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Chapter 30 / Complete chapter

Raising School-Age Kids

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Chapter 30 editorial cartoon: A schoolbag holds more than exams. Enlarge illustration
A schoolbag holds more than exams.

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Editorial cartoon · Chapter 30A schoolbag holds more than exams.

Original illustration with Chinese lettering; the English dialogue is below. Humour is a reading aid, not evidence.

English dialogue
  • Can it wait until after the exam?
  • Listen to the child first.

Child reports sudden, worsening pain — rush to the hospital right away; don’t let him wait until after school.

Some medical conditions are time‑critical — the outcome depends on how many hours pass from symptom onset. When a boy suddenly feels severe pain on on…

Cost
No cost at all. Just take a half‑day off work and take your child to the emergency departm…
Benefit
Researchers compiled data from 30 case series and 2,116 patients with testicular torsion. …

Don’t delay necessary treatment just to “wait until exams are over”; certain treatment windows depend on bone growth, not exam schedules.

Scoliosis is a sideways curvature of the spine. A brace is a rigid shell worn on the back that helps keep the spine straight. When worn while bones ar…

Cost
No monetary cost involved. This point concerns whether to start treatment early or late, n…
Benefit
A multi‑center trial enrolled 242 adolescents with idiopathic scoliosis who met brace‑wear…

When a child is bullied, report it to school the same day and request a written response; for physical assault, theft, or rumor spreading, call the police immediately.

Children who experience peer bullying are roughly 2.2 times more likely to have suicidal thoughts than those who are not bullied, and about 2.6 times …

Cost
There is no cost involved. Speak to the homeroom teacher and the school’s anti-bullying co…
Benefit
This conclusion is based on 34 studies involving 284,375 children and teens. Peer bullying…

Ensuring that children spend at least 2 hours outdoors each day is currently the only myopia‑prevention method backed by randomized trials.

A randomized trial was conducted at 12 primary schools in Guangzhou: first‑grade students were given an extra 40 minutes of outdoor activity per schoo…

Cost
There is no monetary cost. However, it requires setting aside time each day — often at the…
Benefit
In this trial, first‑grade students from 12 Guangzhou schools were randomly assigned to in…

No screen time for children aged 0–3; limit it as much as possible for ages 3–6; for school‑age kids, non‑educational screen use should not exceed one hour per day.

The Health Commission has set strict guidelines: no screens for children aged 0–3, and they should be kept away from screens as much as possible for a…

Cost
There is no monetary cost. The real challenge is keeping screens out of children’s hands a…
Benefit
Article 4 of the “Ten Core Principles for Preventing Myopia in Children and Adolescents” s…

Treating myopia as a lasting injury: the higher the prescription, the greater the future risk of retinal detachment, macular degeneration, and glaucoma

Myopia does not go away on its own, nor does the prescription level decrease. It is far more than simply “wearing glasses.” Compared to people without…

Cost
No cost involved. There is nothing specific to do here; the necessary actions are outlined…
Benefit
A systematic review and meta-analysis compiled studies published up to June 2019, grouping…

Conducting a depression screening for kids aged 12 to 18 — don’t rely on school mental health assessments as a diagnosis

The U.S. Preventive Services Task Force recommends screening adolescents aged 12 to 18 for major depressive disorder, noting that the overall benefits…

Cost
Costs range from zero to just a few dozen yuan; this covers filling out a screening questi…
Benefit
In 2022, the U.S. Preventive Services Task Force issued a recommendation statement advisin…

Do not buy products or services claiming to “cure myopia” or “reduce refractive error”

The State Administration for Market Regulation explicitly states that “under current medical technology, myopia cannot be cured.” Phrases such as “rec…

Cost
There is no cost involved; in fact, you save this money by avoiding such purchases.
Benefit
A notice issued by the General Office of the State Administration for Market Regulation be…

Clear rules exist for sleep, homework, sports, and rankings; if schools fail to comply, parents can raise the issue

These rules are all laid out in writing: elementary students must get 10 hours of sleep per day, junior high students 9 hours, and high school student…

Cost
No cost involved. All you need is to know these rules so you can bring them up with the sc…
Benefit
The Notice on Further Strengthening Sleep Management for Primary and Secondary School Stud…

Parents can request a temporary leave of absence for their child; the school must retain the child’s enrollment status for up to one year.

A temporary leave of absence is a fully established procedure. Parents or legal guardians submit a request, which the school then approves and forward…

Cost
No cost involved. Parents or other legal guardians must submit a formal request to the sch…
Benefit
Article 16 of the “Administrative Measures for Student Enrollment Records of Primary and S…

If poor vision is detected, go to the hospital for cycloplegic refraction and follow up at the recommended intervals as advised by the doctor.

Cycloplegic refraction involves using special eye drops that relax the eye’s focusing muscles, allowing an accurate measurement of refractive errors. …

Cost
The examination and glasses fitting typically cost several tens to several hundred yuan. A…
Benefit
The “Ten Core Principles for Preventing and Controlling Myopia in Children and Adolescents…

Pit and fissure sealants applied after permanent molars emerge

Pit and fissure sealants involve filling the grooves on the chewing surfaces of molars with a special resin so food particles can’t get trapped there.…

Cost
Each application costs just a few dozen to a couple of hundred yuan — specifically, betwee…
Benefit
This conclusion comes from 38 separate trials involving 7,924 children aged 5–16, all sele…

If a child loves playing games, first check whether sleep, homework, and outdoor activities are being crowded out — don’t just focus on how long they play.

Only about two or three out of every hundred kids truly meet the criteria for “gaming disorder.” If surveys use very low thresholds and target only te…

Cost
No cost at all. Simply keep an eye each week on what time your child goes to bed, whether …
Benefit
One meta-analysis combined results from 53 studies conducted in 17 countries, involving 22…

If a child says they’re attracted to the same sex, don’t scold them, don’t kick them out, and don’t send them for “conversion therapy”: how your family reacts can affect whether they attempt suicide.

Among Chinese middle‑school students, those who are attracted only to the opposite sex are far less likely to attempt suicide than peers who are attra…

Cost
There is no financial cost. The real challenge is for parents to manage their own emotions…
Benefit
A nationwide survey of 150,822 students from grades 7‑12 in 506 schools across seven provi…

Do not hit your child, and do not yell or call them stupid: children who are often hit or verbally abused show more behavior and emotional problems

Children who are often physically punished show more aggression and psychological problems, feel more distant from parents, and receive harsher beatin…

Cost
No money. The hard part is stopping your hands and mouth in the heat of the moment and swi…
Benefit
For physical punishment, one meta-analysis counted only open-hand spanking of the buttocks…

If parenting feels out of control and you keep hitting or yelling, take a class that teaches concrete parenting skills

Parenting programs that teach specific techniques reduce children’s hitting and rule-breaking in randomized trials, and parents’ mood improves. Parent…

Cost
Parent schools run by schools, kindergartens, and communities are public and free. Evidenc…
Benefit
Cochrane pooled 13 trials, 10 randomized, 1,078 parents of children aged 3–12 with behavio…

Never enroll your child in enclosed "internet addiction bootcamps" or "special disciplinary academies": Statutory law prohibits methods that harm physical or psychological health, and multiple children have died in confinement

The law explicitly prohibits any intervention for minor internet addiction that infringes upon a child's physical or mental health. In Hefei, an unreg…

Cost
Zero financial cost—and saves substantial tuition fees. The real friction is psychological…
Benefit
Article 68 of the Law on the Protection of Minors strictly provides: "No organization or i…

Teach children to identify private body parts, instruct them to report any inappropriate touch or secrecy demands, and believe without blaming if they disclose

Educational programs teaching children personal safety significantly increase protective self-defense behaviors in simulated stranger-lure evaluations…

Cost
Free. Involves brief conversational explanations during everyday routines such as bathing …
Benefit
A 2015 Cochrane systematic review of 24 school-based education trials (5,802 students aged…

Do not allow children under 12 years old to ride bicycles on public roads, or under 16 to ride electric bicycles: parents bear civil liability for damages and contributory fault in collisions

Chinese traffic regulations mandate that riders must be at least 12 years old to operate bicycles on public roads, and at least 16 years old to operat…

Cost
Free; requires arranging alternative school commutes (public transit, walking, or parental…
Benefit
Article 72 of the Regulations for the Implementation of the Road Traffic Safety Law specif…

If a child sustains a head impact during sports followed by headache, dizziness, or confusion, remove them from play for the rest of the day; seek emergency medical care for repeated vomiting, progressive drowsiness, or worsening headache

Young athletes who continue playing after a concussion take on average 44 days to recover, compared to just 22 days for those removed from play immedi…

Cost
Free. Involves removing the child from training or athletic competition for the remainder …
Benefit
A clinical study tracking 69 adolescent athletes (mean age 15) with sports-related concuss…