Saturday, September 14, 2019

Healthy Habits: Later School Start Times

As millions of young people head back-to-school, Dr. Valerie Crabtree, Chief of Psychosocial Services at St. Jude Children’s Research Hospital, is calling on school districts across the country to follow the Center for Disease Control (CDC) and American Academy of Pediatrics (AAP) guidelines on school start times. 

Dr. Crabtree says our schools follow CDC and AAP guidelines on everything from hand washing to vaccinations, "But they aren’t following the guidelines for later school start times. We must do better about understanding the importance of sleep for our health, and it should start with our education system.”

As the lead researcher on sleep and fatigue in children undergoing cancer treatment and brain tumor survivors, sleep is a major focus for Dr. Crabtree’s work.  She recently spoke at a TedX Talk in Memphis on how very early school start times are detrimental to the health of teenagers as well as those around them.  Dr. Crabtree underscores how insufficient sleep in kids and adults contributes to making us overweight, sick and sluggish.  

“In children and teenagers, poor or insufficient sleep is related to poorer organization, poorer memory, and academic difficulties.  And, frighteningly, chronic sleepiness is correlated to higher rates of depression and increased rates of automobile accidents,” said Dr. Valerie Crabtree, Chief of Psychosocial Services at St. Jude Children’s Research Hospital.

However, Dr. Crabtree points out in her research that schools across the country who have delayed school start times until later have found rewards in a multitude of ways, including:
  • Teens getting more sleep; 
  • Better grades; 
  • Improved attendance, fewer tardies; 
  • Higher graduation rates; 
  • Less substance abuse and lower rates of depression; 
  • Dramatic decrease in automobile accidents;
In my work at St. Jude, I conduct research on sleep and fatigue in children undergoing treatment for cancer and in brain tumor survivors,” said Dr. Crabtree.  “Sleep is the third pillar of health, along with nutrition and movement, that keeps us healthy and balanced. Yet, as a society, we really undervalue the role of sleep in keeping us healthy.”

I had a chance to interview her to learn more.

Why are school start times so early if it's better for kids that they're late? 
Middle and high school start times around the country moved to an earlier time many years ago, typically to accommodate bus schedules. In most school districts, one set of buses are used for all ages, so school start times need to be staggered to allow for one bus to pick up and drop off elementary, middle, and high school students. The older students were often assigned the earliest school start times so that younger children were not standing at the bus stop in the dark. Of course, these changes were made before we had the information we now have about the impact of these very early school start times on adolescents’ physical and mental health, safety, and academic performance.

How can parents advocate for changes in school start times? 
Parents can join or start a local chapter of Start School Later (, a national non-profit agency that is dedicated to advocating for healthy school start times. Parents can also advocate locally with their Parent-Teacher Associations, school boards, superintendents, and even local legislators. Some states have seen legislation to provide mandates for the earliest legal school start time. As an example, California currently has a state senate bill (SB 328) under review that would set healthier limits on how early in the day middle and high schools can start classes in the state.

How can schools adjust start times while still allowing for bus schedules and practices? 
School districts that have seen successful change in this regard have closely involved their stakeholders in the process. The most successful changes have occurred after the districts formed task forces and included representatives from many areas that would be affected (e.g., administrators, parents, teachers, students, community members, coaches, school health officials, mental health providers, etc.) to ensure that all aspects of the change were considered and addressed as much as possible before it was implemented.

Besides the health benefits, how else could later start times benefit families? 
In districts that have moved to healthier start times, parents have described overall more positive family interactions. Mornings are less rushed, families can eat breakfast together, and adolescents are easier to awaken in the morning. When teens’ moods improve, there is typically a more pleasant environment in their homes. Teens who are well-rested also make better decisions, so we see a decrease in risky behaviors (e.g., substance use, risky driving, etc.), which can also decrease conflict within families.

St. Jude Children’s Research Hospital is leading the way the world understands, treats and cures childhood cancer and other life-threatening diseases. It is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children. St. Jude is ranked the No. 1 pediatric cancer hospital by U.S. News & World Report. Treatments developed at St. Jude have helped push the overall childhood cancer survival rate from 20 percent to 80 percent since the hospital opened more than 50 years ago. St. Jude freely shares the breakthroughs it makes, and every child saved at St. Jude means doctors and scientists worldwide can use that knowledge to save thousands more children. Families never receive a bill from St. Jude for treatment, travel, housing and food — because all a family should worry about is helping their child live. To learn more, visit or follow St. Jude on social media at @stjuderesearch.

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