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As summer begins to wane, the back-to-school season brings with it the hustle to buy new clothes and supplies — but it also brings health and safety concerns unique to students returning to school.

The end of the carefree summer can inflame emotional issues at this time of year.

"My practice always gets busier when school starts," said Chrissi Hart, a York-based psychologist who specializes in child anxiety. "Usually in the summer things are a little slow. Kids are out of school, so they don't have those stresses."

Any type of transition can be difficult for children, she said, even if it's one as simple as summer to school or first to second grade.

"This back-to-school anxiety stems from the fear of the unknown," Hart said. "A parent can assuage that by listening to their child's concerns and doing their part to help the child get oriented — maybe visit the school beforehand, or go with the child for their first day, all those kinds of strategies are helpful."

The types of concerns and behaviors indicating anxiety differ across age groups, but common concerns include: getting lost, going from one school to the next — for example transitioning from middle to high school — and that the new work will be too difficult, all in addition to different types of social pressures like what their friends will be doing and where they'll sit at lunch, Hart said.

"Just remind them that they've managed these transitions before at this exact time last year," she said. "Remind them that the differences aren't all that big, and usually when they get back from that first day, they realize it's not going to be as bad as they expected."

More serious anxiety issues can be identified through sleeping problems and nightmares, loss or change in appetite, and any big changes in routine, Hart said.

Getting there: Along with the emotional stresses come potential safety issues.

Whether students ride the bus or walk to school, they should always be aware of their surroundings, York City School District Police Chief Michael Muldrow said.

York City "is primarily a walking district," Muldrow said. "We encourage our kids to use the 'safe route' streets that are marked with green signage."

Some of those safe routes, which are more actively patrolled during the time school begins and lets out, are King, Philadelphia and George streets, Muldrow said.

Parents who have students walking outside of downtown should look for roads that are less congested and have one-way traffic patterns. That way "students only have to worry about the cars coming from one direction," Muldrow said, adding that parents also should look for routes that have crossing guards.

Muldrow advised parents who send kids to school on the bus to educate their students and themselves on the potential hazards.

"We want parents to communicate to their kids to stay as far as away from traffic lanes and the streets as they can," he said. "It's also important that parents familiarize themselves with bus stops. Before the first day of school, just drive by the bus stop locations. That way, if there's any kind of problem that would force students to have to leave, you can formulate a plan and find a safe place near by."

Muldrow also emphasized the importance of both parents and students communicating with their schools about anything suspicious.

"When you see something, report something," he said. "It could be anything that makes you uncomfortable — cars that slow down, any adults that try to talk to them — make sure they know to report it as soon as they get to school or get home."

And whether students walk or take the bus, always make sure they got where they need to be.

"Have a check-in process. Parents, just have kids let you know when they're home. It's an easy thing," Muldrow said. "And with any age group, it always helps to have a buddy to travel with."

Vaccinate: Classrooms can be crowded, and stomach bugs, flus and other sicknesses can pass from student to student very quickly.

Pennsylvania students should receive tetanus, diphtheria, polio, measles, mumps, rubella (German measles), hepatitis B and varicella vaccinations before their first day of class. For seventh grade, they'll also need to have the meningococcal conjugate and Tdap (tetanus, diphtheria, acellular pertussis) vaccines.

Current state regulations allow students in kindergarten through 12th grade to be admitted to school provisionally for up to eight months if there is evidence they have received a vaccination for measles, rubella, polio, diphtheria, tetanus, varicella and hepatitis B in the past.

But that's not recommended.

And while the flu vaccine isn't required, most doctors agree that it's especially important during the school year when children are constantly in contact with each other and school staff.

"Whether you are a school bus driver, principal, teacher, coach or student, you should contact your physician to schedule your annual flu vaccine," said Rizzo.

From 10 a.m. to noon Tuesday, a free to low-cost vaccination clinic will be hosted by the Department of Health at the Paul Smith Library, 80 Constitution Ave. in Shrewsbury.

The clinic is available by appointment only and is open to those who are under- or uninsured.

For more information or to schedule an appointment, call the Pennsylvania Department of Health at (717) 771-4505.

— Reach Jessica Schladebeck at jschladebeck@yorkdispatch.com.

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