Pediatric Annals

Healthy Baby/Healthy Child Free

How Much is Too Much? Getting Children Involved, but Not Too Involved

Valerie Kimball, MD

Abstract

In the pediatric office, the summer months are filled with well-child visits and sports physicals. It is during these visits that it is important to evaluate our patients as a whole, remembering to discuss both physical and emotional concerns. It is also important to discuss the upcoming school year so concerns by both parents and children can be addressed. Extracurricular activities play a vital role in developing social skills, building a sense of community, and allowing children to discover life-long activities they truly enjoy. However, it is important to remind parents that as a family they must find a balance between a busy extracurricular activity schedule and time for rest, relaxation, and family. [Pediatr Ann. 2015;44(9):354–356,358.]

Valerie Kimball, MD, is a Partner Physician, Pediatric Practice of Traisman, Benuck, Merens, and Kimball.

Disclosure: The author has no relevant financial relationships to disclose.

Address correspondence to Valerie Kimball, MD, 1950 Dempster Street, Evanston, IL 60202; email: vkimbal@hotmail.com.

Abstract

In the pediatric office, the summer months are filled with well-child visits and sports physicals. It is during these visits that it is important to evaluate our patients as a whole, remembering to discuss both physical and emotional concerns. It is also important to discuss the upcoming school year so concerns by both parents and children can be addressed. Extracurricular activities play a vital role in developing social skills, building a sense of community, and allowing children to discover life-long activities they truly enjoy. However, it is important to remind parents that as a family they must find a balance between a busy extracurricular activity schedule and time for rest, relaxation, and family. [Pediatr Ann. 2015;44(9):354–356,358.]

Valerie Kimball, MD, is a Partner Physician, Pediatric Practice of Traisman, Benuck, Merens, and Kimball.

Disclosure: The author has no relevant financial relationships to disclose.

Address correspondence to Valerie Kimball, MD, 1950 Dempster Street, Evanston, IL 60202; email: vkimbal@hotmail.com.

Recently I have participated in an informal email discussion with the American Academy of Pediatrics Committee on Sports Medicine and Fitness list serve in which “redshirting 8th graders” has been a topic of discussion. Apparently, in some areas of the country it is not uncommon for 8th grade boys and girls to repeat the 8th grade, despite appropriate academic advancement, to gain an athletic advantage over their peers. The extra year of middle school allows these young athlete’s bodies to further develop, thus entering high school taller and stronger than their freshman counterparts who have not “redshirted” the 8th grade. Or, parents will choose to enroll their child in kindergarten at age 6 years rather than the usual age of 5 years in hopes of giving them an athletic advantage over their peers when they enter middle school and high school.

I was surprised by the number of responses from pediatric colleagues around the country who verified these practices. To my knowledge, this does not occur often in our suburban Chicago neighborhood or in a more affluent community north of ours, where my husband works as a high school academic advisor, teacher, and varsity coach.

A Balancing Act

I have had patients start kindergarten at age 6 years for reasons of a late summer birthday along with immaturity and academic concerns, but never for athletic advantage, not that I am aware of. Later that evening, after reading these emails, in my own daily carpool from my youngest child’s swim practice, to drop off at my middle son’s hockey practice, to pick up from my eldest son’s soccer practice I began to wonder how much is too much? On these nights when I arrive home at 9:30 pm still in my office attire, having grabbed a bite to eat at one of my stops, I am exhausted. If I am exhausted, I can only imagine how the 11-year-old child feels who goes from trumpet practice at school to soccer practice (Figure 1) and then on to hockey practice in the evening after eating a quick sandwich in the car. Or, the adolescent dancer, who dances 4 to 5 days per week while trying to complete her homework nightly and manage the emotional and social turmoil of high school (Figure 2). This scenario is not limited to athletics. Aspiring teen actors and actresses remain in the school auditorium late into the school night working on scenes and rehearsing, leaving little time for homework or sleep. Many children attend a different activity each day of the week; whether it is art class, piano lessons (Figure 3), or foreign language classes, which doesn’t leave room for simple down time. I counsel both my patients and their parents daily that extracurricular activity is important to both physical and emotional health.1,2 However, are parents overprogramming their children? Furthermore, are we as pediatricians supporting this? Are we removing the element of childhood spontaneity and perhaps stifling the opportunity to develop creativity that may occur as a result of being “bored.” The movie “Sandlot” has been a favorite in our household. To me, it represents the epitome of the spontaneity and adventures of summer as an 11-year-old boy. However, as camp and school physicals are in full swing in our office, I realize that a great number of children have their summer all planned out by the end of January. Many children spend weeks at away camp and others have their days filled with organized athletics, art, and swimming (Figure 4).

Two boys on the soccer field.© Shutterstock

Figure 1.

Two boys on the soccer field.

© Shutterstock

A teenage girl looking tired.© Shutterstock

Figure 2.

A teenage girl looking tired.

© Shutterstock

A young girl playing the piano.© Shutterstock

Figure 3.

A young girl playing the piano.

© Shutterstock

A boy swimming.© Shutterstock

Figure 4.

A boy swimming.

© Shutterstock

Competition—Striking the Right Balance

For some families, daily activities are a necessity to prevent latch key children who may otherwise not have the opportunity to interact with peers after school or during the summer. For other families it is a matter of safety. After school activities and summer camp provide a safe environment and keep children off the neighborhood streets where they may become involved in unsafe and unhealthy activities.3 For these children and adolescents, it is important to encourage their continued involvement in these activities, discussing the benefits of their involvement. For their parents, it is important to stress a continued commitment to keeping their children involved and offering resources for community activities.4

For many others, both parents and children, there is the fear of losing the competitive edge. Unfortunately, it appears that athletic “success” in high school and college is now requiring a more complete commitment to one sport at a much earlier age, although studies indicate the importance of involvement in varied athletic activities rather than sport specialization at an early age.5,6 In our pediatric community, it is rare for an older school-aged child to not attend multiple summer sport-specialty camps either within the community or at a larger university to gain the competitive advantage. The school year poses additional challenges, often requiring 3 to 5 sport-specific practices during the week and traveling to competitions over the weekend. Because many sports are no longer season specific, for those who play multiple sports, it requires juggling of practice schedules, games, and at times negotiating with coaches who feel a commitment to their sport must take precedence over all others. This adds undue pressure to attend every practice at the expense of physical and emotional rest, which can result in overuse injuries, emotional burnout, and in some cases overtraining syndrome.5–7 This appears to hold true in performing arts as well, as many of my patients will attend long dance intensive programs or theatre camps throughout the summer. The school year is filled with 3 to 4 hours of dancing most days of the week.

Real Talk—Parent, Child, and Physician

It is extremely important at well visits as well as during sport physicals to address these concerns with both parents and patients. I always address my patient when inquiring about extracurricular activities. This way I can get a sense of the child’s excitement for these activities. Some children and adolescents thrive on a daily and/or weekly schedule of activities. Many parents comment that their child behaves better at home and at school by having these organized activities that allow them to channel his or her energy in productive ways. Adolescent athletes will often comment that in fact they perform better academically when they must adhere to a stricter schedule of sleeping, eating, and getting homework done.

Many parents observe that their children seem to have a more difficult time getting homework done when they are in their off season or when the performance they have been working toward for several months is over. Other children require more time for themselves. Allowing them to catch up on rest and to not feel rushed through their work. They may enjoy having the freedom to choose play dates, remain at the school park, or just simply come home with no plans at least a few days per week. It is important that parents recognize the needs of their children and respect these needs for rest and free time, remembering that every child is different, even within the same family. This is especially important as children enter kindergarten or first grade. Beginning at ages 5 and 6 years many schools and community centers begin to offer after school programs and allow participation in athletic teams. Many parents struggle with deciding how much their child should be involved. I recommend starting with one activity on a weekday with perhaps another on the weekend, especially in the first several months of the school year. As children get older and become more involved in extracurricular activities, both children and parents are better able to recognize the emotional and physical rest they require. Parents and children need to respect these cues and alter their activities accordingly even as teammates and fellow thespians may continue to add more to their schedule. Parents, coaches, and mentors need to heed the signs of emotional burnout and overtraining syndrome in the young athlete. A lack of desire to attend practice, decreased fun and satisfaction from their activity, poor performance on the field or on the stage, falling grades, loss of appetite and sleep, and overuse injuries are signs of burnout.5,7 In young athletes it is recommended that there is a 2- to 3-month time period in which the athlete does not participate in his or her sport of specialization.6 Parents, coaches, and mentors must recognize that at times “less is more.” Giving athletes and performers time away from their activity allows them to process if they really enjoy what they are doing as well as allowing their body time for healing and rest. They are then excited to be back on the field or the stage when the opportunity arises.

Ultimately, I believe the goal is to promote happiness by fostering individual interests and allowing children and adolescents to experience a sense of accomplishment while at the same time learning many valuable life lessons about community, shared goals, and achievement. Involvement in athletics, the performing arts, and community activities gives children and adolescents these opportunities. We as pediatricians must remind parents of these early simple goals.

So, as my son begins to work toward his goal of playing amateur hockey, it is these summer months that we are told are crucial to his development, requiring hours of time in a cold ice rink on a hot summer evening. As I drive him to the rink in the evening, and on the way formulate the ideas for this article, I remember to heed my own advice and to ask him if he is happy and excited to be going to play. I remind him that hockey is his goal, not his father’s or mine, and if he ever wants to stop playing and spend his evenings at the pool, ride his bike, or play pick-up games of basketball, that is perfectly fine.

References

  1. Drake KM, Beach ML, Longacre MR, et al. Influence of sports, physical education and active commuting to school and adolescent weight status. Pediatrics. 2012;130(2):e296–e304. doi:10.1542/peds.2011-2898 [CrossRef]
  2. Woods CB. Adolescents who take part in team sports or who actively commute to school are less likely to be obese. Evid Based Nurs. 2013;16(3):87–88. doi:10.1136/eb-2012-101048 [CrossRef]
  3. Bonny AE, Britto MT, Klostermann BK, Hornung RW, Slap GB. School disconnectedness: identifying adolescents at risk. Pediatrics. 2000;106(5):1017–1021. doi:10.1542/peds.106.5.1017 [CrossRef]
  4. Sege RD. Peer violence and violence prevention. http://www.uptodate.com/contents/peer-violence-and-violence-prevention. Accessed August 20, 2015.
  5. Brenner JSAmerican Academy of Pediatrics Council on Sports Medicine and Fitness. Overuse injuries, overtraining, and burnout in child and adolescent athletes. Pediatrics. 2007;119(6):1242–1245. doi:10.1542/peds.2007-0887 [CrossRef]
  6. Intensive training and sports specialization in young athletes. American Academy of Pediatrics. Committee on Sports Medicine and Fitness. Pediatrics. 2000;106(1 Pt 1):154–157.
  7. Howard T. Overtraining syndrome in athletes. http://www.uptodate.com/contents/overtraining-syndrome-in-athletes. Accessed August 20, 2015.
Authors

Valerie Kimball, MD, is a Partner Physician, Pediatric Practice of Traisman, Benuck, Merens, and Kimball.

Address correspondence to Valerie Kimball, MD, 1950 Dempster Street, Evanston, IL 60202; email: vkimbal@hotmail.com.

Disclosure: The author has no relevant financial relationships to disclose.

10.3928/00904481-20150910-04

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