Pediatric Hematology, Oncology and Bone Marrow Transplant
School Re-Entry Program

Pediatric Hematology, Oncology and Bone Marrow Transplant

School Re-Entry Program

It is vital that children with cancer and hematologic disorders maintain as normal a lifestyle as possible. For school-age children, continued school attendance helps provide a sense of well-being, an opportunity for academic success, and a gain in socialization skills associated with being around their peers. Studies of children who do not return to school have shown they have lower self esteem, difficulty developing relationships and remain very dependent upon their parents.
Parents and children often express anxiety about returning to school after their diagnosis. They are unsure the school will be able to meet the special physical and academic needs of the child. Children are often concerned their classmates may make fun over any changes in appearance or ask them Girl doing homework; American Family Children's Hospital's school re-entry program helps childhood cancer patientsdifficult questions about their disease.
We have found that a proactive school re-entry program can minimize any problems and enhance the school’s contribution in the care of the child. There are several objectives in the implementation of our "School Re-Entry Program":
  • Assist the parents and their child with school re-entry
  • Provide information to school personnel
  • Instruct classmates on the disease and dealing with feelings and concerns
  • Provide updates to school personnel on changes in health status and learning needs
Preparation for School Re-Entry
We stress the importance of school re-entry with parents at the time of diagnosis and discuss their concerns. We always obtain written consent from the parents before contacting school personnel. We enlighten them to their rights according to the law to meet their child's needs.
If the child cannot attend a full day of school, a tutorial program can be set up for part-time or full-time assistance in the home. Counseling is provided to parents to enable them to recognize the symptoms of "school phobia" in their child and learn how to respond positively. Encouraging favorite teaches and classmates to visit with their child before returning to school can reduce the child's fear of how they will be accepted. Role playing with the child on how to respond to difficult situation and questions can also make the child feel more comfortable returning to school.
Children who are hospitalized can send a picture of themselves and a written or taped "HELLO" message to their classmates. We also have a videophone that allows the child and the classmates to talk and see each other over the telephone line.

Informational Materials and Conferences

School personnel can better assist with the integration of the child back into school if they have specific information. The information that should be shared is:
  • The specific disease and treatment plan 
  • Expected and unexpected absenses from school 
  • Potential side effect on physical limitations, changes in appearance, and effects on learning ability and behavior 
  • Infection control precautions (chicken pox, immunizations) 
  • Any special physical appliances (crutches, wheelchairs, etc) and access to the classroom 
  • Special care needs including central line catheter, medications or snacks to be taken in school 
  • Need for special services (OT, PT, or Speech therapy) or a place to rest 
  • The need for tutorial services 
  • Review of what the child and siblings have been told about the illness and their reactions and needs
Many schools organize a conference whose attendees usually include the principal, counselor, teachers, and the school nurse, the hospital nurse, social worker and hospital teacher. Parents often attend this conference as well. This conference allows all involved have input into the plan of care for the child. It also allows school personnel to express their concerns and fears and the experienced hospital staff can help address these issues and provide counseling and reassurance.
The Classroom Visit
The reactions of classmates are often prompted by not having accurate information about the illness delivered at the appropriate age level. They sometimes think the illness may be contagious and that the child will die. Therefore, when the hospital nurse and social worker visit the classroom, they provide information about the illness in an age appropriate method and clarify any misconceptions the students may have. The classmates are asked how they would feel if they had they illness and how they would like to be treated. This helps them to learn empathy and allows them to suggest ways to help their fellow student when hospitalized or when he/she returns to the school. In addition, the hospital staff can provide videos, suggest books to read, or give teaching exercise that can reinforce the content later in classroom discussion. 
A Team Approach Toward Care
The School Re-Entry program was designed to develop a TEAM approach toward the care of children with cancer and hematologic disorders. The team members are: the family, treatment center staff, school personnel, and the local health care providers. The emphasis is sharing information and problem-solving to best meet the special needs of the child. The ultimate goal of this program was best expressed by one parent who said, "Our kids need to succeed, feel normal and work toward a future. They need empathy, not sympathy. They need our help to reach their maximum potential."