Chronic Kids

Andrews (1991) defined the term "chronic health condition" or "chronic illness" to refer to children who have been defined as having a health problem that (1) had lasted more than 3 months; (2) had caused hospitalization more than once; or (3) was likely to last for a while, or not go away, according to a doctor. About 15% to 18% of children in the United States have a chronic health condition (University of Michigan Health System, 2005).

The educational needs of a student with a chronic health condition are not always recognized by the child's teacher. As a child, my teachers were probably unaware that I had a chronic health condition. Subtle learning difficulties likely arose as a result of my classroom absence, the social impact of the illness, difficulty concentrating and paying attention due to discomfort, side effects of medication, and perhaps the impact of the condition itself. Some students with more serious conditions than I had as a child, probably needed to regularly visit the nurse's office during the school day, schedule regular doctor appointments, have a rest period, or have some other need that took them away from the classroom. As a teacher now, I recognize that frequent short absences are likely as disruptive, or even more so, to learning than a single long absence, because it's very challenging for a child to string one lesson together over many teaching intervals and expect them to remember all the details. There will always be the need to miss some school; however, many children with chronic illness will invariably miss several days of school a year beyond those days that are the result of illness, and doctor appointments. Some days I felt like it was too difficult to go to school because I feared that others would tease or reject me because I was different than them, or because I was worried about my health; however, I invariably went to school feeling sick.

Children with chronic stomach aches often wake up in the morning complaining of severe symptoms and then by early afternoon or late morning they appear symptom free (IFFGD, 2005). This is difficult to understand for the parents of the child. As the child stays home from school, part of the stress and anxiety decreases and the symptoms dissipate. Unfortunately, the child may find themselves caught in a vicious cycle where they become more nervous about missing school and making school work up, which then increases their stress and anxiety level, causing an increase in pain that evening, prior to bed, and again the following morning. Children need to go to school, under these circumstances. They need to break the cycle of stress and anxiety, which is made worse by missing school (IFFGD, 2005).

Increasingly today, schools are faced with the challenge of meeting the individual needs of students with very diverse conditions and education requirements, not just related to disabilities, but also chronic health issues. When learning problems are not detected early the student is likely to experience academic failure, further hampering self-esteem and regular school attendance (Sexson & Madan-Swain, 1993). Improving outcomes for students with chronic illness requires a multi-faceted approach that addresses the school environment. The majority of students with chronic illness will participate in their classrooms without any program modification; however, a small but significant group of students will experience an obvious drop in performance associated with their illness either because of the disease itself or due to medical treatment. For these students Individualized Education Programs (IEP's) are necessary to assist them to fully access the curriculum (Clay, Cortina, Harper, Cocco & Drotar, 2004; Shui, 2001; Sexson & Madan-Swain, 1993). An IEP under these conditions can be implemented and designed with the intent to assist in establishing a program for children who need extra help, facilitating ongoing communication between the home and school, and developing well defined and planned transitions from home/hospital to school (Clay, Cortina, Harper, Cocco & Drotar, 2004; Shui, 2001; Sexson & Madan-Swain, 1993).