Chronic Kids

Teachers play a crucial role in facilitating a smooth transition back into the classroom for a child with a chronic illness, such as cancer (Nessim & Katz, 1995). There are several aspects to this role, one of which is knowledge of all relevant information about the child and his or her illness. Teachers should be aware of the type of cancer that a child has, its symptoms, the prognosis, and the treatments and their side effects. Also, teachers should be aware of the wishes of the parents and the child regarding what they want the classmates and other school personnel to know about the child's illness. Additionally, teachers should be knowledgeable regarding the effects of the disease and treatments, and how these effects can affect certain skills needed for learning, such as attention, memory, nonverbal skills, language skills, and motor skills. Teachers should be aware of the psychological effects of cancer and be prepared to deal with issues such as anxiety, behavior problems, emotional difficulties, peer relationship difficulties, and frustration related to school difficulties. Finally, teachers should receive a schedule of upcoming medical appointments, so that they can help the child prepare ahead for absences. The onus on teachers to be knowledgeable in order to educate a chronically ill child is enormous.

The relationship among school absence, health status and academic performance is complex. Fifty-eight percent (58%) of students with chronic conditions routinely miss school, and 10% miss more than 25% of the year (Sexson & Madan-Swain, 1993). Interestingly, total number of days absent is not directly related to academic achievement, nor is illness severity. Rather the pattern of absence and the chronicity of the condition itself makes it difficult for these children to achieve their potential (Sexson & Madan-Swain, 1993). Most children with chronic conditions experience multiple brief absences, missing a few days or half days, as opposed to prolonged absences that are more likely to be noticed. Thies (1999) writes, "Chronicity of the illness saps energy, making it difficult to participate fully in the academic life of the school. The combination of chronicity, absence, and side effects of illness and treatment are subtle, but the cumulative effect is potentially damaging. Falling behind academically leads to catching up, and catching up takes away from keeping up. Self-confident and achievement are undermined." (p. 393). Children with chronic illness often fall between regular and special education, making do with accommodations until problems that could have been anticipated can no longer be ignored (Thies, 1999). School administration and teachers must recognize the educational implications of childhood chronic illness and the child's perspective. Schools need to recognize that the population of children with chronic illnesses is growing because there is a shift away from in patient acute care to community-based management of chronic illness (Thies, 1999). Schools must identify the chronically ill students and develop a systematic approach for identifying and working with them. Schools must think differently about this group of students and should encourage educators to think creatively by utilizing educational approaches such as an IEP or a 504 plan.