evidence for homework in primary school

Is Homework Good for Kids? Here’s What the Research Says

A s kids return to school, debate is heating up once again over how they should spend their time after they leave the classroom for the day.

The no-homework policy of a second-grade teacher in Texas went viral last week , earning praise from parents across the country who lament the heavy workload often assigned to young students. Brandy Young told parents she would not formally assign any homework this year, asking students instead to eat dinner with their families, play outside and go to bed early.

But the question of how much work children should be doing outside of school remains controversial, and plenty of parents take issue with no-homework policies, worried their kids are losing a potential academic advantage. Here’s what you need to know:

For decades, the homework standard has been a “10-minute rule,” which recommends a daily maximum of 10 minutes of homework per grade level. Second graders, for example, should do about 20 minutes of homework each night. High school seniors should complete about two hours of homework each night. The National PTA and the National Education Association both support that guideline.

But some schools have begun to give their youngest students a break. A Massachusetts elementary school has announced a no-homework pilot program for the coming school year, lengthening the school day by two hours to provide more in-class instruction. “We really want kids to go home at 4 o’clock, tired. We want their brain to be tired,” Kelly Elementary School Principal Jackie Glasheen said in an interview with a local TV station . “We want them to enjoy their families. We want them to go to soccer practice or football practice, and we want them to go to bed. And that’s it.”

A New York City public elementary school implemented a similar policy last year, eliminating traditional homework assignments in favor of family time. The change was quickly met with outrage from some parents, though it earned support from other education leaders.

New solutions and approaches to homework differ by community, and these local debates are complicated by the fact that even education experts disagree about what’s best for kids.

The research

The most comprehensive research on homework to date comes from a 2006 meta-analysis by Duke University psychology professor Harris Cooper, who found evidence of a positive correlation between homework and student achievement, meaning students who did homework performed better in school. The correlation was stronger for older students—in seventh through 12th grade—than for those in younger grades, for whom there was a weak relationship between homework and performance.

Cooper’s analysis focused on how homework impacts academic achievement—test scores, for example. His report noted that homework is also thought to improve study habits, attitudes toward school, self-discipline, inquisitiveness and independent problem solving skills. On the other hand, some studies he examined showed that homework can cause physical and emotional fatigue, fuel negative attitudes about learning and limit leisure time for children. At the end of his analysis, Cooper recommended further study of such potential effects of homework.

Despite the weak correlation between homework and performance for young children, Cooper argues that a small amount of homework is useful for all students. Second-graders should not be doing two hours of homework each night, he said, but they also shouldn’t be doing no homework.

Not all education experts agree entirely with Cooper’s assessment.

Cathy Vatterott, an education professor at the University of Missouri-St. Louis, supports the “10-minute rule” as a maximum, but she thinks there is not sufficient proof that homework is helpful for students in elementary school.

“Correlation is not causation,” she said. “Does homework cause achievement, or do high achievers do more homework?”

Vatterott, the author of Rethinking Homework: Best Practices That Support Diverse Needs , thinks there should be more emphasis on improving the quality of homework tasks, and she supports efforts to eliminate homework for younger kids.

“I have no concerns about students not starting homework until fourth grade or fifth grade,” she said, noting that while the debate over homework will undoubtedly continue, she has noticed a trend toward limiting, if not eliminating, homework in elementary school.

The issue has been debated for decades. A TIME cover in 1999 read: “Too much homework! How it’s hurting our kids, and what parents should do about it.” The accompanying story noted that the launch of Sputnik in 1957 led to a push for better math and science education in the U.S. The ensuing pressure to be competitive on a global scale, plus the increasingly demanding college admissions process, fueled the practice of assigning homework.

“The complaints are cyclical, and we’re in the part of the cycle now where the concern is for too much,” Cooper said. “You can go back to the 1970s, when you’ll find there were concerns that there was too little, when we were concerned about our global competitiveness.”

Cooper acknowledged that some students really are bringing home too much homework, and their parents are right to be concerned.

“A good way to think about homework is the way you think about medications or dietary supplements,” he said. “If you take too little, they’ll have no effect. If you take too much, they can kill you. If you take the right amount, you’ll get better.”

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Should Kids Get Homework?

Homework gives elementary students a way to practice concepts, but too much can be harmful, experts say.

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Effective homework reinforces math, reading, writing or spelling skills, but in a way that's meaningful.

How much homework students should get has long been a source of debate among parents and educators. In recent years, some districts have even implemented no-homework policies, as students juggle sports, music and other activities after school.

Parents of elementary school students, in particular, have argued that after-school hours should be spent with family or playing outside rather than completing assignments. And there is little research to show that homework improves academic achievement for elementary students.

But some experts say there's value in homework, even for younger students. When done well, it can help students practice core concepts and develop study habits and time management skills. The key to effective homework, they say, is keeping assignments related to classroom learning, and tailoring the amount by age: Many experts suggest no homework for kindergartners, and little to none in first and second grade.

Value of Homework

Homework provides a chance to solidify what is being taught in the classroom that day, week or unit. Practice matters, says Janine Bempechat, clinical professor at Boston University 's Wheelock College of Education & Human Development.

"There really is no other domain of human ability where anybody would say you don't need to practice," she adds. "We have children practicing piano and we have children going to sports practice several days a week after school. You name the domain of ability and practice is in there."

Homework is also the place where schools and families most frequently intersect.

"The children are bringing things from the school into the home," says Paula S. Fass, professor emerita of history at the University of California—Berkeley and the author of "The End of American Childhood." "Before the pandemic, (homework) was the only real sense that parents had to what was going on in schools."

Harris Cooper, professor emeritus of psychology and neuroscience at Duke University and author of "The Battle Over Homework," examined more than 60 research studies on homework between 1987 and 2003 and found that — when designed properly — homework can lead to greater student success. Too much, however, is harmful. And homework has a greater positive effect on students in secondary school (grades 7-12) than those in elementary.

"Every child should be doing homework, but the amount and type that they're doing should be appropriate for their developmental level," he says. "For teachers, it's a balancing act. Doing away with homework completely is not in the best interest of children and families. But overburdening families with homework is also not in the child's or a family's best interest."

Negative Homework Assignments

Not all homework for elementary students involves completing a worksheet. Assignments can be fun, says Cooper, like having students visit educational locations, keep statistics on their favorite sports teams, read for pleasure or even help their parents grocery shop. The point is to show students that activities done outside of school can relate to subjects learned in the classroom.

But assignments that are just busy work, that force students to learn new concepts at home, or that are overly time-consuming can be counterproductive, experts say.

Homework that's just busy work.

Effective homework reinforces math, reading, writing or spelling skills, but in a way that's meaningful, experts say. Assignments that look more like busy work – projects or worksheets that don't require teacher feedback and aren't related to topics learned in the classroom – can be frustrating for students and create burdens for families.

"The mental health piece has definitely played a role here over the last couple of years during the COVID-19 pandemic, and the last thing we want to do is frustrate students with busy work or homework that makes no sense," says Dave Steckler, principal of Red Trail Elementary School in Mandan, North Dakota.

Homework on material that kids haven't learned yet.

With the pressure to cover all topics on standardized tests and limited time during the school day, some teachers assign homework that has not yet been taught in the classroom.

Not only does this create stress, but it also causes equity challenges. Some parents speak languages other than English or work several jobs, and they aren't able to help teach their children new concepts.

" It just becomes agony for both parents and the kids to get through this worksheet, and the goal becomes getting to the bottom of (the) worksheet with answers filled in without any understanding of what any of it matters for," says professor Susan R. Goldman, co-director of the Learning Sciences Research Institute at the University of Illinois—Chicago .

Homework that's overly time-consuming.

The standard homework guideline recommended by the National Parent Teacher Association and the National Education Association is the "10-minute rule" – 10 minutes of nightly homework per grade level. A fourth grader, for instance, would receive a total of 40 minutes of homework per night.

But this does not always happen, especially since not every student learns the same. A 2015 study published in the American Journal of Family Therapy found that primary school children actually received three times the recommended amount of homework — and that family stress increased along with the homework load.

Young children can only remain attentive for short periods, so large amounts of homework, especially lengthy projects, can negatively affect students' views on school. Some individual long-term projects – like having to build a replica city, for example – typically become an assignment for parents rather than students, Fass says.

"It's one thing to assign a project like that in which several kids are working on it together," she adds. "In (that) case, the kids do normally work on it. It's another to send it home to the families, where it becomes a burden and doesn't really accomplish very much."

Private vs. Public Schools

Do private schools assign more homework than public schools? There's little research on the issue, but experts say private school parents may be more accepting of homework, seeing it as a sign of academic rigor.

Of course, not all private schools are the same – some focus on college preparation and traditional academics, while others stress alternative approaches to education.

"I think in the academically oriented private schools, there's more support for homework from parents," says Gerald K. LeTendre, chair of educational administration at Pennsylvania State University—University Park . "I don't know if there's any research to show there's more homework, but it's less of a contentious issue."

How to Address Homework Overload

First, assess if the workload takes as long as it appears. Sometimes children may start working on a homework assignment, wander away and come back later, Cooper says.

"Parents don't see it, but they know that their child has started doing their homework four hours ago and still not done it," he adds. "They don't see that there are those four hours where their child was doing lots of other things. So the homework assignment itself actually is not four hours long. It's the way the child is approaching it."

But if homework is becoming stressful or workload is excessive, experts suggest parents first approach the teacher, followed by a school administrator.

"Many times, we can solve a lot of issues by having conversations," Steckler says, including by "sitting down, talking about the amount of homework, and what's appropriate and not appropriate."

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Primary school children get little academic benefit from homework

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Homework: a word that can cause despair not just in children, but also in parents and even teachers. And for primary school children at least, it may be that schools setting homework is more trouble than it’s worth.

There is evidence that homework can be useful at secondary school . It can be used to consolidate material learnt in class or to prepare for exams.

However, it is less clear that homework is useful for children at primary school (ages 5 to 11) or in early years education (ages 3 to 5).

What is homework for?

There are no current guidelines on how much homework primary school children in England should be set. In 2018 then education secretary Damien Hinds stated that “We trust individual school head teachers to decide what their policy on homework will be, and what happens if pupils don’t do what’s set”.

While there is not much data available on how much homework primary school pupils do, a 2018 survey of around 1,000 parents found that primary pupils were spending an average of 2.2 hours per week on homework.

The homework done by primary school children can include reading, practising spellings, or revising for tests. Charity the Education Endowment Foundation suggests that the uses for homework at primary school include reinforcing the skills that pupils learn in school, helping them get ready for tests and preparing them for future school lessons.

Homework can also act as a point of communication between home and school, helping parents feel part of their child’s schooling.

However, the 2018 Ofsted Parents’ Panel – which surveyed the views of around 1,000 parents in England on educational issues – found that 36% of parents thought that homework was not helpful at all to their primary school children. The panel report found that, for many parents, homework was a significant source of stress and negatively affected family life.

Little academic benefit

Not much academic research has been carried out on the impact of homework for children in primary school. The available meta-studies – research that combines and analyses the findings of a number of studies – suggest that homework has little or no positive benefit for the academic achievement of children of primary school age . A central reason for this seems to be the inability of children to complete this homework without the support provided by teachers and the school.

Some research has suggested that primary pupils lack the independent study skills to do homework, and that they are not able to stay focused on the work.

What’s more, homework may actually have a negative effect if parents set unrealistic expectations, apply pressure or use methods that go counter to those used at school.

Homework may also increase inequalities between pupils. High achievers from economically privileged backgrounds may have greater parental support for homework, including more educated assistance, higher expectations and better settings and resources.

However, it is possible that setting homework for primary school children has benefits that cannot be easily measured, such as developing responsibility and independent problem-solving skills. It could also help children develop habits that will be useful in later school life.

A common task set for homework in primary schools is for children to read with their parents. There is some evidence that this has a positive impact as well as providing enjoyment, but the quality of interaction may be more important than the quantity.

If the purpose of homework is to develop the relationship between home and school and give parents more stake in the schooling of their children then this may well be a positive thing. If this is its purpose, though, it should not be used as a means to improve test scores or school performance metrics. For the youngest children, anything that takes time away from developmental play is a bad thing.

Rather, any homework should develop confidence and engagement in the process of schooling for both children and parents.

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What’s the Right Amount of Homework?

Decades of research show that homework has some benefits, especially for students in middle and high school—but there are risks to assigning too much.

Many teachers and parents believe that homework helps students build study skills and review concepts learned in class. Others see homework as disruptive and unnecessary, leading to burnout and turning kids off to school. Decades of research show that the issue is more nuanced and complex than most people think: Homework is beneficial, but only to a degree. Students in high school gain the most, while younger kids benefit much less.

The National PTA and the National Education Association support the “ 10-minute homework guideline ”—a nightly 10 minutes of homework per grade level. But many teachers and parents are quick to point out that what matters is the quality of the homework assigned and how well it meets students’ needs, not the amount of time spent on it.

The guideline doesn’t account for students who may need to spend more—or less—time on assignments. In class, teachers can make adjustments to support struggling students, but at home, an assignment that takes one student 30 minutes to complete may take another twice as much time—often for reasons beyond their control. And homework can widen the achievement gap, putting students from low-income households and students with learning disabilities at a disadvantage.

However, the 10-minute guideline is useful in setting a limit: When kids spend too much time on homework, there are real consequences to consider.

Small Benefits for Elementary Students

As young children begin school, the focus should be on cultivating a love of learning, and assigning too much homework can undermine that goal. And young students often don’t have the study skills to benefit fully from homework, so it may be a poor use of time (Cooper, 1989 ; Cooper et al., 2006 ; Marzano & Pickering, 2007 ). A more effective activity may be nightly reading, especially if parents are involved. The benefits of reading are clear: If students aren’t proficient readers by the end of third grade, they’re less likely to succeed academically and graduate from high school (Fiester, 2013 ).

For second-grade teacher Jacqueline Fiorentino, the minor benefits of homework did not outweigh the potential drawback of turning young children against school at an early age, so she experimented with dropping mandatory homework. “Something surprising happened: They started doing more work at home,” Fiorentino writes . “This inspiring group of 8-year-olds used their newfound free time to explore subjects and topics of interest to them.” She encouraged her students to read at home and offered optional homework to extend classroom lessons and help them review material.

Moderate Benefits for Middle School Students

As students mature and develop the study skills necessary to delve deeply into a topic—and to retain what they learn—they also benefit more from homework. Nightly assignments can help prepare them for scholarly work, and research shows that homework can have moderate benefits for middle school students (Cooper et al., 2006 ). Recent research also shows that online math homework, which can be designed to adapt to students’ levels of understanding, can significantly boost test scores (Roschelle et al., 2016 ).

There are risks to assigning too much, however: A 2015 study found that when middle school students were assigned more than 90 to 100 minutes of daily homework, their math and science test scores began to decline (Fernández-Alonso, Suárez-Álvarez, & Muñiz, 2015 ). Crossing that upper limit can drain student motivation and focus. The researchers recommend that “homework should present a certain level of challenge or difficulty, without being so challenging that it discourages effort.” Teachers should avoid low-effort, repetitive assignments, and assign homework “with the aim of instilling work habits and promoting autonomous, self-directed learning.”

In other words, it’s the quality of homework that matters, not the quantity. Brian Sztabnik, a veteran middle and high school English teacher, suggests that teachers take a step back and ask themselves these five questions :

• How long will it take to complete?
• Have all learners been considered?
• Will an assignment encourage future success?
• Will an assignment place material in a context the classroom cannot?
• Does an assignment offer support when a teacher is not there?

More Benefits for High School Students, but Risks as Well

By the time they reach high school, students should be well on their way to becoming independent learners, so homework does provide a boost to learning at this age, as long as it isn’t overwhelming (Cooper et al., 2006 ; Marzano & Pickering, 2007 ). When students spend too much time on homework—more than two hours each night—it takes up valuable time to rest and spend time with family and friends. A 2013 study found that high school students can experience serious mental and physical health problems, from higher stress levels to sleep deprivation, when assigned too much homework (Galloway, Conner, & Pope, 2013 ).

Homework in high school should always relate to the lesson and be doable without any assistance, and feedback should be clear and explicit.

Teachers should also keep in mind that not all students have equal opportunities to finish their homework at home, so incomplete homework may not be a true reflection of their learning—it may be more a result of issues they face outside of school. They may be hindered by issues such as lack of a quiet space at home, resources such as a computer or broadband connectivity, or parental support (OECD, 2014 ). In such cases, giving low homework scores may be unfair.

Since the quantities of time discussed here are totals, teachers in middle and high school should be aware of how much homework other teachers are assigning. It may seem reasonable to assign 30 minutes of daily homework, but across six subjects, that’s three hours—far above a reasonable amount even for a high school senior. Psychologist Maurice Elias sees this as a common mistake: Individual teachers create homework policies that in aggregate can overwhelm students. He suggests that teachers work together to develop a school-wide homework policy and make it a key topic of back-to-school night and the first parent-teacher conferences of the school year.

Parents Play a Key Role

Homework can be a powerful tool to help parents become more involved in their child’s learning (Walker et al., 2004 ). It can provide insights into a child’s strengths and interests, and can also encourage conversations about a child’s life at school. If a parent has positive attitudes toward homework, their children are more likely to share those same values, promoting academic success.

But it’s also possible for parents to be overbearing, putting too much emphasis on test scores or grades, which can be disruptive for children (Madjar, Shklar, & Moshe, 2015 ). Parents should avoid being overly intrusive or controlling—students report feeling less motivated to learn when they don’t have enough space and autonomy to do their homework (Orkin, May, & Wolf, 2017 ; Patall, Cooper, & Robinson, 2008 ; Silinskas & Kikas, 2017 ). So while homework can encourage parents to be more involved with their kids, it’s important to not make it a source of conflict.

Does homework really work?

by: Leslie Crawford | Updated: December 12, 2023

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You know the drill. It’s 10:15 p.m., and the cardboard-and-toothpick Golden Gate Bridge is collapsing. The pages of polynomials have been abandoned. The paper on the Battle of Waterloo seems to have frozen in time with Napoleon lingering eternally over his breakfast at Le Caillou. Then come the tears and tantrums — while we parents wonder, Does the gain merit all this pain? Is this just too much homework?

However the drama unfolds night after night, year after year, most parents hold on to the hope that homework (after soccer games, dinner, flute practice, and, oh yes, that childhood pastime of yore known as playing) advances their children academically.

But what does homework really do for kids? Is the forest’s worth of book reports and math and spelling sheets the average American student completes in their 12 years of primary schooling making a difference? Or is it just busywork?

Homework haterz

Whether or not homework helps, or even hurts, depends on who you ask. If you ask my 12-year-old son, Sam, he’ll say, “Homework doesn’t help anything. It makes kids stressed-out and tired and makes them hate school more.”

Nothing more than common kid bellyaching?

Maybe, but in the fractious field of homework studies, it’s worth noting that Sam’s sentiments nicely synopsize one side of the ivory tower debate. Books like The End of Homework , The Homework Myth , and The Case Against Homework the film Race to Nowhere , and the anguished parent essay “ My Daughter’s Homework is Killing Me ” make the case that homework, by taking away precious family time and putting kids under unneeded pressure, is an ineffective way to help children become better learners and thinkers.

One Canadian couple took their homework apostasy all the way to the Supreme Court of Canada. After arguing that there was no evidence that it improved academic performance, they won a ruling that exempted their two children from all homework.

So what’s the real relationship between homework and academic achievement?

How much is too much?

To answer this question, researchers have been doing their homework on homework, conducting and examining hundreds of studies. Chris Drew Ph.D., founder and editor at The Helpful Professor recently compiled multiple statistics revealing the folly of today’s after-school busy work. Does any of the data he listed below ring true for you?

• 45 percent of parents think homework is too easy for their child, primarily because it is geared to the lowest standard under the Common Core State Standards .

• 74 percent of students say homework is a source of stress , defined as headaches, exhaustion, sleep deprivation, weight loss, and stomach problems.

• Students in high-performing high schools spend an average of 3.1 hours a night on homework , even though 1 to 2 hours is the optimal duration, according to a peer-reviewed study .

Not included in the list above is the fact many kids have to abandon activities they love — like sports and clubs — because homework deprives them of the needed time to enjoy themselves with other pursuits.

Conversely, The Helpful Professor does list a few pros of homework, noting it teaches discipline and time management, and helps parents know what’s being taught in the class.

The oft-bandied rule on homework quantity — 10 minutes a night per grade (starting from between 10 to 20 minutes in first grade) — is listed on the National Education Association’s website and the National Parent Teacher Association’s website , but few schools follow this rule.

Do you think your child is doing excessive homework? Harris Cooper Ph.D., author of a meta-study on homework , recommends talking with the teacher. “Often there is a miscommunication about the goals of homework assignments,” he says. “What appears to be problematic for kids, why they are doing an assignment, can be cleared up with a conversation.” Also, Cooper suggests taking a careful look at how your child is doing the assignments. It may seem like they’re taking two hours, but maybe your child is wandering off frequently to get a snack or getting distracted.

Less is often more

If your child is dutifully doing their work but still burning the midnight oil, it’s worth intervening to make sure your child gets enough sleep. A 2012 study of 535 high school students found that proper sleep may be far more essential to brain and body development.

For elementary school-age children, Cooper’s research at Duke University shows there is no measurable academic advantage to homework. For middle-schoolers, Cooper found there is a direct correlation between homework and achievement if assignments last between one to two hours per night. After two hours, however, achievement doesn’t improve. For high schoolers, Cooper’s research suggests that two hours per night is optimal. If teens have more than two hours of homework a night, their academic success flatlines. But less is not better. The average high school student doing homework outperformed 69 percent of the students in a class with no homework.

Many schools are starting to act on this research. A Florida superintendent abolished homework in her 42,000 student district, replacing it with 20 minutes of nightly reading. She attributed her decision to “ solid research about what works best in improving academic achievement in students .”

More family time

A 2020 survey by Crayola Experience reports 82 percent of children complain they don’t have enough quality time with their parents. Homework deserves much of the blame. “Kids should have a chance to just be kids and do things they enjoy, particularly after spending six hours a day in school,” says Alfie Kohn, author of The Homework Myth . “It’s absurd to insist that children must be engaged in constructive activities right up until their heads hit the pillow.”

By far, the best replacement for homework — for both parents and children — is bonding, relaxing time together.

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More than two hours of homework may be counterproductive, research suggests.

A Stanford education researcher found that too much homework can negatively affect kids, especially their lives away from school, where family, friends and activities matter.   "Our findings on the effects of homework challenge the traditional assumption that homework is inherently good," wrote Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of a study published in the Journal of Experimental Education .   The researchers used survey data to examine perceptions about homework, student well-being and behavioral engagement in a sample of 4,317 students from 10 high-performing high schools in upper-middle-class California communities. Along with the survey data, Pope and her colleagues used open-ended answers to explore the students' views on homework.   Median household income exceeded $90,000 in these communities, and 93 percent of the students went on to college, either two-year or four-year.   Students in these schools average about 3.1 hours of homework each night.   "The findings address how current homework practices in privileged, high-performing schools sustain students' advantage in competitive climates yet hinder learning, full engagement and well-being," Pope wrote.   Pope and her colleagues found that too much homework can diminish its effectiveness and even be counterproductive. They cite prior research indicating that homework benefits plateau at about two hours per night, and that 90 minutes to two and a half hours is optimal for high school.   Their study found that too much homework is associated with:   • Greater stress : 56 percent of the students considered homework a primary source of stress, according to the survey data. Forty-three percent viewed tests as a primary stressor, while 33 percent put the pressure to get good grades in that category. Less than 1 percent of the students said homework was not a stressor.   • Reductions in health : In their open-ended answers, many students said their homework load led to sleep deprivation and other health problems. The researchers asked students whether they experienced health issues such as headaches, exhaustion, sleep deprivation, weight loss and stomach problems.   • Less time for friends, family and extracurricular pursuits : Both the survey data and student responses indicate that spending too much time on homework meant that students were "not meeting their developmental needs or cultivating other critical life skills," according to the researchers. Students were more likely to drop activities, not see friends or family, and not pursue hobbies they enjoy.   A balancing act   The results offer empirical evidence that many students struggle to find balance between homework, extracurricular activities and social time, the researchers said. Many students felt forced or obligated to choose homework over developing other talents or skills.   Also, there was no relationship between the time spent on homework and how much the student enjoyed it. The research quoted students as saying they often do homework they see as "pointless" or "mindless" in order to keep their grades up.   "This kind of busy work, by its very nature, discourages learning and instead promotes doing homework simply to get points," said Pope, who is also a co-founder of Challenge Success , a nonprofit organization affiliated with the GSE that conducts research and works with schools and parents to improve students' educational experiences..   Pope said the research calls into question the value of assigning large amounts of homework in high-performing schools. Homework should not be simply assigned as a routine practice, she said.   "Rather, any homework assigned should have a purpose and benefit, and it should be designed to cultivate learning and development," wrote Pope.   High-performing paradox   In places where students attend high-performing schools, too much homework can reduce their time to foster skills in the area of personal responsibility, the researchers concluded. "Young people are spending more time alone," they wrote, "which means less time for family and fewer opportunities to engage in their communities."   Student perspectives   The researchers say that while their open-ended or "self-reporting" methodology to gauge student concerns about homework may have limitations – some might regard it as an opportunity for "typical adolescent complaining" – it was important to learn firsthand what the students believe.   The paper was co-authored by Mollie Galloway from Lewis and Clark College and Jerusha Conner from Villanova University.

Clifton B. Parker is a writer at the Stanford News Service .

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Does homework have any benefits for primary school children? Jen Hogan and Dr Leah O’Toole discuss

Homework is an emotive and divisive issue among parents and children. the evidence doesn’t support traditional approaches.

Homework, what is it good for? And what change should there be?

Jen Hogan: Homework instils unhealthy work and play habits

There’s a notable change in the mood in this house since homework returned. (The kids aren’t that impressed either.) Goodbye free and easy evenings of summer; we’re back to the days of kitchen table battles, once again instilling unhealthy work, rest and play habits in our children, as the single worst thing about school takes hold.

I know I’m not alone. Years of campaigning against homework has led to countless discussions with other parents and teachers who would also like to see an end to this most miserable of tasks. With studies – including one carried out by Duke University, Sydney – showing no strong links between homework and academic achievement in primary school, one would have to wonder why we’ve allowed it to continue at all.

At best, homework appears to make little to no difference to a primary schoolchild’s academic performance. At worst it is counterproductive, creating a negative association with education and learning. But we Irish are sticklers for tradition, and appear loath to let it go.

As adults, we often grapple with the difficulties of finding and maintaining a healthy work-life balance. And though many of us work beyond the hours we should, this is not something to be advocated. You’re unlikely to hear anyone tell an adult “do you know what you should do after a day’s work? You should go home and do some more”. And yet here we are, telling children who are focusing and sitting and concentrating for large parts of their day that they should go home and do some more.

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Play is children’s work. That is what we should be advocating and that is what we should be facilitating.

Consolidation is often an argument in favour of homework, and yet research does not back this up. For a child who has already grasped a concept, doing more in the evening feels largely like “going through the motions”. For the child who hasn’t grasped a concept, it’s even worse. Trying to do so after a long day in school, when the child is tired, and maybe even cranky, is never going to be the best time to go at it again. The phrase “flogging a dead horse” springs to mind.

Many children and parents consider homework to be the most miserable of tasks. Photograph: iStock

If teachers were freed up from the time they spend allocating and correcting homework, there would be more time to revisit the concepts being studied – only this time there would be continuity to the way it’s taught.

Keeping on top of what our children are learning, and any difficulties they may be encountering, can coexist with a no-homework policy. The apps we became so familiar with during Covid, such as Aladdin, can be put to good use with a very brief weekly update. The copybooks and workbooks could come home at weekends for parents to browse.

Reading is a given. Every parent wants their child to read, and ideally for pleasure so that they’ll choose to do it more. And there is more to learning than formal academics and yet an ability to support formal academics in informal ways. Learning life skills, having time to do the things that float your boat, and having precious family time matters. As does wellbeing – the actual things children can do to support their wellbeing, rather than writing about those things in the workbook, for homework.

In Ireland one in six adults has difficulties with literacy. One in four has difficulties with maths. That’s a lot of households where parents struggle to support their children with homework, causing embarrassment, shame and further stress. For children with additional needs, the stress of homework can be unbearable for the child and family. Not every child has a suitable home environment for homework. And not every child experiences family life and its complexities and commitments the same way. Blinkered privilege often sees us oblivious to the challenges others may face. “Pull the ladder up Jack, sure mine are grand”, just doesn’t cut it any more.

Few children enjoy doing more school work after coming home from school. Photograph: iStock

Dr Leah O’Toole and Dr Joan Kiely: If homework is to have a role, it needs to be reinvented

When it comes to research on homework, there is such a range of evidence, both positive and negative, that conceivably it would be possible to champion any opinion.

The positive impacts of homework include inculcation of good study habits and skills, improved self-directed learning, and increased parental involvement in children’s education. There is also evidence that homework can lead to physical and emotional exhaustion for children, and denial of recreation time.

Homework can cause confusion for children because teachers and parents can interpret tasks differently, and sometimes parents over-assist with homework, limiting children’s independent learning. It can reinforce disparities in achievement because children experience different levels of support at home. This can be misinterpreted by schools as lack of interest by some parents, without acknowledging the differing pressures on some families in terms of poverty, lack of quiet space to work, lack of time due to work or other caring duties, or lack of capacity for some parents based on their own educational levels. There is evidence of significant stress caused by homework to children and parents alike, and some writers talk about the “colonisation of the home” by homework. Significantly, many of these studies were done with older children, and homework in the primary years is under-researched.

A few years ago, as part of a larger study of parental involvement in children’s education, we investigated experiences of homework in primary schools in Ireland. It proved to be a highly emotive and contested issue. One of the potential benefits of homework identified was the creation of links between home and school, allowing parents to understand what their children were learning, and how well (or not) they were managing. However, homework was associated with considerable stress for children and parents in our study, regardless of children’s dispositions or academic abilities.

Homework can be associated with considerable stress for children and parents

Considering the fact that homework felt mostly stressful to parents, we argued that it does not support positive parental involvement in children’s learning and may not be the best tool for schools to make links with homes. Homework set was often incongruent with practical reality, in its type, amount, purpose and time limits. Choice was crucial in the effectiveness of homework, but it was rare for children to be asked their views. When children were offered choice in the format of homework (for example, showing knowledge of the same topic through a written submission, a verbal presentation or a visual/arts-based creation) or when to do it (for example, a submission at the end of the week with homework done on days that suited them), children’s motivation and learning improved. Stress for both children and parents also reduced.

We supported schools to trial alternatives to traditional homework, including dialogic story-reading, games and oral-language activities like practising weather reports or interviewing grandparents. Children loved this type of homework and highlighted its playful nature as well as the choice provided. Parents also reported that this homework was more enjoyable and less stressful, although they did note that it still took up a lot of their time. Recommendations from our study included increased guidance on homework at a national level, a review of school homework policies, incorporation of more playful, fun activities into homework, and more choice for children.

We encouraged schools when setting homework to consider the demands on children’s and parents’ time, and the importance of free play, particularly outdoors, for learning and development. This becomes even more crucial the younger the child, and we suggested removing homework altogether for junior-infant classes except for story reading.

So overall, when it comes to homework, like many things in education and in life, it isn’t what you do, it’s the way that you do it.

Dr Leah O’Toole is assistant professor in early childhood education at Maynooth University and Dr Joan Kiely is head of early childhood education at Marino Institute of Education

[  How homework can help children feel happier  ]

Ten ways schools are reinventing homework

1. Mindfulness Mondays (The only homework given is mindfulness practice)

2. Homework set at beginning of week and the child decides when to do it

3. Homework choices given

4. Homework differentiated according to children’s needs

5. Physical exercise homework only during the Active Schools Programme

6. Teddy Bear homework – bring home Teddy and record his adventures with the family

7. Child teaches something they learned at school at home to their family

8. Oral language exercises such as interviewing a family member or playing language games

9. Reading for pleasure programme. Reading only homework

10. Project – based and cross-curricular homework

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NEWS • 13 May 2022

Primary school children get little academic benefit from homework

Paul Hopkins , Lecturer and Researcher in Education, on the usefulness of homework for primary school pupils.

Homework: a word that can cause despair not just in children, but also in parents and even teachers. And for primary school children at least, it may be that schools setting homework is more trouble than it’s worth.

There is evidence that homework can be useful at secondary school. It can be used to consolidate material learnt in class or to prepare for exams.

However, it is less clear that homework is useful for children at primary school (ages 5 to 11) or in early years education (ages 3 to 5).

What is homework for?

There are no current guidelines on how much homework primary school children in England should be set. In 2018 then education secretary Damien Hinds stated that “We trust individual school head teachers to decide what their policy on homework will be, and what happens if pupils don’t do what’s set”.

While there is not much data available on how much homework primary school pupils do, a 2018 survey of around 1,000 parents found that primary pupils were spending an average of 2.2 hours per week on homework.

The homework done by primary school children can include reading, practising spellings, or revising for tests. Charity the Education Endowment Foundation suggests that the uses for homework at primary school include reinforcing the skills that pupils learn in school, helping them get ready for tests and preparing them for future school lessons.

Homework can also act as a point of communication between home and school, helping parents feel part of their child’s schooling.

However, the 2018 Ofsted Parents’ Panel – which surveyed the views of around 1,000 parents in England on educational issues – found that 36% of parents thought that homework was not helpful at all to their primary school children. The panel report found that, for many parents, homework was a significant source of stress and negatively affected family life.

Little academic benefit

Not much academic research has been carried out on the impact of homework for children in primary school. The available meta-studies – research that combines and analyses the findings of a number of studies – suggest that homework has little or no positive benefit for the academic achievement of children of primary school age. A central reason for this seems to be the inability of children to complete this homework without the support provided by teachers and the school.

Some research has suggested that primary pupils lack the independent study skills to do homework, and that they are not able to stay focused on the work.

What’s more, homework may actually have a negative effect if parents set unrealistic expectations, apply pressure or use methods that go counter to those used at school.

Homework may also increase inequalities between pupils. High achievers from economically privileged backgrounds may have greater parental support for homework, including more educated assistance, higher expectations and better settings and resources.

However, it is possible that setting homework for primary school children has benefits that cannot be easily measured, such as developing responsibility and independent problem-solving skills. It could also help children develop habits that will be useful in later school life.

A common task set for homework in primary schools is for children to read with their parents. There is some evidence that this has a positive impact as well as providing enjoyment, but the quality of interaction may be more important than the quantity.

If the purpose of homework is to develop the relationship between home and school and give parents more stake in the schooling of their children then this may well be a positive thing. If this is its purpose, though, it should not be used as a means to improve test scores or school performance metrics. For the youngest children, anything that takes time away from developmental play is a bad thing.

Rather, any homework should develop confidence and engagement in the process of schooling for both children and parents.

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The Great British Homework Debate 2024 – Is It Necessary At Primary School?

Alexander Athienitis

The homework debate is never much out of the news. Should homework be banned? Is homework at primary school a waste of time? Do our children get too much homework?

Not long ago, UK-based US comedian Rob Delaney set the world alight with a tweet giving his own personal view of homework at primary school. We thought, as an organisation that provides maths homework support on a weekly basis, it was time to look at the facts around the homework debate in primary schools as well as, of course, reflecting the views of celebrities and those perhaps more qualified to offer an opinion!

Here’s how Rob Delaney kicked things off

Gary Lineker leant his support with the following soundbite:

And even Piers Morgan weighed in, with his usual balance of tact and sensitivity:

A very experienced and knowledgeable Headteacher, Simon Smith, who has a well-earned following on Twitter (for someone working in education, not hosting Match of the Day) also put his neck on the line and, some might think controversially, agreed with the golden-heeled Crisp King of Leicester…

Fortunately Katharine Birbalsingh, Conservative Party Conference keynote speaker and Founding Headteacher of the Michaela School, was on hand to provide the alternative view on the importance of homework. Her op-ed piece in the Sun gave plenty of reasons why homework should not be banned.

She was informative and firm in her article stating: “Homework is essential for a child’s education because revisiting the day’s learning is what helps to make it stick.”

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How much homework do UK primary school children get?

Sadly, there’s little data comparing how much homework primary school-aged children in the UK and across the globe complete on a weekly basis. A study of teenagers used by The Telegraph shows that American high-schoolers spend an average of 6.1 hours per week compared with 4.9 hours per week of homework each week for UK-based teens.

Up until 2012, the Department of Education recommended an hour of homework a week for primary school Key Stage 1 children (aged 4 to 7) and half an hour a day for primary school Key Stage 2 children (aged 7-11). Many primary schools still use this as a guideline.

Teachers, parents and children in many schools across the land have seen more changes of homework policy than numbers of terms in some school years.

A ‘no-homework’ policy pleases only a few; a grid of creative tasks crowd-sourced from the three teachers bothered to give their input infuriates many (parents, teachers and children alike). For some parents, no matter how much homework is set, it’s never enough; for others, even asking them to fill in their child’s reading record once a week can be a struggle due to a busy working life.

Homework is very different around the world

We’d suggest that Piers Morgan’s argument for homework in comparing the UK’s economic and social progress with China’s in recent years based on total weekly homework hours is somewhat misguided – we can’t put their emergence as the world’s (if not already, soon to be) leading superpower exclusively down to having their young people endure almost triple the number of hours spent completing homework as their Western counterparts.

Nonetheless, there’s certainly a finer balance to strike between the 14 hours a week suffered by Shanghainese school-attendees and none whatsoever. Certainly parents in the UK spend less time each week helping their children than parents in emerging economies such as India, Vietnam and Colombia (Source: Varkey Foundation Report).

Disadvantages of homework at primary school

Delaney, whose son attends a London state primary school, has made it plain that he thinks his kids get given too much homework and he’d rather have them following more active or creative pursuits: drawing or playing football. A father of four sons and a retired professional footballer Gary Linaker was quick to defend this but he also has the resources to send his children to top boarding schools which generally provide very structured homework or ‘prep’ routines.

As parents Rob and Gary are not alone. According to the 2018 Ofsted annual report on Parents Views  more than a third of parents do not think homework in primary school is helpful to their children. They cite the battles and arguments it causes not to mention the specific challenges it presents to families with SEND children many of whom report serious damage to health and self-esteem as a result of too much or inappropriate homework.

It’s a truism among teachers that some types of homework tells you very little about what the child can achieve and much more about a parent’s own approach to the work. How low does your heart sink when your child comes back with a D & T project to create Stonehenge and you realise it’s either an all-nighter with glue, cardboard and crayons for you, or an uncompleted homework project for your child!

Speaking with our teacher hats on, we can tell you that homework is often cited in academic studies looking at academic progress in primary school-aged children as showing minimal to no impact.

Back on Twitter, a fellow teacher was able to weigh-in with that point:

Benefits of homework at primary school

So what are the benefits of homework at primary school? According to the Education Endowment Foundation (EEF) (the key research organisations dedicated to breaking the link between family income and educational achievement) the impact of homework at primary is low, but it also doesn’t cost much.

They put it at a “+2 months” impact against a control of doing nothing. To put this into context, 1-to-1 tuition is generally seen as a +5 months impact but it’s usually considered to be expensive.

“There is some evidence that when homework is used as a short and focused intervention it can be effective in improving students’ attainment … overall the general benefits are likely to be modest if homework is more routinely set.”

Key to the benefit you’ll see from homework is that the task is appropriate and of good quality. The quantity of homework a pupil does is not so important. In this matter Katharine Birbalsingh is on the money. Short focused tasks which relate directly to what is being taught, and which are built upon in school, are likely to be more effective than regular daily homework.

In our view it’s about consolidation. So focusing on a few times tables that you find tricky or working through questions similar to what you’ve done in class that day or week often can be beneficial. 2 hours of worksheets on a Saturday when your child could be outside having fun and making friends probably isn’t. If you really want them to be doing maths, then do some outdoor maths with them instead of homework !

At Third Space Learning we believe it’s all about balance. Give the right sort of homework and the right amount at primary school and there will be improvements, but much of it comes down to parental engagement.

One of our favourite ways to practise maths at home without it become too onerous is by using educational games. Here are our favourite fun maths games , some brilliant KS2 maths games , KS1 maths games and KS3 maths games for all maths topics and then a set of 35 times tables games which are ideal for interspersing with your regular times tables practice. And best of all, most of them require no more equipment than a pen and paper or perhaps a pack of cards.

Homework and parents

One of the key benefits cited by EEF is in regard to parental engagement. Time after time, the greatest differentiator between children who make great progress at school – and those, frankly – who don’t is due to the same factor in the same studies: parental engagement .

It is a fair assumption that if a parent is engaged in their child’s learning, they’re probably going to be the same parents who encourage and support their child when they’re completing their homework.

Whereas parents who are disengaged with their child’s school and schooling – for whatever reason (sorry, Piers, it’s rarely due to laziness), are highly unlikely to be aware of what homework gets set each week, let alone to be mucking in with making sure it gets handed in completed and on time.

We also encounter time and again, the issue of parents’ own lack of confidence in maths. A survey by Pearson found that:

• 30 percent of parents “don’t feel confident enough in their own maths skills to help their children with their primary school maths homework”
• 53 per cent insisted they struggled to understand the new maths teaching methods used in modern classrooms. Fortunately that’s what we’re here to address.

Setting the right homework at primary school can be tricky

Although we disagree with Piers, we can see what he may be driving at in terms of setting appropriate homework.

The question quickly becomes what would Piers think of as being ‘interesting’ homework, and if all four of his children would agree upon the same thing being ‘interesting’.

That’s the problem.

One would imagine Piers would find it hard enough finding one task to satisfy the interest of all of his four children – it’s almost impossible to find a task that will engage the interest of 30 or more children in their out of school hours.

Each with different emotional, behavioural and learning needs, then sprinkle in the varying levels of poverty each family suffers (be it financial or in terms of time), and you can see how it isn’t just about being a good or bad teacher – whatever that means – in regards to being able to set Morgan-approved homework tasks.

What does this mean for my child?

Ultimately, the question at the top of mind whenever a parent thinks about homework is a more general one – am I doing the best for my child?

Although the world is changing at a faster pace than ever before in human history, what’s best for children hasn’t changed that much (if at all).

One-to-one support is best, and young people benefit most from adult-child conversations where they acquire new vocabulary and language structures to form and share their thoughts and opinions.

These insights – that one-to-one support is best and that regular, structured adult-child conversations are life-changing within a child’s development – are what inspired us to create Third Space Learning.

A platform where children can engage with a community of specialist tutors in a safe, structured learning environment where they are able to engage in one-to-one conversations that enable them to progress in their learning with confidence.

• How to help your child with their maths homework – A parents guide
• The Best Homework Hacks: 18 Tips And Tricks To Help Busy Parents Get It Done Faster!
• The 20 Most Recommended Teaching Blogs for UK Teachers and School Leaders

DO YOU HAVE STUDENTS WHO NEED MORE SUPPORT IN MATHS?

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Since 2013 these personalised one to one lessons have helped over 150,000 primary and secondary students become more confident, able mathematicians.

Learn about our experience with schools or request a personalised quote for your school to speak to us about your school’s needs and how we can help.

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Evidence for Learning: Homework

A summary of the research evidence on homework in the Australasian context.

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Stanford University School of Medicine blog

From Palo Alto to rural India: A cultural exchange is advancing perinatal health

Three first-time mothers dressed in identical pink, floor-length hospital gowns and blue surgical masks sat in a small, windowless hospital conference room in rural Gujarat, a state of 60 million people on India's western coast, roughly half the size of California.

The young women described the experience of having a child in the neonatal intensive care unit at this modern hospital located so far from their homes that they were staying in the mothers' onsite dormitory. One mom had been there for nearly two months.

Speaking in Gujarati, the mothers shared worries about how their families were faring without them back home -- some as far as a three-hour drive away. One talked about the pain of lactation and the others readily agreed. Another said she was angry with God, though, with her baby's health now improving, her faith was starting to rebuild.

By the end of the conversation, all agreed group therapy sessions where NICU moms could talk about how they're feeling, just as they had done that day, would be helpful in relieving stress and alleviating loneliness.

It was a valuable experience for several Stanford Medicine clinicians who were part of the conversation and able to ask the mothers questions with the translational help of an Indian psychiatrist.

The doctors had traveled to Shrimad Rajchandra Hospital and Research Centre (SRHRC) at the invitation of Stanford neonatologist Nilima Ragavan , MD, and were there in part to determine what types of perinatal mental health programs could work in rural India -- where the direct and codified approach of Western psychology may not be appropriate. 

 "It might be enough to start out with just encouraging people to talk about their emotions," said Stanford child and adolescent psychiatrist Richard Shaw , MD. 

The January visit to India was a byproduct of a nearly decade-old medical and cultural exchange between Stanford Medicine, SRHRC, and the government of Gujarat that was cultivated by Ragavan, who was born and raised in India.

The goal is to foster the sharing of lessons and evidence-based best practices between clinicians in the U.S. and India. The Stanford Global Child Health Program has taken note: The Indian center is one of just a few approved global health sites that can host Stanford pediatric trainees. 

SRHRC is a unique international partner because it offers acute, comprehensive care provided to a largely underprivileged, rural population. The hospital was founded as a charitable institution to serve the tribal and migrant communities of South Gujarat at no cost or substantially subsidized rates. 

Five faculty members and one neonatology fellow made up the Stanford Medicine contingent that accompanied Ragavan to India in January. Each presented at an annual symposium organized by Ragavan, SRHRC and Gujarat faculty that brings together doctors, nurses and other health care representatives to discuss advances in perinatal medicine.

One of the primary objectives this year was gauging the appetite for implementing palliative care and perinatal mental health interventions among symposium attendees. Historically, mental health has been a taboo topic in India, Ragavan explained. She wasn't sure how discussions of perinatal depression and anxiety would be received, or even if mental health was perceived as a problem among clinicians and families.

"Before trying to impose a solution to a problem," said Shaw, "we needed to figure out whether there was a problem and how it's similar to, or different from, what we see in the U.S."

Shaw emphasized the importance of coming into such a situation with humility. And SRHRC clinicians at the hospital in Gujarat said they took notice of how the relationship with Stanford has felt different than others. "The beauty of what Stanford has done is truly partnering with us, rather than just giving us advice," said pediatrician Atmarpit Dr. Mansiji, MD.

A two-way exchange

Because Gujarat, India and Palo Alto, California share few surface-level similarities, Shaw was surprised to hear the NICU moms talking openly about many of the same things as his patients in the Bay Area.

He left the interaction sensing that guilt may be a universal feeling for NICU moms no matter the location, but also recognized that mental health interventions should originate from Indian clinicians who understand the language, tribal needs and cultural norms.

The key for anybody who's going to do global health work is that you have a partner on the ground.

"The key for anybody who's going to do global health work is that you have a partner on the ground," Ragavan said.

Local know-how is especially important in India, which is estimated to be the most populous country in the world. UNICEF reports over 25 million babies are born in India each year, whereas annual U.S. births hover around 3.6 million, according to the most recent census data. The Indian government recognizes 22 official languages (in addition to English), and there are hundreds more unofficial languages and thousands of dialects spoken. 

Shrimad Rajchandra Mission Dharampur has been providing accessible care for the community of South Gujarat since 2004, operating a hospital in Dharampur for 18 years. In 2022, the mission opened a state-of-the-art care center with 250 beds, including 30 NICU beds, which are often fully occupied.

It looks like a Western medical institution and stands out from its agrarian surroundings. Not even a mile away are homes with beds sheltered by a simple roof, otherwise fully exposed to the elements. Cows can be seen wandering the streets.

In addition to the main campus in Dharampur, SRHRC also runs a robust mobile outreach program (established in 2005) that reaches an estimated 800-1,000  people per day and provides public health education and medical care. 

Photo gallery: Scenes from the mobile clinic

A 'very anti-Silicon Valley' approach

While the collaboration between Stanford Medicine and SRHRC has grown over the last 10 years, it began in humble fashion, with a great deal of listening.

"It was very anti-Silicon Valley," Ragavan said. "Many in the Bay Area talk about being game-changers, but we didn't go into our partnership with SRHRC with grand visions. The approach was: Let's just start at the grassroots level and then let's build up upon our success." 

Mansij, the pediatrician who leads the neonatology team at the Indian center and received medical training in both the U.S. and India, said it was clear from the outset that Ragavan's approach to service was refreshing.

Nilima actually understood the context of where we are, what we have and what small interventions could make huge differences in outcome

"Nilima actually understood the context of where we are, what we have and what small interventions could make huge differences in outcome," she said.

Shah estimates Stanford Medicine's contributions have improved care for an overwhelming majority of moms and babies at SRHRC because the focus is on foundational change rather than technical interventions that might improve outcomes for only a small number of babies. 

For instance, the NICU staff at SRHRC shared a distressing statistic: The mortality rate for babies born elsewhere and brought to SRHRC was three times higher than that of babies born at the hospital. In response, in 2018, Ragavan and a team of Stanford Medicine doctors, nurse practitioners, critical care transport nurses and respiratory therapists worked with SRHRC to develop a specialized neonatal transport team and van that has improved outcomes for outborn babies.

Photo gallery: Collaboration between the Stanford and India clinicians

Still, the transport data revealed a new problem -- about 10% of the transported babies are leaving the hospital with their parents sooner than doctors recommend. Ragavan lists several possible reasons, such as economic constraints, living long distances from the hospital, or a breakdown in communication between clinicians and patients.

"In the past, many of these babies probably never even made it to medical care and were dying in their villages," said Ragavan. "Now, there are more that have been transferred to tertiary centers as medical services have improved, and that's a good thing. But we are often not considering what these families go through to be able to access that level of medical care."

Giving and getting back

Given the trauma families often experience as a result of having a child in the NICU, it made sense to Ragavan and the core team in India to introduce the topic of perinatal mental health at SRHRC and to the broader community of obstetricians and pediatricians in Gujarat.

At the request of the government of Gujarat, Ragavan has scaled up Stanford's presence in the state and she now regularly communicates with clinicians at other Gujarat hospitals and medical colleges about their needs. "Our patients are really suffering," she recalls them saying.

Stanford pediatric and perinatal psychologist Celeste Poe , PhD, presented on perinatal mental health disorders at the January symposium and was excited to share her expertise, noting that psychologists working in NICUs are still rare, even in the U.S. 

"Families benefit when everyone they encounter in the hospital shares the importance of mental health, especially in the perinatal period," she said, adding that just asking families how they're doing can go a long way.

In India, like the U.S., there is often an expectation that moms are selfless nurturers who put themselves last. As Poe spoke with Indian clinicians about addressing "self-care" with new moms, the clinicians shared that "self care" connotated selfishness. 

When she reframed it to focus on the benefits for both moms and babies -- for example, moms getting adequate nutrition or sleep to be able to better care for their babies -- there was wider agreement about its applicability. "That was an enlightening conversation about how to approach some of those mental health aspects in a culturally sensitive way and adapt terminology," Poe said. 

Ragavan is pleased clinicians in India were receptive to addressing perinatal mental health and looks forward to further meaningful collaboration between the two institutions and the state. 

In reflecting on what continues to drive the near decade-long exchange, Ragavan described a shared mission to make sure that evidence-based care is equitably and widely disseminated across Gujarat  and beyond. What does she see when she visits? Clinicians from both the U.S. and India who are enthusiastic about making holistic improvements to care. 

"Both sides feel so positive about the partnership," Ragavan said. "The team came back to California thinking what we received from our time in India is more than what we gave." 

The view of the amphitheater outside the ashram seen at night and during the day (Laura Hedli)

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