Back to School

Child Life Program helps ease kids back into the classroom

NOTE: Sheila Morris has since retired and the programs discussed below are now available through C.S. Mott Children's Hospital. To learn more about what's currently available, please visit the Cancer Care (Pediatric) web page.

No kid is ever wild about heading back to school after a break. But for children with cancer, facing schoolwork and classmates after an extended absence can be particularly trying. To ease the transition, University of Michigan Rogel Cancer Center Child Life specialists work with schools to help teachers and students understand the challenges children with cancer face.

We talked with Child Life Specialist Sheila Morris about her work.

Q: What challenges do children face after they have been out of school because of cancer treatment?

A: Obviously, when a child or teen is diagnosed with cancer, there is a separation from school for a period of time, whether it's several months or longer. The ability to be in a peer group is strained as medical care becomes the primary focus. Many young people receive instruction through homebound educational programs, but it can be difficult to keep up. When they go back to school, young people often feel overwhelmed by academic expectations. They may be worried about their self-image because of the side effects of treatment. Rebuilding peer relationships can be difficult. Chemotherapy and other treatment may influence their stamina and ability to concentrate. Avoiding exposure to infection is also a key concern. The issues are complex, so our team plans collaborative meetings and prepares detailed reports to help schools meet a students' needs.

Q: Tell us more about the reports.

A: They include everything school staff may need to know about students who have been diagnosed with cancer: an overview of the illness and treatment; information about side effects and physical limitations; infection control standards; guidelines for when to call a parent if a child isn't feeling well; and educational plans and accommodations that might be needed. Treatment may cause changes in learning abilities -- for example, a child might need extra time to take tests. When possible, one of our Child Life specialists arranges a meeting to discuss the report with the parents, school staff and-if the patient is a teenager-the student.

Q: What is the goal of the meeting?

A: We try to establish a partnership among parents, the child, school staff and health-care providers. We're empowering parents to be confident in presenting their child's needs so that they can work together with the school. When teenagers are involved, we want to help them learn to be advocates for themselves-a skill they may need in the future to get further support if they go on to college or training programs.

Q: You mentioned that it might be difficult for kids to fit in with their peers after being away from school for treatment. What does your team do to help with those concerns?

A: For classmates, there can be confusion about why a child is not at school. They may be uncertain about what to do or say when the child returns, especially if there are changes in appearance or abilities. A child undergoing treatment may have a weight gain from medications or hair loss. Classmates may not know how to react or they may worry that they can catch the illness. When students are confused, teasing can follow. We have found that providing classmates with information promotes understanding and acceptance.

Q: How do you do that?

A: For elementary school-age students, our Child Life team is available for classroom presentations. We discuss the illness and treatment in a developmentally appropriate manner. Many hands-on teaching aids, such as dolls and vinyl bones, are used to teach about cancer. Photographs of their classmate with Rogel Cancer Center caregivers help students understand what the child experiences while she is away from school. We talk about good infection control techniques, especially handwashing, and how classmates can be "hospital helpers." We also answer their questions and help them to feel at ease.

Q: What do you do for older children?

A: We discuss the visit with parents and the child or teen before going to the school. If a classroom visit is planned, the child or teen is offered some choice and control in what is discussed, their level of participation and even if they want to be present during the discussion. Often teens will be more comfortable having the discussion with a smaller group of peers, for example members of their sports team or club.

Q: We know that siblings of children with cancer often face challenges as well. Do you also involve them in the process?

A: Absolutely. We share information about the emotional needs of siblings and also possible changes in siblings' behavior or academic progress. The goal is to provide teachers with the information and ideas for helping siblings to express feelings and maintain their individuality.

Continue reading the Summer, 2009 issue of Thrive.