What are practical strategies for teachers/educators to help students and their families?
Attending school helps children with cancer feel normal. Children who continue their schooling, whether in the hospital, at home, or in school, are given a message which conveys hope and says to the child "you have a future."
Educators have a significant role to play in encouraging children's integration into a normal life routine. At the same time, it is natural for teachers to have concerns and worries about having the child in their classroom. Educators need practical strategies and support to help children with cancer during diagnosis, and before, during, and after treatment.
Communication
Communication with parents and those directly involved with the child's needs is a vital aspect in supporting the child with cancer.
Principals and teachers should take an active role in establishing communication as soon as possible rather than in reaction to a crisis. They should maintain this interaction throughout the child's formal school years. As students mature, they may be able to assume some responsibility for communication.
As the school administrator, the principal is the continuing link with the child and family and must keep informed of and assess information to be communicated within the school, as this changes overtime.
Educators can facilitate students moving from elementary to secondary school by establishing good communication between the two schools.
Educators, e.g., guidance counsellors, can assist in establishing communication with those individuals involved with the students' successful transition into pursuing further education or to employment.
To prepare for talking with the student about their illness, which can be difficult, teachers should find out from parents what the student knows about their illness and how much parents want them to know.
Students may know they are very ill and be afraid that they might die, but may be too scared to talk to their parents. Sometimes an independent counsellor, such as a teacher or psychologist, can help relieve anxiety and ease communication among family members about these difficult issues.
Practical Strategies
Initiate and keep in regular contact with the parents to be current on the child's progress at the hospital, at home, and at school.
Contact the related treatment and support team, as appropriate, to get information on the impact of the disease on the student and family.
Visit the child in the hospital and at home to maintain the link with school, and offer support to parents.
With parental permission, provide all school staff with sufficient information and understanding of the student's condition so they can contribute to a safe and caring learning environment as the student progresses through treatment to remission, cure and survivorship, or relapse and death.
Returning to School
The student may initially return to school on a part-time basis. This transition takes place slowly and depends on the rate of recovery and the ability of the school to provide appropriate support.
Educators must work closely with parents and medical staff to plan the transition. Important decisions should be made about what to tell other children and how much the child can be expected to achieve when they first start back. With older children it is important that their view be respected when their return to school is discussed.
Practical Strategies
Make the necessary preparations to deal with students who are reluctant to return to school.
Look out for potential learning disabilities.
Observe any physical problems the student may be having at school and respond appropriately.
Recognize emotional and behavioural changes, follow up with parents, and access professional assistance, if necessary.
Be cognizant of the variety of resources available locally and nationally to students and their families, e.g. Childhood Cancer Foundation's Scholarship Program which offers university/college scholarships to young Canadians who are in treatment or who have survived childhood cancer.
Support childhood cancer survivors at the secondary level in attaining educational and vocational success by accessing resources such as Pathways to Success For Survivors of Childhood Cancer from organizations who provide specialized educational and vocational counselling.
Home Instruction and Attendance
Home instruction is most useful in the period after diagnosis. Children go in and out of hospital so much that attending school regularly is impossible. Attendance varies with each individual case; however, it is possible for them to miss as much as three to twelve months or more of school after diagnosis.
Each province and school district differs in the resources they have available for home instruction. Some are able to offer limited support as soon as it is needed, while others do so only when children miss a specified amount of time.
Principals should be familiar with the policies and procedures in place for home schooling and records of attendance within their schools and boards.
Practical Strategies
Recognize the student's ability, e.g., short concentration span, and program accordingly.
Collaborate with the home tutor who can be a bridge between home and school.
At Risk and Special Needs
Children with cancer are faced with potential learning problems as a result of the cancer and treatments. Some cancers, such as brain tumours and tumours located in the eye, head or facial area put students at higher risk of experiencing educational difficulties.
As a result of treatment, they may have:
reduced attention span and energy;
reduced vision and hearing;
memory problems;
physical disabilities.
Practical Strategies
With parental consent, initiate an evaluation of the student to identify their special needs.
Determine an appropriate individual education plan which includes accommodations that address special needs.
Review and revise the education plan on a regular basis, as the student's needs change over time.
Ways to Address Special Needs
Modify learning goals and work expectations.
Give extra help with processing and organizational skills.
Allow extra time for work completion, assignments, and testing.
Adjust work load.
Work with special educational services such as: psychological counselling, physical therapy, speech therapy, occupational therapy, and transportation.
Reduce the amount of written work required.
Arrange oral rather than written exams.
Provide copies of notes from lessons and activities.
Consider applicable assistive devices e.g., use of computer instead of handwriting.
Modify physical education activities.
Assign a buddy for in-school support.
Provide second set of textbooks for use at home.
Ensure easy access to school facilities, e.g., washrooms, elevator.
Allow extra time for transitions from class to class.
speaks to the parents of the ill child before speaking to the child or their classmates (to find out who should or should not attend, what should or should not be talked about, what words should be used) and gets permission from the parents of students who will attend the presentation;
keeps in mind the ages of the children in the classroom. Classroom presentations that are age appropriate are most effective;
provides straightforward, reassuring answers to children's questions to help turn anxious classmates into supportive friends; address myths and reduce fear and confusion:
Is cancer contagious?
How did he/she get cancer?
What are my chances of getting cancer?
Will the cancer go away?
Will it ever come back?
Does he/she have to do schoolwork or homework? Is it fair?
provides scientific basis for the disease, makes explanations that are geared to the developmental level of the students;
explains treatment and side effects, stressing that even though their friend may look or act differently, they are still the same person inside and need their friendship;
encourages the class to speak about their feelings;
considers the fact that there will be students who have prior experience with cancer that ended in death; others will know people who have survived. Also takes the opportunity to reiterate the survival rate of childhood cancer;
reassures classmates and friends that nothing has changed in their friendship with the sick child and motivates them to continue to be good friends and to keep in touch, even if they can't visit regularly;
helps students to understand the need to treat the student with cancer the same as others;
realizes that taking the time to do an informative presentation is beneficial, e.g., educating students about cancer may help them to grow up to be compassionate adults who will reach out to others in times of need (character education).