are ready to part with their pump can visit the Medela website where they can print out a pre-paid shipping label to send their pump to Medela. Medela will  then send all eligible breastpumps to a third-party processing center where they will be broken down and all recyclable parts will be recycled appropriately. To help Medela reach its goal, please visit www.medelarecycles.com and help spread the word! 

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Breastfeeding Moms in the News

 Maybe it’s just me but breastfeeding moms seem to be everywhere in the media this week! Who’s the Boss star Alyssa Milano responded to her haters in a new interview and said she has zero regrets about sharing this breastfeeding photo on social media with these sweet sentiments to her newborn daughter, “Happy Birthday, my beautiful Elizabella. You’ve taught me that my heart has no end. You were the missing piece to my soul. Thank you for choosing me.”

This picture has gone viral of a group of active duty Army soldiers at Fort Bliss in El Paso posing for a photo while breastfeeding their babies in uniform.

Tara Ruby Photography

Tara Ruby Photography

The Texas-sized response to this beautiful photograph is a reminder we’re all in this together.

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RMHC photos: Laura Hatch Photography. In partnership with Medela Inc. All opinions are our own.

When Childhood Cancer Hits Close to Home: Our Friend Stefan’s Journey

There are very few families that go unscathed from cancer’s ravages. When my husband was in his late-20s, he was diagnosed and underwent chemotherapy for Hodgkin Lymphoma. Since that time, we’ve had grandparents, uncles and aunts battle cancer but never have we had a childhood friend diagnosed…until now.

Did you know that childhood cancer is the number one disease killer of children under the age of 15 in the United States?  September is Childhood Cancer Awareness Month and 15,780 children under the age of 21 are diagnosed with cancer every year, a diagnosis that turns the lives of the entire family upside down. 

My 9-year-old son’s friend Stefan returned to school like any other fourth grader. He’d had a summer crammed with travels, adventures and camps with his twin brother, Ian. Their mom Cindy had just purchased a new home and they had recently moved in. They were living a fun-loving and enviable life…until every parent’s worst nightmare happened: Stefan was diagnosed with Burkitt’s Lymphoma.

I have been inspired by this wonderful family’s positive attitude. Cindy started a private Facebook group for friends and family to follow Stefan’s journey and with her permission, I am sharing part of their experience. 

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Our thoughts and prayers are with Stefan and his family.  The objective of Childhood Cancer Awareness Month is to put a spotlight on the types of cancer that largely affect children, survivorship issues, and – importantly – to help raise funds for research and family support. Go to the American Childhood Cancer Organization for more information on how you can help.

 

25 questions to ask your kids after school

It never fails. After a long day at school when I ask my kids “How was your day?” They always answer “fine.” End of conversation.

So, I’ve stopped asking “yes” and “no” questions and instead ask them to expound upon open-ended queries. In the very least, I get a complete sentence as a response and at best, I get some pretty colorful answers that give a glimpse at how my kids’ day at school really went–the good and the bad!

1. What was the best part of your day?

2. What games did you place at recess and with whom?

3. Who did you sit with on the bus?

4. What did you or your teacher read in class?

5. Tell me something that made you laugh.

6. What was something that was hard or boring?

7. Who would you like to sit by in class and who would you not like to be beside and why?

8. Tell me something new you learned today?

9. Who is someone funny in your class and why are they funny?

10. How did you help someone or did someone help you?

11. Is there anyone in the class who needs a timeout?

12. Can you think of anything you did today that would make your teacher proud to have you in their class, or that would have made us proud of you?

13. What was your favorite time of day today?

14. What’s the biggest difference between last year’s teacher and this year’s teacher?

15. There are some new kids in your class. What are their names and what are they like?

16. What subject do you feel you are doing the best in, and which subject are you struggling in the most?

17. Do you have any homework? What can I help you with?

18. We used to have a mean boy in my class when I was your age. I still remember what a bully he was. Do you have anyone like that in your class?

19. What are you doing in class tomorrow? 

20. Who in your class do you think you could be nicer to and needs to be included?

If you suspect your child is struggling to fit in or is experiencing bullying, focus on questions that deal with less structured times like lunch and recess. Most importantly, be intentional and engaged when they arrive home. Smile, make eye contact and show you really do care about the details of their day.

What are some questions you’d add to this list?