One of the joys of being a pediatrician is having the special privilege of interacting with children of all ages, as well as parents and grandparents. Every age is an age of discovery, driven by a curiosity that often comes from within us, stoked (and hopefully not doused) by family, friends, and teachers. Wisdom is most often gained by listening to those who came before us. Knowledge, however, is gathered from the experience of life-long learning. Back in the day (or at least, back in my day), most of our learning occurred in the classroom, from teachers’ lessons, textbooks, and the occasional educational movie shown on a two-reel projector. Today, kids have so many additional tools to feed their curiosity and build their knowledge. The incorporation by schools, teachers, and parents of new, mostly electronic, technologies to help kids learn more information in the same amount of time (there are only still 24 hours in a day, last I checked) is pretty amazing when you think about it. So it should come as no surprise that the three saddest words pediatricians hear all too often from children we care for are:


“I hate school.”

Those three words strung together, usually expressed during a regular annual checkup when the pediatrician asks, “So how is school going for you?” are what we call in this business, red flags.

You may be aware of “Red Flag Warnings” you see on a beach during summer vacation, alerting you to stay out of the ocean due to strong currents, heavy seas, strong winds, or bad weather. The red light on a traffic signal is, metaphorically, a red flag. “Stop!” it tells you. Abnormal blood test results literally pop up on our electronic health records with a red flag next to them. Red flags get your attention fast. And just as rapidly, red flag warnings should be heeded. “I hate school” is one of those things pediatricians consider a red flag because the comment indicates one of three things we don’t want to miss:

1. ”I hate school” really means “I’m having a really hard time learning.” Obstacles in learning pathways can come from an inability to pay attention and focus on learning tasks (ADHD is an example) or a specific learning disability. There are several different types of learning disabilities — dyslexia, dyspraxia, dysgraphia, dyscalculia are some examples — that can occur in isolation, which can be approached more directly, or in combination, which requires a multi-pronged effort to overcome. Because most learning disabilities can be overcome with first acknowledging the problem, then recognizing a child’s learning strengths (and not only his/her weaknesses), and then following a multidisciplinary approach to teaching, learning disabilities are better described as “learning differences.” It’s important to identify children who are struggling academically as early as possible — even in preschool — before their natural curiosity and developing feelings of self-esteem are squashed.

2. ”I hate school” really means “I’m just saying that because I’ve got an “ear worm” put there by my peers (or, more tragically, a parent) that makes me say it.” The amount of negativity children encounter every day can be extraordinary. This negativity must be addressed by parents, even if they themselves are the source, and managed by teachers in the classroom. It’s not easy. Kids are easily influenced by parents (mostly), peers (a close second), and what they see and hear from mainstream, electronic and social media. If they are exposed to enough negativity, and absorb it into their own selves, then the negative perceptions about school (and about life) become self-fulfilling. This has all sorts of bad “juju” — adverse personal, social, and health outcomes — associated with it. Besides, nobody likes negative people.

3. ”I hate school” really means “I don’t like school. Honestly, I don’t like it.” This is one of the more challenging situations that parents and teachers may face: a genuinely intelligent and capable child who most likely has extraordinary talents — “playing the game” and going to school just isn’t one of them. For a lot of these kids, trying to make them conform is like trying to bang a square peg into a round hole: eventually, the harder the pounding, the more likely something is going to break. Sometimes family dynamics break. Other times, rules and other boundaries are broken. But what is most sad is when a child’s spirit to live, to learn, to enjoy life itself is broken. That happens way too much in our society.


Children have strengths and talents. They also have weaknesses and inabilities/disabilities. This is true of all of us: nobody is perfect — none of us. The real challenge isn’t so much helping children identify their strengths and talents and encouraging them to develop those. Rather, the real challenge is to identify the things we are weak at — things we have a hard time doing, or feeling, or understanding — and finding  other routes and pathways to become better, instead of avoiding them. Or hating them. Each of us has that potential. We need to find and nurture that potential in every child.

That’s the challenge.