Q: Our son is about to turn 11 years old and will start 6th grade this fall. How should we approach the transition from elementary school (with one or two teachers) to middle school, where he sees six or seven different teachers over the course of the day?

A: Moving up to middle school can feel like a big leap for children (and their parents!), not only because of the more complicated schedule, but because these years represent a time of true change for children as they navigate the road toward young adulthood.

To get preparations for the new school year underway, set up a meeting with all of your child’s teachers, the school administrators, and the school nurse. As a parent of a school-age child with type 1 diabetes, you have no doubt met before with school staff, whether at a formal 504 Plan meeting if your child goes to public school or a “plan of care” meeting if your child attends a private school that doesn’t receive government funds. The goal of this meeting, as always, is to solidify how your son’s type 1 will be managed at school. This includes things like insulin use, when and where he will test blood sugar, access to food and snacks, what to do in the event he experiences low blood sugar, a plan for after-school activities, and any special accommodations your son may need during the school day.

As you work with staff to plan your son’s day, take into account the increased social needs of a child at age 11. For example, for prelunch testing, you may want to request that he be allowed to leave class a few minutes early to do this, rather than having his visit to the nurse’s office cut into his lunch period. In middle school, lunch isn’t just about eating, it’s also a very important social time for adolescents.

Depending on his personality, your child may want to participate in this meeting to offer specific feedback about the plan, such as whether or not he is capable of self-testing (and whether he prefers testing at the nurse’s office versus going to a corner of the classroom). In general, when a child does something at home (like self-testing), it’s reasonable to expect the child to be responsible for the same task at school — with oversight.

Having your child at the meeting also affords him the chance to explain how comfortable he is with other students knowing about his diabetes. Some middle school students with type 1 may enter the science fair with a project all about their diabetes and want people to ask questions. Other students may prefer only their close friends to know. It’s good for teachers to have a sense of what your child’s thinking is on this.

One last piece of the puzzle to have in place before the school year begins is getting to know the lay of the land in your child’s new school. Introduce him to his teachers and the school nurse and, once you have your son’s schedule, chart a course from the various rooms your child will be in, including the lunch room and cafeteria, back to the nurse’s office. Walk it a few times until it feels familiar so he’ll be able to hit the ground running on the first day of school.

Judy Ayala–Judy Ayala is a licensed clinical social worker and certified diabetes educator at the Diabetes Center for Children at The Children’s Hospital of Philadelphia.


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Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.