Back-to-school season is here. This time of year can bring up a lot of big feelings, both for kids and for the parents supporting them. For many children with HIE, whether they're entering the school system for the first time or coming back after a long summer break, new routines, new environments, and new expectations can feel like a lot to navigate. In our latest Child Life Q&A, Annie Gunning, CCLS, talks through what these transitions can look like and shares practical tools to help kids head into the classroom feeling more confident and supported.
Missed the live Q&A? No worries. We took notes, and like any good partner, we're willing to share.
But First - What is a Child Life Specialist?
Child life specialists are experts in child development and family dynamics, helping them navigate the emotional and psychological impact of hospitalizations, diagnoses, and life-changing events. They focus on supporting the child and the whole family, using their knowledge to ask, "How can we make this experience better for everyone involved?"
Evolution of Child Life Services
Child life services have roots as far back as the 1920s, when hospital volunteers used play to help children cope. But the profession really came into its own in the 1960s, thanks to Emma Plank. Her groundbreaking book, Working with Children in Hospitals, provided a blueprint for addressing the unique needs of children during hospital stays and is still considered foundational in the field today.
Over the years, child life has grown far beyond hospital playrooms. Today, child life specialists provide support in a wide variety of settings, tailoring their care to meet the needs of both patients and their families. Whether offering emotional guidance, helping siblings adjust, or educating parents about medical procedures, child life professionals create a more supportive healthcare experience for everyone involved.
Annie's Role as Hope's Certified Child Life Specialist
And now, let's fast forward to Annie's role as the Child Life Specialist at Hope for HIE. Her main objective is to help children and families navigate medicalized life by empowering and supporting both children and their caregivers and fostering the ability to advocate for their needs while simultaneously reducing stress, pain, and anxiety. This often looks like support for patients and their families facing surgeries, tests, procedures, diagnoses, and hospitalizations by offering preparation, creating personalized coping plans, providing education, fostering creative expression, and incorporating medical play.
Common Challenges with the Back-to-School Transition
A new school year is exciting, but it also asks a lot of kids all at once. Families can expect their child may be navigating:
Meeting new people — new teachers, classmates, and staff, and figuring out who's who and who's there to support them.
A new environment and routine — sensory input, accommodation plans, and the physical layout of a classroom, including mobility needs or devices to support them in a learning environment.
Academic demands — learning new material on top of everything else that's new.
Being fully understood by the school — making sure teachers and staff know a child's physical, medical, and emotional needs and their strengths and learning style, so the year can be set up for success from the start.
Tools and Strategies for the Back-to-School Transition
For many children, the start of a new school year can feel overwhelming. Kids with HIE may face extra challenges, like separation anxiety, adjusting to new routines, or navigating sensory overload in unfamiliar environments. There are ways parents can help make the transition easier.
How can families ease the return after a long break or extended time at home?
Reactions to heading back to school are mixed. Some kids can't wait, while others would rather stay in summer mode. Either way, most children ultimately do well once they're back in a predictable routine. A few ways to ease that transition:
Talk through the day ahead of time. What are their classes like? When do they have breaks or eat lunch? Walking through the shape of the day helps kids start processing what to expect, builds confidence, and reduces worry.
Read books about starting school – Stories give kids a chance to see their feelings reflected and open space to talk about their own concerns.
Use a visual calendar or social story. A social story Canva template is available for families to customize. Annie shared that she's made social stories tailored to specific situations — one that walked through a general school day from morning routine to pickup, and another built specifically around one child's first day of preschool, using real photos of her classroom, teacher, and even where her backpack hook was located. Families without access to those specifics can still use general school photos as placeholders.
Practice short separations – If your child is anxious, try gradually building up time apart so they learn they can manage and reconnect with you after. Have your child spend 30 minutes at someone's house, or step out briefly to run an errand. This reinforces "I'm coming back" in smaller, lower-stakes moments before the first day.
Highlight what's ahead. New friends, a favorite teacher, science projects, special activities — naming what a child is looking forward to matters just as much as preparing for what's hard.
What routines or prep activities are helpful to implement?
Familiarity reduces the unknowns that tend to drive anxiety. Parents can consider:
Driving by the school, walking the halls, or visiting the playground ahead of time.
Meeting the teacher, counselor, or school nurse in person if your school offers that opportunity.
Taking photos of the classroom door, hallway, nurse's office, or counselor's office to review together during the lead-up to the first day.
Timing the prep to your child's age. As a general rule, younger children do best with preparation closer to the first day, while older kids can handle looking further ahead — but you know your child best, and some families find too much lead time increases anxiety rather than easing it.
Restarting the daily routine a few days early. Getting up, getting dressed, and eating breakfast on a school-day schedule before the actual first day can soften what would otherwise feel like an abrupt shift.
Communicating Your Child's Needs to the School
Making sure the adults around your child understand their needs is one of the most important parts of back-to-school prep.
With teachers and staff:
Share relevant diagnoses, medical or developmental information, and anything that affects learning, emotion, or safety — including specific triggers and warning signs (for example, what a seizure looks like for your particular child, since presentation varies widely).
Include emergency plans, and connect any of this information to an existing IEP or seizure action plan where applicable.
With your child:
Talk with them ahead of time about how they want to handle questions from classmates — for instance, if someone asks about a medication or an AFO. Kids get to decide how much they want to share.
Role-playing these conversations at home, before they come up in real time, can help a child feel more prepared and in control of their story. This previous Child Life Q&A about self-advocacy and helping kids in our community own their story also provides some great tools and resources to navigate this!
Fostering Social Connection and Confidence
Join the school's parent group or social media page to stay in the loop on meetups, playground gatherings, or grade-level events — these are also chances for your child to meet peers ahead of time. You can also check out this past Child Life Q&A on fostering peer relationships, which includes helpful tools and strategies.
Encourage clubs, activities, or groups where they can meet peers with shared interests.
Ask about a buddy program, where incoming students are paired with a peer before the first day.
Highlighting strengths and normalizing differences. Every child learns and moves differently — that's true for every kid in the room, not just yours. Framing differences as universal, rather than singling a child out, helps build both confidence and empathy. Encouraging kids to be a support to their peers, too, can build a sense of belonging on both sides. This Child Life-curated book list is all about titles that celebrate differences and inclusivity!
Boosting Self-Esteem
Give kids real responsibility. Being the "helper," or having a role that matters, builds genuine confidence.
Listen and validate before problem-solving. Adults don't always need to jump in and fix things. Asking "What do you think we should do?" builds a child's own problem-solving skills and independence.
Celebrate all wins, not just big ones. Making it through an hour without tears is still progress worth naming out loud.
Make sure accommodations are in place and know they can change. If something isn't working the way you expected, it's okay to adjust.
Encouraging Emotional Expression
Even expected transitions can stir up excitement and worry at the same time. A few ways to make space for that:
Check in with open-ended questions, especially with older kids who may not volunteer how they're feeling. "What are you curious about this year?" tends to open more doors than a yes-or-no question.
Validate first. "This is going to feel hard, and that's okay" goes further than jumping straight to a solution.
Offer creative and physical outlets — drawing, dress-up or pretend play, sensory play, or big movement like running or stomping water balloons.
Expect after-school meltdowns, especially in the first few weeks. Many kids hold things together all day at school and release those big feelings once they're home, where they feel safest. Behavior is communication — tired, overstimulated, or in pain can all look like a meltdown.
Reactions can look different by age. Younger kids may show frustration, tantrums, clinginess, sleep changes, or a new bossiness as they test out control. Older kids may show it more physically — headaches, stomachaches, moodiness, withdrawal, or emotional outbursts. Both are normal responses to a big transition.
Adapting for Unexpected Transitions
Even with the best preparation, life brings curveballs: a sudden hospitalization, a classroom change, or a shift in friendships. The same tools used for expected transitions can flex to meet these moments too.
Build a plan with the whole family, including siblings. If a sibling is hospitalized during the school day, talk through logistics ahead of time: who picks the other child up, where they're going after school, and who will follow up with them.
Ask your child how they want to be updated. Some kids want to know what's happening right away; others prefer to wait until the school day is over so it doesn't interrupt their day. Following their preference—and including them in the plan at all—helps children feel like a valued, informed part of the family, which supports their overall sense of safety and predictability.
Helpful Resources
You don’t have to figure this all out on your own—there are great resources available to help you feel more confident and supported as you navigate these moments. Remember that Annie is available for 1:1 support for you and your whole family - get connected at HIE.Support.
Social story template (Canva) — a customizable starting point families can adapt with their own child's details and photos.
Annie also recommends following children's book curators on social media who specialize in inclusive and back-to-school titles as another way to find age-appropriate stories. Mai Storybook Library has great book recommendations!
Watch the full recording, along with our other Child Life Q&As, on Hope for HIE's YouTube channel under the Child Life Series playlist, or download our Key Takeaway resource for an at-a-glance look at our biggest highlights!
