WASHINGTON — The start of a new school year can be a challenging time for any child. But it can be exceptionally tough for students with severe food allergies.

Little kids just starting school, and their parents, face special challenges, says Linda Herbert, a psychologist with the Children’s National Health System’s food allergy program.

Pre-school age children are generally “home with parents … who have control over all aspects of food-allergy management,” says Herbert. “So school is a much different thing for them.”

She encourages parents to take the initiative and contact the school well before opening day. The ideal situation would be to meet with all those who might be involved in their child’s care: teachers; health staff; even a nutritionist if the school has one.

The goal is to come up with an action plan that details the nature of the food allergy and exactly what needs to happen in the event of an allergic reaction.

Herbert says that for elementary school kids, “you want to make sure the teacher is aware of the child’s food allergies, knows the symptoms of an allergic reaction and also knows how to treat it and where epinephrine is available.”

It’s also a good idea to find out whether food will be a part of classroom celebrations, and whether other ways can be found to mark big occasions.

And don’t overlook the school cafeteria. Herbert advises finding out whether a teacher or another staff member is assigned to monitor the cafeteria. Insist that that person be trained to deal with allergies.

While it’s important to talk to the school employees, parents also need to talk with their kids.

Knowledge is power, Herbert says, and a child needs to know how to be his own best advocate.

Herbert says kids with allergies feel more confident when they know how to solve problems on their own. They need to be taught which foods are safe and which aren’t, and to be shown how to comfortably turn down food they shouldn’t eat.

At the food allergy program at Children’s, Herbert often role-plays with patients, practicing the skills they need when interacting with other students. She says parents and siblings can do the same at home.

Herbert was added to the staff at the food program in 2013 in large part because of the psychological problems sometimes faced by children with severe allergies. She often deals with the bullying that can surround food allergies.

A study published in the January 2013 issue of the journal Pediatrics found that nearly a third of children with food allergies experienced bullying. On the Children’s National Health System website, Herbert urges parents to be on the lookout for these signs of trouble:

• The child’s behavior pattern changes;
• The child is not excited or delays going to school;
• The child is not interested in recess, hanging out with friends or doing anything he used to consider fun;
• The child cries easily or complains of frequent headaches or stomachaches;
• The child comes home with dirty or ripped clothes;
• The child shows other signs of depression, anxiety or low self-esteem.

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