Kids health

Why aren't all the provinces keeping kids safe with rapid testing and masking?

As we wait for vaccines to be approved, some provinces are falling short in protecting kids from COVID.

“How are the kids doing?” is a question whose answer depends on where one lives. In British Columbia, before classrooms reopened, the rate of infection for those under 10 years of age stayed below that of older residents, though all rates were rising, according to the BC COVID-19 Modelling Group. The panel warned that children under 12 not yet eligible for inoculation make up nearly half of the unvaccinated population in the province, making them a large risk group, especially as they have high numbers of contacts.

On Sept. 8, the day after school began, the under-10 rate of new cases per 100,000 population exploded in a sharp upward trajectory while the rate for those 10-and-older stayed pretty much flat. By the end of the month, the rate of COVID-19 among unvaccinated children was more than double that of older residents.

In neighbouring Alberta, data was harder to obtain as the province restarted reporting data on COVID in the classroom just before Thanksgiving. By then, 54 schools reported outbreaks (10 or more cases) and a total of 756 of the 2,400 schools in the province had at least two cases. The situation also isn’t good in New Brunswick, which reintroduced masks in schools by mid-September and where rising case counts forced more than a dozen schools to shift to online learning a week ago.

The number of students contracting COVID-19 in Alberta, B.C. and other hotspots highlights a pressing worry for both parents and decision-makers: children are now the largest unvaccinated group, vulnerable to a variant that has proved highly efficient at finding pockets of unprotected victims—especially those who are in congregate settings like schools for hours each day.

Are governments doing enough to mitigate the risks during the third school year affected by this pandemic? And how close are we to vaccinating our children? 

Ontario, whose education system was pummelled by COVID-19 earlier in the pandemic that students spent much of their school year online, has largely avoided the problems plaguing the West. Its number of daily new cases in schools has been essentially flat since the school year started, with 16 per cent of schools reporting at least one case. One key difference may be mask mandates, especially for unvaccinated children. Well before school began, Ontario announced that face coverings would be worn by everyone from Grades 1 to 12. In contrast, it took until Oct. 1 for B.C.’s provincial health officer, Dr. Bonnie Henry, to extend the province’s mask mandate to students in kindergarten to Grade 4.

“There are a list of options on the table for how to mitigate transmission in schools and some of those options haven’t been pursued to the extent that they could be,” says Dr. Devon McDonald, an ICU physician in Lindsay, Ont. He singles out the Toronto public school system, which enacted stricter public-health protocols than those mandated by the province, including requiring students to remain within their cohorts, even during lunch, and masks for even kindergarteners.

McDonald also wonders if another reason could be Toronto’s investment in HEPA filters, which are operating in many of its classrooms. As of Tuesday, the vast public school system had reported only two schools out of 583 with more than 10 cases, with one closure.

Another tool being rolled out in more and more provinces: rapid testing for students. In September, Quebec began having schools in hot spots administer rapid tests to kids who display symptoms; the system went provincewide this week. In an effort to keep schools open, New Brunswick began distributing rapid tests on Tuesday to students who are deemed close contacts to someone who has COVID-19. As of now, one quarter of the province’s schools have COVID-19 cases, CBC News reports.

Ontario has gone a different route. On Oct. 5, it announced that it would provide rapid tests only to public health units experiencing a high risk of transmission so they could test asymptomatic children.

McDonald is a proponent of rapid testing on a much larger scale, pointing out it is almost ubiquitous in the United Kingdom, where households are given free tests, as well as in Europe and Asia. He did rough math on what could happen if Ontario tested all students, using a popular rapid test’s own error rates. He determined that the province could expect to find and remove 4,156 infectious students from the classroom while the tests would miss 144 infectious students, though the vast majority, 988,730, would be correctly identified as negative.

At the same time, his basic calculations found that 6,970 students would receive false positive results, though he believes that rough analysis could be high. Those students would be away from classrooms for a day or two until more precise PCR tests came back negative. “I think we would find we would be better off accepting some school absences due to false positives,” he says, “rather than the current situation, where we have entire schools closed because of COVID-19 outbreaks and classrooms transitioned to online learning.”

And for students, teachers and parents, hope is building that those ages 5 to 11 will soon be eligible for COVID-19 vaccines. This week, Pfizer is expected to seek approval from Health Canada, while Procurement Minister Anita Anand tweeted that the federal purchase agreement with Pfizer “allows for access to pediatric doses upon the receipt of regulatory approval” and that they intend to make doses available as soon as possible. B.C. is already prepping for that day. Over the holiday weekend, it openedits COVID-19 vaccine registration system to kids 5-11, so they can be notified as soon as appointments are available.

Vaccinating children could dramatically help Canada reach its goal of getting more than 90 per cent of the population protected against COVID-19. Trevor Tombe, an economics professor at the University of Calgary who has been crunching vaccine data, told Maclean’s that there are 2,885,026 individuals aged 5-11, as of 2020. Assuming children got vaccinated at the same rate as the 12-17 age group (85 per cent have at least one dose and 76 per cent with both doses, according to his estimates), that would add more than six percentage points to our national tally, which currently sits at 77.1 per cent with one dose, and 71.3 per cent fully vaccinated.

As well, anecdotes and social media posts suggest many children and their parents are eager to get them vaccinated as soon as possible. One nine-year-old girl informed this reporter of exactly what she’s going to wear when she gets her first dose (for the record, there will be lots of pink). She’s still thinking about style options for her second shot.

Kids health

If you're freaked about long COVID in kids, here are the facts

Long COVID in children isn’t common—but can be debilitating for those it affects.

When now 13 year-old Manuel Firkus first got sick with COVID-19 in March of 2020, his only symptoms were constant burping and about three days of diarrhea. In fact, his family, who lived in B.C. at the time, would have thought nothing of his brief illness if it weren’t for his sister’s high fever and cough, his mom’s horrible wet cough and the fact that the World Health Organization had just called COVID-19 a global pandemic. 

His mom, Jaymie’s, symptoms persisted—she was unable to return to work due to fatigue, a racing heart, low blood pressure, brain fog, loss of taste and smell and a host of other symptoms that terrified her. But Manuel’s symptoms went away completely—until a sunny day in May, when he suddenly collapsed while mowing the lawn. “His legs were too weak and we had to carry him into the house,” recalls his mother, who now lives in Alberta. That night he experienced chest pain and strange heat sensations throughout his chest and torso, which he described as his insides “sparking up” with the heat. His mom says that over the next week he started vomiting, got severe headaches and dizziness and his toes turned purple and sore. They took him to the hospital but didn’t get any answers. “There was a lot of confusion and different opinions about what was occurring,” recalls Jaymie. No one in the family had been tested for COVID-19—at the time of their first symptoms, testing was sparse and Manuel wouldn’t have qualified anyway—but they were working under the assumption it had gone through their family. Doctors agreed COVID could have been at the root of Manuel’s symptoms but said there was nothing they could do. He was sent home to recover on his own.

When COVID-19 first started circling the globe, parents were reassured by reports that kids mainly get mild cases of the disease—a fact that remains true, although we now know some do have more severe illness. What’s also become clear, however, is that a small subset of kids will go on to suffer debilitating symptoms that can last for months. According to Danilo Buonsenso, a paediatrician at the Gemelli University Hospital in Rome, who has published several papers on long COVID in children, one to four percent of kids who get COVID could have symptoms that last longer than six months. Susie Goulding, the director of the support group Long Covid Kids Canada, says more than 200 families across Canada have reached out to her group for support since the pandemic began, and the number is growing. While the overall risk of a child getting long COVID still appears low, experts say more awareness of the condition is needed so those suffering can get the help they need. 

Symptoms of long COVID in kids

So far, it seems that most children who develop long COVID have initial infections, like Manuel, that are mild. According to two studies published by Buonsenso, over 95 percent of children who have persisting symptoms were not hospitalized. About three quarters of those initially infected had mild to moderate symptoms like fever, sore throat, cough or shortness of breath that could be managed at home and, depending on the study,  twelve to twenty-five percent were asymptomatic. Although we don’t have a lot of data in Canada so far, these trends appear consistent here. According to Thanh Diem Nguyen, a paediatric respirologist at the Post-COVID-19 Clinic at Ste Justine hospital in Montreal, all of the children seen so far at the clinic had mild initial infections. Of the 22 children that attend the clinic, most had flu-like symptoms like a wet cough, headaches, shortness of breath or fever.  

Some long-haul kids continue to have symptoms from the time they first get infected. Other kids seem to get better but within several weeks a wide range of physical or neurological symptoms set in. According to information reported by members of Long Covid Kids Canada, the symptoms among Canadian children run the gamut from fatigue, headache, sore throat, diarrhea, reflux, nausea and vomiting, joint and muscle pain, brain fog or dizziness, rashes, mood changes and chest pain. Other symptoms reported include fevers, shortness of breath, feeling illness or discomfort after exertion, weight loss, abnormal heartbeats, seizures, hair loss, testicular pain, phantom bruising, hallucinations, intracranial hypertension, bladder inflammation, temperature dysregulation, sore or bleeding gums, mouth blisters or canker sores, and changes in vision. “The symptoms can ebb and flow in what seems like a never-ending cycle,” says Goulding, who has spoken with many of the families. “Old symptoms may come back, and you never know what symptoms you may have on any given day.  Some children can even experience 40 to 50 symptoms.”

Kids at the Post-COVID-19 clinic in Montreal have many of these same symptoms, but the most common one there is fatigue. Other symptoms like dizziness and heart palpitations are common enough that one designated cardiologist and one ENT (ear-nose-throat) specialist are available for fast-track consultations. Less common symptoms seen there have been memory retention problems, loss of smell, or not being able to smell properly.

Does long COVID go away?

The good news is, most kids recover from long COVID within three to five months, says Buonsenso. However, some continue to experience symptoms for much longer. Nguyen has treated children with symptoms lasting 18 months but this isn’t common. 

Although it’s unknown whether those with persisting symptoms will eventually get better, both Buonsenso and Nguyen are cautiously optimistic. Buonsenso believes that large public interest in COVID will lead to more research and a better understanding of long COVID, including treatments. He also says that preliminary evidence suggests that inflammation or viral persistence could be causing lingering symptoms in most children. Kids’ progress in the Montreal clinic seems to confirm that permanent lung damage is unlikely. “So far our tests show that all of our patients have normal lung function, even though they have a decreased capacity for exercise.  We’re not sure why just yet,” says Nguyen. “Most of the kids are getting better with time, but it’s much slower than with the flu or other viruses.  However, even though they’re getting better, they’re still not reaching their condition before COVID.  I believe that it will eventually go away, but it’s hard to tell. It may take several months to years.” 

There isn’t enough data yet to know whether vaccination may improve long COVID symptoms in kids, or if it may help prevent them from getting long COVID if they become infected, although Buonsenso says it’s reasonable to believe that vaccinated kids will have a very low risk of long COVID.

Who’s at risk for long COVID?

The biggest risk factor in developing long COVID is probably age. According to Buonsenso, adolescents are at a higher risk than younger children, and the Post-COVID-19 clinic in Montreal has mostly seen kids 12 years old and older. However, any child can be affected. “We have an even mix across all ages,” says Goulding, of the long COVID kids support group.  “The youngest is only 13 months old.”

It’s less clear whether other factors can increase the risk of a child developing long COVID. In the Montreal clinic, 64 percent of the patients are girls, but there are no other clear risk factors. One UK study found that asthma, eczema and allergies were the most common pre-existing conditions. However, most of the kids in published studies, the clinic, and the Long Covid Kids Canada group were healthy, active and had no known risks before getting long Covid.

What’s the impact of long COVID on kids?

While so far, it appears that the statistical chance of your child getting long COVID is low, if your kid does get long COVID, it can have a big impact on their lives. A few of Nguyen’s patients are failing their classes because of memory retention problems. Others can’t do physical education and need to be removed from the class. According to Goulding, members of the Long Covid Kids Canada group are reporting similar problems. Some of the kids are having trouble paying attention or concentrating in class while others need to take virtual classes and take five-hour naps during the day. “Some children are bedridden and can’t attend school at all. Grades definitely slip and so does mental health,” she says. “Kids have to stay in while their friends are out playing outside. They can’t participate and do the things that they could before.” 

Getting support for long COVID can be difficult. “It can be hard to find providers in small communities outside of big cities, and provinces with low caseloads may not have knowledgeable providers,” says Goulding, speaking of several group members’ experiences. “Long Covid is so new and the issues these children are having often don’t show up on any diagnostic imaging. The families are often not believed.”  Also, many symptoms can easily be attributed to something else. “Most (kids) are told that this is psychological and no investigations are offered nor treatment,” says Buonsenso. One 15-year-old girl in the Long Covid Kids Canada group who suffered from phantom bruising experienced this firsthand. She went to three different medical professionals, who all said that she was self-harming. 

For Manuel, the fatigue, chest pains, and dizziness occurred on and off for about six months.  “It was a frightening and lonely time,” recalls his mother, who eventually got antibody testing for her family that indeed showed they had been previously infected with COVID. “There were frequent naps, almost like when the kids were toddlers.” Manuel’s symptoms got worse after running around and he couldn’t attend school for a while. After about six months, his symptoms finally started to subside—although mom’s are ongoing. “He does seem to be better now,” says Jaymie, noting that it took until March 2021 for his purple toes to clear up. “This year will be his first time back at school since getting ill. He hasn’t quite gotten back to team sports, but hopefully will soon.”  Though he has improved physically, his experience with long Covid has left an emotional toll.  “He still doesn’t want to go into stores or visit with a lot of people. He’s scared to get the virus again and bring it into the home.”

What should families do to protect their kids?

Though long Covid is concerning, there’s no need to panic, says Buonsenso. “Parents should not be worried since most kids recover, but should try their best to minimize risk of contracting COVID through vaccinations, hand washing and masks.” Still, it’s important to be aware of. “People only see the accessible data like hospitalizations,” says Nguyen. “They are less aware of the impact of long COVID.” 

With files from Emily Latimer

Kids health

Kids still can’t see optometrists in Ontario and it’s becoming a problem

If you're thinking it might be time to book your kid's annual eye exam, think again. Job action by Ontario's optometrists means children can't get an appointment.

Is your kid due for their annual eye exam soon? If you have an appointment booked and you live in Ontario, you should expect a cancellation call any day now.

Since the beginning of September, Ontario optometrists haven’t been seeing any patients who are covered under OHIP—and that includes kids. Children in the province can’t currently have their eyes examined by an optometrist, and there’s no telling when that will change.

Here’s what you need to know about the optometrist situation in Ontario.

Why aren’t optometrists seeing kids right now?

Earlier this year, Ontario’s eye care professionals warned that they intended to withdraw their services for any patients who are covered by Ontario’s health insurance plan (OHIP), which includes kids under 19 (and also adults over 65). They say OHIP doesn’t pay them enough to cover their expenses.

According to the Ontario Association of Optometrists (OAO), optometrists in Canada’s most populous province are the lowest compensated in the country. They’re reimbursed $47 per exam; as a comparison, in Alberta, that number jumps to $137.

Ontario’s optometrists are asking for more money, and so far, the Ford government hasn’t been willing to meet their demands, so they took job action beginning September 1.

According to Claudia Lee, an optometrist in Whitby, Ont. and a member of the board of the OAO, a vote of the association’s members resulted in 96% agreeing to withdraw their services until their compensation is increased.

What should parents do if their child wakes up with eye pain, vision problems or some other eye emergency?

Call your optometrist, says Lee. “We’re still taking those calls, and we encourage them to contact us if there is an emergency.” The doctor won’t be able to see you, but they can advise you on where to go. Your options are your child’s regular healthcare provider, or, for urgent matters, the emergency department.

Unfortunately, some GPs and paediatricians aren’t doing in-person visits. What’s more, most lack the equipment to do a proper eye assessment, says Lee. What they can do is refer your child to an ophthalmologist. (Click here if you want to know the differences between optometrists, ophthalmologists and opticians.)

What if a parent thinks their kid needs glasses? 

If your child is having trouble seeing the teacher’s chalkboard or says words look blurry in books, your child may need glasses. This is where optometrists shine, but unfortunately, the job action means they can’t help right now. “In this situation, they’d be referred to their GP to get a referral to an ophthalmologist, or they would be put on a wait list for when the job action is over,” says Lee.

What if a parent is willing to pay out of pocket?

It’s illegal. Provincial law prevents anyone from paying for any OHIP-insured service, even if you have alternate insurance or wish to pay independently for insurance. If an optometrist accepted direct payment for an OHIP-covered service, they too would be breaking the law.

Is there any end to the job action in sight?

The matter has the attention of health minister Christine Elliott, who has so far offered a one-time payment of $39 million for retroactive costs, plus an increase of 8.48 percent in reimbursement. OAO president Sheldon Salaba spoke out against the payment offer in a news release, saying that his members would prefer the government keep the money and instead “commit to working out a deal where we will no longer receive the lowest compensation for an eye exam in all of Canada.”

The province and the doctors will surely come to an agreement eventually, but even then, kids will have to wait a while to see their optometrist, thanks to an inevitable backlog. “It’s going to take months and months for us to catch up,” says Lee.

Kids health

The COVID vaccine for kids 5 to 11 years: What parents need to know

If you have a school-aged child, it's almost their turn for a COVID-19 vaccination, and you may have questions. Here are the answers.

UPDATE: On October 7, 2021, Pfizer confirmed that it is working with Health Canada on the final steps before it makes a formal request for its COVID vaccine to be authorized for use on kids ages 5 to 11, which it expects to do in mid-October. This comes after an announcement on October 2 that the vaccine manufacturer had submitted its paediatric study results to Health Canada.

When the COVID-19 vaccine became available to teenagers in Canada back in May of 2021, many parents rejoiced. After all, being vaccinated is highly protective against the nasty virus, which has now taken the lives of more than 27,000 people in Canada, and infected more than 1.5 million of us. Widespread use of the vaccine is also a key element of the larger plan to end the pandemic.

But now that it’s almost time for younger kids the get the COVID-19 vaccine, parents have questions. Here are some answers.

What do we know about the safety and effectiveness of the vaccine in kids aged 5 to 11?

At the moment, only one vaccine manufacturer, Pfizer, has discussed the results of its studies on how the vaccine works in school-aged kids.

In a press release published in September 2021, the company said that its trials showed the vaccine had a “favorable safety profile” and “robust neutralizing antibody responses” in children aged five to 11. Put simply, it was found to be highly safe and effective in that it created the necessary antibodies, just as it does in adolescents and adults. It was also well-tolerated as far as side effects—no new side effects were identified. Such good news!

Will kids need one vaccination or two? 

Parents of needle-phobic little ones will inevitably be wondering if their child will need one shot or two. Kids are small and light, so do they really need two doses?

Pfizer said that in its study, which was conducted on 2,250 kids aged five to 11 years, kids received two needles administered three weeks apart. It’s worth noting that the dose given was a third of what teens and adults received—10 micrograms per shot as opposed to 30 micrograms.

It remains to be seen if other vaccine manufacturers are developing shots that can be administered in just one dose.

Why is the dosing based on age, not weight? What if my child is heavy for their age?

With most medications, weight plays a big role in dosage. But that’s not the case for vaccine doses. “This is because your immune response is not weight dependent,” explains Sabina Vohra-Miller, the Toronto-based founder of Unambiguous Science, a platform that aims to make science accessible to Canadians. Instead, researchers look for a dose that creates a strong immune response in that age group while minimizing side effects.

When can we expect the vaccine roll-out for kids in Canada to begin?

While some experts, including B.C. provincial health officer Bonnie Henry, are predicting the vaccine could be available for five- to 12-year olds by the end of October, it really depends on how quickly the next few steps can happen.

Pfizer must first formally submit the results of its trials to government regulators, which it says it will do shortly, although it hasn’t given a specific date. “We are pleased to be able to submit data to regulatory authorities for this group of school-aged children before the start of the winter season,” says Ugur Sahin, CEO and co-founder of BioNTech, which partnered with Pfizer to create the groundbreaking vaccine.

Once the data is in the hands of Health Canada, it could be mere weeks or several months before it is approved and the roll-out begins. Previously, Health Canada moved quite swiftly to authorize the use of the vaccine in teenagers after receiving clinical study data.

What are the vaccine’s side effects in children?

Pfizer reports that in the study, the vaccine’s side effects in kids were similar to the side effects seen in teens and adults.

According to the World Health Organization, reported side effects to COVID-19 vaccines have mostly been mild to moderate and short-lasting. They include fever, fatigue, headache, muscle pain, chills, diarrhea and pain at the injection site. More serious or long-lasting side effects to vaccines are possible—but extremely rare.

You may have read about myocarditis (inflammation of the heart muscle), and pericarditis (inflammation of the outer lining of the heart) occurring after an mRNA COVID19 vaccination. In Canada, there have been “a small number” of these reports, according to a report from SickKids hospital in Toronto. As of September 11, 2021, there have been 369 reports of myocarditis or pericarditis after the COVID-19 mRNA vaccines in Ontario, out of the more than 21 million doses received. The symptoms of these conditions include chest pain, shortness of breath and feelings of having a fast-beating, fluttering, or pounding heart, and are more likely to occur after the second dose. Adolescents who developed myocarditis or pericarditis after their vaccine generally experienced mild illness, responded well to conservative treatment and rest, and their symptoms improved quickly, says SickKids.

It’s not clear yet whether any of the kids in the trial experienced myocarditis after the shot. However, Stephen Freedman, professor in the department of paediatrics at the Cumming School of Medicine at the University of Calgary, told the Globe and Mail that kids infected with COVID-19 have a much greater chance of experiencing severe illness, hospitalization or other severe outcomes compared to those with vaccine-induced heart inflammation and that vaccine-induced heart inflammation seem to be much milder than those that occur as the result of a viral infection.

Do kids truly need the vaccine?

Since early in the pandemic, parents have been assured that when kids contract COVID-19, it’s almost always a mild illness, and that serious illness and death are extraordinarily rare. This led many parents to believe that vaccinating kids against the virus was unnecessary.

But according to Health Canada, although kids are less likely than older adults to get very sick from COVID, they can still get sick, and some will become very sick and could require hospitalization. Hospitals in the United States have seen paediatric admissions surge with the Delta variant and now that schools are open in Canada many experts worry about a similar situation occurring in Canada. There’s also a very real concern about infected kids experiencing longer-term effects, known as “long COVID.”

It’s also worth remembering that kids with COVID, even if the case is mild or asymptomatic, can spread the virus to others. Many experts believe that, because of the Delta variant, to achieve herd immunity, we need almost everyone in the country vaccinated, including children.

Should any kids avoid the vaccine?

Anyone who has had a severe allergic reaction to any ingredient of the Pfizer vaccine should not get the vaccine, according to Pfizer, but speak to your healthcare provider if this is the case for your child.

What about kids younger than 5?

Pfizer says that data on the other two age cohorts from its trial—children 2 to 5 years of age and children 6 months to 2 years of age—is expected to be released before the end of the year, perhaps as early as October.

School-age

6 ways to support your kid when they're learning to read

When they’re starting to build fundamental reading skills at school, there’s lots you can do at home.

If your kid is in kindergarten or grade 1, they’re probably starting to bring books home from school to learn to read. Parents can play an important role in making the experience positive and helping them learn important decoding skills. It’s important to know that not all classrooms support decoding and phonics in the same way. These tips below from experts in structured literacy—a systematic way of teaching phonics and decoding skills—will help you support your kid as they’re learning to read.

1. Focus on sounding out, not guessing

When kids learn to read, they need to match letters or combinations of letters to sounds, explains Liisa Freure, a former elementary teacher and reading expert who trains teachers in structured literacy. “If they sound out or decode a word successfully a few times, then that word transfers into their sight vocabulary, which means when they see that word, they can remember what that word is, rather than having to sound it out each time.”

If your child is stuck on a word, don’t let them guess, says Alicia Smith, president of the International Dyslexia Association Ontario. “If they have learned how to decode it, help them sound it out.

If not, just tell them how, or tell them the word.” If you find your kid is consistently guessing based on context or pictures, cover up the picture or have them practice reading short, easily decodable words (like “cat,” “dog” or “sun”) that are not in context.

2. Don’t rush to books

“One of the biggest mistakes we can make is thrusting books at our kids and expecting them to read on their own before they’ve mastered letters and sounds—it’s putting the cart before the horse,” advises Smith. This can not only frustrate them, but also set them up for bad habits if they don’t yet have the skills to decode. “Don’t get too worried about whether your child is reading books or even sentences in kindergarten; help them grasp that connection between sounds and print.”

3. Look for decodable readers

The books in your kid’s classroom or that get sent home from school are typically levelled texts. The levels are determined by things like length of sentence and how many high-frequency words appear. In the English language, however, the highest-frequency words are also the oldest, which means their pronunciation has changed over the years and they are not very “decodable”— and that means kids can’t sound them out using conventional rules, explains Freure. Words like “said” and “talk” are good for a kid to recognize, but don’t actually help them solidify letter-sound relationships. When your child is ready, Hackett-Helmkay suggests finding decodable books online from the publishing house Flyleaf or the reading program SPIRE, or look for the Moon Dogs series, described as “catch-up readers.”

4. Get them curious about words

English can be a very complicated language to learn because it includes words from various languages, like German, Greek and Latin. Instead of saying, “Oh, English is so confusing, it makes no sense,” get them curious about different spellings and letter sounds, suggests Freure. For example, kids often wonder why the word “talk” has an “L” in it. Freure tells her students, Well, we’re telling a tale, and the words ‘tell’ and ‘tale’ both have an ‘L’ in them. The word ‘talk’ has an ‘L’ in it because it’s related to those other words.” Encourage your kid to find other strange spellings in a book and find out together (you can google it) what the origin (etymology) of the word is and why it’s spelled that way.

5. Teach them about suffixes and prefixes

“Every word has a base, and then we can add things to the base,” says Freure. Show your kid what common suffixes (like “s,” “ed” and “er”) and prefixes (“re,” “un” and “in”) look like and what they mean (this is called “morphology”). When your kid is faced with a longer word, they can look for these parts of words to help them figure it out.

6. Time it right

If your kid is struggling with learning to read, keep the sessions short and sweet and at a time when they’re not too overwhelmed. Avoid practicing when they’re tired, too. And don’t forget, all reading is reading, so look for opportunities around you to practice decoding, like a Pokémon card or the back of a cereal box.

School-age

I laid all the groundwork, but public school failed to teach my kids to read

The way we teach reading isn't right for all kids—and not all families can afford the tutoring they need. That's not right.

Two of my three kids failed to learn to read in public school. We did all the right things—filled our house with books, read to them as babies, enrolled them in preschool programs and sat with them in the evenings as they muddled through their early readers sent home by kindergarten and grade one teachers. With my eldest, we patiently waited for the click. “Oh, she’s just young,” her kindergarten teacher told us. Which was true—her birthday is in late December, making her one of the youngest in the class. “She’s just not interested” was another common teacher assessment. Our daughter was a lively, imaginative kid who seemed to prefer a game of make-believe over sitting down to read.

Fast-forward 10 years and our daughter is entering high school still struggling to read unfamiliar words. We learned in grade two, after doing private testing, that she had a learning disability in reading, but because of poor advice given to us by the psychologist who did the testing as well as her teachers and the school, we started specialized tutoring only in grade four and then moved full-time to a school for kids with dyslexia in grade five.

We’ve learned now that she missed a critical window to cement early phonemic awareness and the decoding skills (understanding the relationship between letters and sounds) that she needs to fluently read. In an ideal world, she would have been screened in kindergarten, with intervention starting right away. Now, although her reading has certainly come a long way, instead of seeing patterns in new words and using prior knowledge to figure out what they are, she looks up at me and guesses. It’s heartbreaking to see this smart kid still falter.

Our middle child learned to read without much difficulty, but when our youngest was in grade one, his teacher flagged him as a kid who was falling a bit behind. Even though her advice was for him to just continue to practice with the books she sent home and to “wait and see,” we knew that—if he had similar challenges to his sister—he needed more intervention, and the sooner the better. Testing showed similar weaknesses to our eldest and pointed to dyslexia so we started a specialized program with him right away. Now in grade four, he’s not a perfect reader, but he’s at grade level and loves to sit around on a Saturday morning with a book. I truly believe that he won’t go on to have the same difficulties his sister has because we knew he needed specialized help at a young age.

This is both a relief and utterly frustrating. The type of reading instruction my kids needed—known as structured literacy, which uses a systematic approach to teaching reading and includes phonics—is not what teachers generally use in our schools here in Canada.

Instead, they use an approach that promotes guessing based on context and other clues, and it implies that if kids are surrounded by books and are read to on a regular basis, they will learn to read. There’s nothing wrong with having a houseful (or classroomful) of books, of course, it’s just not what’s going to teach children like mine—and hundreds of thousands of others—to read. Estimates vary, but anywhere from six to 20 percent of the population is thought to have dyslexia, and you don’t have to be diagnosed with dyslexia to benefit from structured literacy. While there are kids who seem to be natural readers, the truth is, nobody is born with an innate ability to read. All kids need some direct instruction, and if schools used structured literacy, then nobody would fall through the cracks.

Here’s another thing: Multiple studies have shown that when kids get early specialized instruction in phonemic awareness and decoding, many of them don’t actually go on to even meet the criteria for the labels of dyslexia or a learning disability. They just…learn to read. We have the knowledge and the ability to teach most kids to read in a way that works for their brains (a small number of kids will still go on to need support even if taught early), but we don’t do it. Kids like mine—who have well-educated, English-speaking parents who can navigate the Canadian school system and pay for specialized tutoring (which can run $500 a month or more)—typically will learn to read, even if slowly and deliberately. But other kids, whose parents aren’t as well-connected or just simply trust that the school is doing the best they can (because, why wouldn’t they?), often fall behind.

Parent to parent, here’s my advice to you. If you have a young child who is currently learning how to read, pay attention. Are they truly making connections or do they seem to be guessing? Do they mix up simple words like “it” and “the”? Do they skip words when they read? If you’re at all concerned, reach out to their teacher. But if you don’t feel satisfied with the answers you get, keep trying other avenues. A child who struggles to learn to read needs to be given the right tools at a young age so they don’t wind up with a lifetime of difficulties. Help them make sure their future will be as wide open as they can imagine.

Family health

What parents need to know about COVID-19 rapid testing

From where to buy them to when to use them—and how useful they are in the first place—we've got answers to all your rapid testing questions.

In addition to new running shoes, masks and hand sanitizer for her three kids, ages 4, 7 and 9, Toronto mom Mandy Hergott* bought some rapid antigen test kits as part of her back-to-school shopping. “It won’t replace the proper lab test but in anticipation of testing centres being less available, for my own peace of mind I wanted to have them at the ready,” says Hergott. 

As families navigate this stage of the pandemic, where kids under 12 aren’t vaccinated—and some of the adults around them aren’t either—some parents are picking up at-home COVID-19 tests, which come with questions of their own. Are they worth the cost? How accurate are they? Why can I get free tests at my workplace and not at my kid’s public school? And why is this process STILL so haphazard? Here’s what you need to know about COVID-19 rapid tests.

What’s a rapid antigen test?

A rapid antigen test is a screening tool. It can identify the presence of specific SARS-CoV-2 (the virus that causes COVID-19) protein markers in your body, which indicate an infection. You can use the test at home and the results are ready in about 15 to 30 minutes—the sample does not need to be sent to a lab. They work  best when you have high levels of the virus (which may or not result in symptoms).

In contrast, the “gold standard” for COVID-19 testing is the PCR (polymerase chain reaction) test, which detects genetic material from the SARS CoV-2 virus. That’s the test where a technician takes a sample from further into your nasal cavity using a long swab, which is then analyzed in a lab. Those results take at least 24 hours. (Or as many of us have discovered, five business days or more, depending on demand and where you live.)

How do you use a rapid antigen test?

Each brand will be slightly different, but generally speaking the process is fairly straightforward. You add drops of a liquid called a buffer (which comes in the kit) to a tube (which also comes in the kit). Then you take the provided nasal swab, put it into each nostril, about a centimetre in, and rotate it gently, following directions about the number of times and where to place the swab. Next, you put the swab in the tube containing the buffer liquid and follow the directions about how to mix the swab with the buffer. Finally, you add a certain number of drops of the swab-and-buffer mixture to the kit’s reader strip, which looks like a pregnancy test. The result will be ready in 15 to 30 minutes. One line means the test is negative. Two lines means the test is positive. “It’s pretty simple to do,” says Janine McCready, an infectious disease physician at Michael Garron Hospital in Toronto.

Is a rapid antigen test suitable for kids?

Right now, the tests are in a grey area with Health Canada, and have not been officially approved for kids. That said, “Because of the pandemic, we’re having to do a lot of things in real time. We’re not waiting for large-scale validation for different age groups,” notes McCready. She says that as long as samples are being collected properly, there’s no reason to think that a rapid antigen test wouldn’t work the same way for a child as for an adult.

How accurate is a rapid antigen test?

False positives—or the test says you are infected with COVID-19 but you actually are not—are rare. In other words, if the rapid antigen test says you are positive for COVID, call your health unit to get advice about getting in touch with contacts, booking a PCR test to confirm, and who in the household should stay home.  

False negatives—or the test says you are not infected with COVID when you actually are—are more common. “The range of sensitivity is more like 50 to 95 percent,” says McCready, meaning that 5 to 50 percent of the time, the virus won’t be detected on the day you test, but could be on a subsequent day when the levels of the virus are higher. In an ideal situation, the rapid antigen tests are designed to be used frequently, even daily, to monitor potential infection. “The chance of getting a correct result depends on how infectious the person is…it depends on at what stage you are, if you have symptoms, if you have no symptoms, how much virus you’re shedding,” she says. “Even if you haven’t been exposed and don’t have symptoms, if you test negative on the rapid antigen test it doesn’t necessarily mean that you 100 percent don’t have it, because it could just be missing the virus there.” 

The reality is rapid antigen tests are a good extra screening tool, but the risk is that many people will accept a negative result despite symptoms or a known exposure and inadvertently spread the virus. 

When should you use a rapid antigen test?

Despite those caveats, a rapid antigen test can be useful to families in a few ways, says McCready. 

If your child has COVID-19 symptoms

In this case, the rapid antigen test gives you a quick answer about positivity: You can test as soon as symptoms start and if it’s positive, you call your health unit and follow their recommendations about booking a PCR test and notifying possible contacts. If it’s negative, you still stay home, still book a PCR test and still monitor for symptoms. The advantage is knowing that you’re positive right away, rather than possibly having to wait days for PCR test results. 

If your child has a known exposure to COVID

When you’re isolating at home for the set period of time and monitoring for symptoms, using a rapid antigen test means you can test daily or every other day, rather than waiting for a PCR test partway through the exposure period (often day 7 after a known exposure). Although you would still have to go for the PCR test at the recommended time to confirm your child is negative.

If your child has no symptoms, but is going into a different group setting

Some parents are using rapid tests to OK a visit with grandparents, for example, and that’s reasonable, according to McCready. “If your kid is going to go join a group of kids that they don’t usually play with, or you’re going to go to visit grandparents, or you’re going to be indoors with people at a big family gathering, it would add a layer of safety for everyone who is going to that gathering to do a rapid antigen test,” she says. “Again, it’s not foolproof. You’re still screening for symptoms, still trying to be outdoors, wearing masks if you can’t distance, all those good things. But if you’re going to do those activities anyway, the testing would give an extra layer of protection.”

As part of a surveillance program

We’re not there yet in most parts of Canada (although some schools in Montreal hotspots have started using rapid testing to detect cases), but experts say rapid tests can be incredibly useful as part of a surveillance program. McCready points to a program in Utah called “Test to Play,” where public high school students were required to do a rapid antigen test every 14 days in order to participate in extracurricular activities. A similar program called “Test to Stay” had optional rapid testing when a school had an outbreak and if students opted for the test and tested negative, they could continue to stay in school. The result: more than 100,000 days of in-person instruction were saved and 95 percent of athletic events went ahead. Between November 30, 2020 and March 20, 2021, nearly 60,000 students were tested and 1,886 (3.2 percent) had a positive test. 

Where do you buy rapid tests?

Right now in Canada the tests are either fairly expensive (about $15 and up) and therefore out of reach for many, or totally free. (In Germany, rapid antigen tests are less than $1 USD and in Britain they’re free for everyone, twice a week.

Here, parents are mainly buying tests through several Canadian websites like rapidtestandtrace.ca or haventesting.com or getting them through the free federal or provincial program for employees at their workplace. Hergott, the Toronto mom of three, paid $400 plus another $74 in taxes and shipping for 25 tests from a Canadian website, but hasn’t used any yet. “They were so bloody expensive that I want to save them for when one of my three kids inevitably develops symptoms!”

In addition, at participating Shoppers and Loblaws pharmacies in Ontario and Alberta you can pay $40 to have a rapid antigen test done in-store with results while you wait. This is only available if you have no symptoms, no known exposure, and no previous positive test.

If you’re testing at home with a test you bought yourself, there really isn’t a provincial or national system in place yet to help guide you. You still have to isolate and call your local health unit to book a PCR test to confirm the rapid antigen test.

There are at-home PCR tests on the horizon too, at least in some places. In Toronto, McCready co-leads a program that has just expanded to offer a free take-home PCR test (with a swab that’s done inside the mouth and just inside the nostrils, rather than the long swab to the back of the nose), which families at Toronto public schools and child care centres can do at home if a child has COVID symptoms or there is a positive case in a cohort. The sample is then delivered to a set drop-off point and processed in a lab in about 24 hours, with follow-up calls and guidance on what to do next when it comes to isolating and contacting people in your circle. 

The bottom line: “We need to make testing as easy as possible for everyone so that it’s easy for families to do the right thing and get tested and not ignore the symptoms,” says McCready. “Everyone needs to look out for their communities and protect the other kids around them.”

* Name has been changed

Daycare

Here’s what each political party is promising for child care

With child care at the centre of the discussion in 2021, this election is more important than ever for Canadian families.

The pandemic triggered Canada’s first “she-cession,” where women lost the majority of the employment—particularly lower-earning women, who also may be racialized, single mothers, precariously housed and/or of precarious status. Economic recovery from this pandemic must be a “she-covery” and child care is crucial for women to re-enter the workplace, or to continue working.

Liberals

In the 2021 budget, the Liberal Party promised more than $27.2 billion (over five years) towards establishing a national child care program that promises $10-a-day child care. This plan continues to be a major plank of their re-election campaign.

To date, the Liberals have signed agreements with eight provincial and territorial governments (B.C., Yukon, Saskatchewan, Manitoba, Quebec, Nova Scotia, P.E.I, and Labrador and Newfoundland), which would result in a 50 percent cut in child care fees next year, with the goal to reach that $10-a-day threshold sometime in the next five years.

To increase capacity, the Liberals plan to build 250,000 new high-quality child care spaces, hire 40,000 more early childhood educators, work with Indigenous partners to ensure Indigenous children have access to culturally appropriate child care, and enact federal child care legislation to strengthen and protect a Canada-wide system.

Conservatives

Canada’s Conservative Party is taking a different approach to reducing child care costs. Party leader Erin O’Toole has said that despite signed agreements, a Conservative government would scrap plans for $10-a-day child care and instead create a refundable tax credit that would cover up to 75 percent of the cost of child care for lower-income families.

This would be done by converting the existing Child Care Expense Deduction (the line on your tax form where you put how much you spent on child care each year) into the proposed tax credit. The Parliamentary Budget Office estimates that this plan would cost Canadians $2.6 billion over the next five years.

The child care tax credit would be claimable by anyone, regardless of income level, but according to analysis done by Lindsay Tedds, Gillian Petit and Tammy Schirle for Policy Options, only child care costs up to $8,000 would be eligible for the credit.

The Conservative plan does not specify any commitments about expanding the number of child care spaces, nor does it mention increasing the number of early childhood educators.

NDP

Like the Liberal Party, the New Democrats are promising $10-a-day child care, which would leverage the existing agreements with provinces and territories to facilitate this shift. While the Parliamentary Budget Officer didn’t provide a cost for this plan, given that the NDP would be using the Liberal’s blueprint, it’s safe to assume that the costs would be similar.

In addition to $10-a-day child care, the New Democrats want to save not-for-profit child care centres, create enough spaces in order to avoid lengthy wait lists, and ensure that early childhood educators are paid a fair, living wage.

Green Party

The Green Party also wants to create a universal child care program, which would see them working with provinces, territories and Indigenous communities to develop guiding principles and a framework for what this looks like. It is unclear if the Greens, like the NDP, would leverage the work already done by the Liberals.

In addition, the Greens’ child care proposal wants to increase federal child care funding to achieve the international benchmark of spending 1 percent of GDP annually on child care.

Unfortunately, the Green Party’s platform is short on specifics, so providing insight into feasibility, timelines and cost isn’t possible.

The economics

How should child care be delivered? To answer this question, the parties are basically looking at two types of responses: one that reduces market costs through tax incentives and one that creates a regulated system that caps child care costs at $10 a day by increasing physical supply of spaces (i.e. building capacity). Which approach is better? Any economist worth their salt will always answer this question with “it depends.”

The Conservatives, who have chosen the former response over the latter, have an ostensibly progressive policy in that as family income increases, the amount of the refundable tax credit drops. Unfortunately, while the absolute amount drops, the tax is actually regressive in that the proportion of child care fees paid per total family income increases as family income falls. What this means is that even though lower-earning families will pay less in terms of total amount of child care fees, the proportion with respect to income increases. This increases the tax burden on lower-earning families rather than middle-class and wealthy ones.

The Liberals, NDP and Greens support varying systems that build capacity. This is a better plan to increase accessibility, supply and affordability. However, there’s a caveat. The Liberals’ child care plan would amount to families paying $2,600 per year, which is also regressive. For lower-earning families, that amounts to about 20 percent of their income and that percentage drops with increasing income. This plan, however, would still reduce total fees and proportion of income spent on child care more than the Conservatives’ plan.

The fine print

With these child care plans, it’s important to note that the Liberal and NDP proposals would significantly reduce the child care costs to an average of $10 a day, which means that some people will pay more and others will pay less. Similarly, the Conservative plan is a tax credit up to 75 percent of costs, so the higher your income, the less you will be impacted by the promise.

Ultimately, voters need to go with the plans and parties that make the most sense for them, but make sure to do your research!

Daycare

This federal election, I’m voting for child care—here’s why you should, too

A tax credit wouldn't have helped me when I was stuck on 12 waitlists. It won't help the mother struggling to pay fees each month, or the parents whose daycare closes overnight.

Canada has never been closer to having an accessible, affordable child care system. Eight provinces and territories have signed deals with the Trudeau government that will flow billions of dollars to build thousands of regulated child care spaces and make them affordable. But in the upcoming federal election, the main parties have very different ideas on child care. This is why it’s more important than ever that we parents speak up about how important child care is, not just for our pocketbooks, but for our children’s—and our country’s—future.

I’ve seen Canada’s child care crisis up close, and it isn’t pretty. Like many parents across the country, the moment that I found out I was pregnant, I drew a circle on a map around our apartment and got on every waiting list at every daycare in the area. In our neighbourhood in Toronto, that was 12 lists, all told. So far, so good—in some “child care deserts,” I would have been lucky to find even one regulated program.

After my son was born, I waited to hear back from even one centre with a spot in an infant room. But no such luck.

Because I’d worked as an early childhood educator and a child care policy researcher, I knew the challenge that was coming. But still, with only a few months before I was supposed to head back to work, and still no space secured for my kid, I was panicking. I started to call child care centres. Years of experience in the sector meant that I knew how things worked. I told each centre director that if, for any reason, they had a sudden vacancy that they had to fill immediately, I would take a spot right away and forgo the last months of my parental leave.

In the end, that’s just what happened. In the Hunger Games that is Canada’s child care market, another family’s misfortune was our windfall. Another mother lost her job and had to give up their daycare spot. The centre had to fill the space immediately or risk losing income, so they needed another family to start right away. I told them I could start on Monday.

I’ve been thinking about the other mother a lot, especially now that child care is once again an election issue. That child care space was so expensive that she had to abandon it the moment that her employment was disrupted. Even though it was a great place for her child, even though it would have given her time to get back on her feet, find another work contract or go back to school. It was just too expensive. And for me, the space was so rare that I had to let go of the last precious months of dedicated time with my infant son, or risk not having a child care space at all. I still get calls from some of the centres to tell me that I’ve finally reached the top of the waitlist—and my son is now four. Imagine what would have been possible for both of our families if we had a real child care system.

Now that I work for a child care advocacy organization, I often hear from parents who have experienced the very worst of the child care crisis. Like the families who woke up one day to find out that their child care program had closed overnight (and that it hadn’t been licensed or regulated to begin with, and was being investigated!). Or parents who have had to give up their jobs because they can’t patch together a child care arrangement. Parents who work non-standard hours, outside the typical nine-to-five, and have no regulated options available.

None of this is fair. None of this is just. It should not have to be this way. And—at last—it doesn’t have to be this way. The pandemic has finally made employers and governments aware of a child care crisis that we parents have known about for years. We finally have a $30 billion plan to create more affordable, regulated, flexible child care across the country, to build a real system.

In the federal election, both the Liberals and NDP have pledged their support for the plan. Meanwhile, the Conservatives have said they would cancel it. Their offer is a tax credit—but no tax scheme alone can solve Canada’s child care crisis.

Would a tax credit have helped me when I was on 12 waitlists? It won’t help the mother struggling to pay fees month to month, or the parents whose entire centre closes overnight. Would a tax credit help the early childhood educators earning shamefully low wages despite years of training and the importance of their work? No.

While the Conservatives’ herald their tax credit as being about “choice,” real choice comes when parents have high-quality options available to them. That’s what building a child care system is all about.

It’s understandable to be skeptical about the possibility of building a real, affordable child care system across Canada. It’s taken 50 years of struggle from child care advocates to get us to where we are today. We’ve come close before—but this time is different. Even Conservative-led provinces have signed on already, or, like Ontario, have said they want to sign on. 

Whether your child care challenges are nearly over, or just beginning, in the federal election on September 20, we finally have a chance to address the child care crisis head-on. While the debate has been framed as being about which plan—$10 a day child care versus a tax credit—is better for your personal finances, it’s actually about something bigger. For children, for parents, for our economy and our recovery, this election is about solving the child care crisis once and for all.

Carolyn Ferns is a policy coordinator at the Ontario Coalition for Better Child Care and the mother of a four-year-old.

School-age

After-school restraint collapse is a real thing—here’s how to deal with it

There’s a reason your kid is an angel at school or daycare but a hot mess at home. It's called after-school restraint collapse. Here's how to deal with it.

When Parker Kraychy started grade one, his mom, Kristi Kraychy, heard nothing but positive reviews about his behaviour. He was a total angel, said his teacher; he worked hard and listened well. Naturally, Kraychy was pleased—but she could hardly believe it. That’s because Parker was routinely a hot mess at home after school. Angry, yelling meltdowns were an almost-daily occurrence for months.

If this sounds familiar, it’s because it’s a real phenomenon. After a long day at school or daycare, many kids totally lose it when their parent picks them up or when they get home. There’s even a name for it: after-school restraint collapse.

It happens, says Andrea Loewen Nair, the London, Ont.-based counsellor and parenting educator who coined the term, because kids hold it together all day and only release their true emotions when they get to a safe place. Some kids become weepy, while others scream, throw things and become generally unreasonable. Older kids might act rude and disrespectful, hurling insults at you and their siblings.

Some children are more susceptible to after-school restraint collapse than others. “More sensitive and intense kids, and kids struggling with learning and social skills, will be more likely to be affected,” says Vanessa Lapointe, a parenting educator and registered psychologist in Surrey, BC. “More chill kids can have their days too if it was a particularly challenging day, or they are extra tired or getting sick.” It can last all school year but is more common in the first few months, and Lapointe says it tends to subside as kids fully adjust to the change in environment and schedule, and feel less physically and emotionally spent at the end of the day.

Why after-school restraint collapse happens

At school, “Kids do what they need to in order to ‘be good’ or keep the peace,” says Nair, who is also head of London, Ont.-based Infinity School. “After they’ve done that all day, they get to the point where they just don’t have the energy to keep this restraint, and it feels like a big bubble that needs to burst.”

Managing the challenges that happen at school wipes kids out, says Lapointe. “Kids have to hold it together all day long at school. There are all sorts of expectations, disappointments and challenges to manage, and all of this without your loving presence nearby. It can be exhausting.”

Lapointe adds that some kids melt down simply because they are tired or over stimulated, particularly if they’re making the transition to full school days. That was the case with Kraychy’s daughter, Rylie, who started kindergarten when Parker started grade one. She’d come home super tired, and would cry and hide in her room if she was asked to do something. “Her meltdowns were clearly linked to fatigue and less of an emotional breakdown,” says Kraychy. “If I didn’t ask her to do too much, didn’t tease her and stuck to a simple routine with a healthy snack and kindness, she was okay.”

But the after-school restraint collapse meltdown is often about more than just fatigue, thanks to something psychologists call defensive detachment. “Your child really needed you, and you weren’t there,” explains Lapointe. “Now you’re there, but the initial flood of relief is quickly subsumed by a tidal wave of defensive detaching—they’re angry and push you away. It’s like when a parent and child reunite after the child has gone missing in a grocery store. The parent will have a few seconds of clutching relief as they hug their child and then bam! Defensive detachment kicks in with anger as they admonish their now-found child.”

As a teacher herself, Kraychy wasn’t surprised by her children’s behaviour—but she wasn’t prepared for Parker’s daily tornado of emotion, either. “I understood what was happening,” she says. “The ‘good kids’ at school use a lot of energy being well-behaved and navigating the complexities of social behaviour. They wait until they’re safe at home to unleash all the pent-up emotions with someone they trust and love. Even knowing this, it was hard to deal with every day.”

It’s important to note that these outbursts are not tantrums where your child is testing boundaries or trying to get their way. The after-school restraint collapse is exactly that—a collapse, or meltdown, because your child is so emotionally overwhelmed that they can no longer keep it together.

How to handle it in the moment

You’re home and your kid is freaking out. What next? Make lots of room for the blow-out and validate your kid’s emotions, says Lapointe. “As they shout, throw and generally lose it, just go alongside and say, ‘It was a long day, wasn’t it?’ or ‘I’ve got you,’” she says. That’s obviously not easy when you’re managing more than one kid, and if you’re also trying to get a snack or dinner prepared, but try to find a way.

Kraychy would let Parker release his energy and emotions however he needed so long as he wasn’t hurting himself or others. Still, letting the meltdown happen can feel like a Herculean task. “Try not to get triggered by it or take it personally,” says Kraychy (who acknowledges how hard that is it to do when insults are being flung at your face).

Nair recommends trying to find a way for your kid to decompress at the end of the day, whether it’s riding a bike, a tickle fight, telling jokes, listening to music or simply doing nothing. This daily decompression activity can become a ritual, and help both you and your child make your way through the intense emotions. “We humans love our routines,” says Lapointe. “We love the safety of having a script for exactly how things are going to go. These kinds of scripts provide a boatload of safety during an emotional storm.”

What about screen time as a decompression method? Lapointe says it’s OK as a last resort if it seems to work for your kids—as long as you fill them up with some human connection first.

Can after-school restraint collapse be prevented?

Thankfully, there are ways to mitigate this after-school agony. Nair recommends getting in the habit of reconnecting positively when you see your kids after school. “Greet your child with a smile and a hug instead of questions about homework.”

She also suggests giving your child some time and space after pick up. “If you’re driving, put on the radio and stay quiet. If you are walking, say little or just comment on the nice little things you notice,” she says. “This isn’t the time for big conversations.” She learned through her personal experience with her son’s restraint collapse to steer away from play dates or scheduled activities right after school so that he could have time to regroup.

Like any of us, kids are often more irritable when they’re hungry and tired. So it’s a good idea to just go ahead and feed your kids rather than asking if they are hungry. It’s a safe bet they need replenishment after school, so set out water and healthy snacks like veggies, fruit and cheese. If your kid is in daycare or after-school care where snacks are served, don’t assume they can’t possibly be hungry.

Above all, both Lapointe and Nair emphasize staying connected during the day. “Send yourself to school with them,” says Lapointe. “Write notes for their lunch box. Fill their hands full of kisses. Keep a picture of you and them together in their backpack.” If your kids feel like you’re with them, supporting them through the day, they’re less likely to feel vulnerable, and later, angry with you for not physically being there.

Try to fill them up with your attention before school, too. “Give your child more of you in the mornings before school,” says Lapointe. “Set your alarm 15 minutes earlier and use that extra time to snuggle in a rocking chair or read a story. Just do something together full of the spirit of connection and care.”

The meltdown aftermath

You could easily substitute school for work in after-work restraint collapse when you think about how many of us have come home from an exhausting day of work and freaked out at our partners or children for no apparent reason. In fact, some adults don’t seem to ever shake the after-work jerk syndrome.

So don’t be disappointed, if, despite all your efforts, after-school meltdowns still sometimes occur. “In most cases, if the meltdown still happens, it needed to happen,” says Lapointe. Talking about it afterwards may not make much of a preventative difference, but kids can often feel badly about their outbursts so it’s important to reassure them that it’s okay.

Wait for your kid to completely calm down, says Lapointe. “You want to close the loop so they know you love them no matter what, and plant the seed of ability for next time. You can say, ‘I love all the parts of you—even the meltdown part! The next time you feel like you’re going to blow up, take a deep breath. Tell me with your words what’s up.’” Let them know they are loved and move on. Don’t dwell on the meltdown behaviour.

If you want to know if anything precipitated a meltdown, Nair advises waiting for your child to come to you. “Give your child the lead to start talking when he or she is ready. When that happens, you can inquire about any emotionally intense moments that may have happened during that day.”

“Let your kids know that home is their safe zone, and help them learn how to communicate their frustrations,” adds Kraychy. After the heat of the moment passes, she helps Parker identify his feelings so they can talk about what made him feel so upset. Then they come up with ways to cope and help him from feeling so overwhelmed. After some investigation, she discovered that Parker has such high expectations of himself at school that if he thought anything was less than perfect during the day, it was almost traumatic for him—but he’d hold in that devastation until he got home. To manage this, they came up with an interesting strategy. “We actually encouraged Parker to see if he could make a mistake at school to show him the world didn’t end if he wasn’t perfect at school—that it’s okay not to be perfect.”

It all comes down to your kids feeling safe and supported, particularly when they’re vulnerable and you can’t be with them. Lapointe says to stay connected, and keep them brimming with “messages of enduring, no-matter-what, love and acceptance.”

This article was originally published online in September 2018.