A student arrives at school on Feb. 17. March, when the new school year begins in Korea, is a time of increased concern for children and parents. Yonhap

“It's a mix of excitement and worry.”

Kim, 41, whose son is entering elementary school this year, expressed concern about how well he would adapt to the new environment. “I'm worried about whether he will adjust smoothly,” Kim said, recalling a friend who struggled with a child who refused to go to school. “Since school life is different from kindergarten, I will carefully observe whether my child experiences significant anxiety or stress."

As the new school year approaches, many parents are increasingly concerned about "back-to-school syndrome."

“Most symptoms of back-to-school syndrome improve naturally over time, but if they persist for more than one to two weeks or worsen, medical consultation is necessary," said Lee Moon-soo, a professor of psychiatry at Korea University Guro Hospital. Persistent symptoms indicate that the child is experiencing severe anxiety and stress related to school adjustment.

Back-to-school syndrome presents in various ways. Children may suddenly complain of stomachaches or headaches, lose their appetite or become unusually irritable. Some may have trouble sleeping at night, frequently visit the bathroom without a clear reason, or exhibit tic disorders, such as excessive blinking, throat clearing or repetitive mouth sounds.

Younger elementary school students are particularly vulnerable. Introverted children may experience heightened anxiety about making friends and adapting to the school environment, and some may develop separation anxiety when away from their parents.

Experts advise against scolding children when they resist going to school, as it is ineffective. “Instead of rushing to resolve their anxiety or forcing them to cope, it's crucial to allow children to manage their feelings at their own pace," Lee said. "If parents acknowledge their concerns and engage in open conversations, children will feel more emotionally secure.” Discussing potential challenges at school and exploring solutions together can help children overcome back-to-school syndrome.

In addition to psychological concerns, children who are shorter or physically smaller than their peers may experience stress, making it essential to monitor their development. Typically, children grow 20–30 centimeters in their first year after birth, around 12 centimeters the following year and 5–6 centimeters annually until puberty. During puberty, growth accelerates to 7–12 centimeters per year before stopping when growth plates close.

If an elementary school child grows less than 5 centimeters per year, a growth disorder may be suspected. A child is classified as having short stature if they rank among the shortest 3 percent of their age and gender group. While 70–80 percent of short stature cases stem from genetic or constitutional factors, the remaining 20–30 percent are often linked to skeletal, chromosomal, congenital metabolic, or endocrine disorders.

If growth issues are suspected, comprehensive evaluations, including growth plate examinations and hormone tests, are conducted. A key indicator is "bone age," which should be within 12 months of the child's actual age. If bone age is more than a year ahead, precocious puberty may be a concern, while a delay of more than two years could indicate growth hormone deficiency. “Ages 8–9 are the optimal time for treating growth disorders, so if there is a noticeable change in growth rate, parents should take action,” said Park Hye-young, director of the growth clinic at Incheon Himchan General Hospital. When bone age advances beyond actual age, the time remaining before growth plate closure is limited.

With the start of the school year, outdoor activities increase, and traffic accidents among children and adolescents also rise, which requires extra caution. According to the Korea Disease Control and Prevention Agency, an analysis of school commute-related traffic accidents among children aged 4–19 from 2019 to 2023 found that lower elementary school students were most often involved in pedestrian accidents (53.8 percent), while upper elementary students were more prone to bicycle accidents (50 percent), more than twice the 22.6 percent rate for younger students.

Traffic accidents frequently result in fractures, which can affect growth plates even if the injuries seem minor. If the end of a bone containing the growth plate is fractured, it can cause long-term growth issues. If only one side of the body sustains a fracture that affects the growth plate, uneven growth may occur. “Seeking immediate medical treatment after a childhood fracture can significantly reduce the risk of growth plate damage, making early intervention critical," said Kim Tae-seung, an orthopedic specialist at Bupyeong Himchan Hospital.

This article from the Hankook Ilbo, the sister publication of The Korea Times, is translated by a generative AI system and edited by The Korea Times.