By Nicole Boik
Teachers and those that work in schools often have a front row seat to the struggles their students face, including a struggle as serious as a cancer diagnosis or the cancer diagnosis of a loved one. However, school personnel are often not equipped to adequately support these students (Chekryn, Deegan, & Reid, 1987).
When it comes to supporting a student that had or currently has cancer, there are some important things to keep in mind. There are also some great, free resources to help school workers better understand the child's situation, as well as how to better support them and their classmates.
Children Attending School During Treatment
When a child with cancer is given permission to continue attending school during treatment, it's important that a wide range of school staff be aware and prepared (Prevatt, Heffer, & Lowe, 2000). First and foremost, school staff must create an open dialogue with the child and their family and ensure that there is a consistently available line of communication. This alone can help ensure that all parties are on the same page and will continue to be on the same page as the child goes through treatment. As the staff member having that first conversation with the family following the diagnosis, you're going to want to understand exactly what the child knows about their diagnosis and treatment and figure out what the child and/or the family are comfortable with you discussing with classmates and/or other parents. This information will help you create a comfortable classroom environment for the child with cancer, their peers, and their peers' parents. Once you feel like you have the information you need, then it's important to decide on logistics, like school work expectations and grading, absences, and remaining involved in the class during absences. It's also important to discuss those what-if situations, such as what happens if the child needs medical attention at school. Ideally, the parents will initiate these conversations. If all they say is that their child has cancer, it's okay for teachers and school workers to encourage, or even request, these conversations. In all likelihood, the parents aren't avoiding these conversations, they're just trying to navigate an incredibly complex situation while managing their typical responsibilities and their own emotions. They may not know what to say or where to start, so they lead with the one piece of information that they know to communicate: their child has cancer.
After those important conversations are had with the child with cancer and their family, teachers and school workers can turn their attention to what they plan to do with all this new information. Some things to consider are how pertinent information is going to be shared with classmates and how to make the environment comfortable in a situation that even makes adults uncomfortable. Prevatt, Heffer, and Lowe describe the most comprehensive school reintegration programs to include ongoing collaboration and an individualized approach that is child-centered (2000). Doing some research and seeing what resources are available can be helpful because, more than likely, the teacher or school worker isn't prepared to deal with this situation with it being fairly uncommon. For younger children, books are a great way to help children process information while working on literacy skills. There are developmentally-appropriate books about cancer and going to school with cancer, as well as child-friendly videos on these topics. We often encourage parents in these situations to provide developmentally-appropriate information to their child and these resources will really only be of value if the child and their classmates have some basic information about the child's cancer diagnosis and treatment.
Children Returning to School After Treatment
When a child returns to school after treatment, teachers and staff must be prepared for a different child, both emotionally, physically and mentally. Chemotherapy and other treatments for cancer can cause hair loss, weight loss, discolored skin, scars and more. Children who have had cancer treatment may have a port under their skin or a central line for medication. For both physical and emotional safety, teachers should speak with the parents and child about their needs for returning to the classroom. Will the child wear a hat or a wig? Or do they want to leave their head uncovered? Can they play sports safely or will their port inhibit them? Will they be extra tired or fatigued? Exploring these questions can help establish a safe and healthy way for the child to return to school.
Siblings of a Child with Cancer Going to School
In an ideal situation, parents that have a child with cancer and other children at home, will inform the school staff at their other children's schools of what's happening at home. As discussed previously, if all they mention is that so and so's brother or sister has cancer, it's okay to ask more questions. However, the information discussed should center around how the sibling is coping with their brother or sister's diagnosis and treatment and what to do if the sibling needs to skip school or be absent from school for any reason. Absences aren't encouraged, but it's important for teachers and school staff to be understanding if the sibling needs a day off for any reason. Having a brother or sister with cancer can be a very day-to-day situation, so you never know exactly what's happening. In regards to discussing what the child with cancer knows and what the sibling knows, we always encourage parents to provide developmentally appropriate information to the child and their siblings. Teachers and school staff understand child development and how children learn and understand, so they can be an ally to the healthcare team when it comes to encouraging these conversations. If the sibling has informed their peers of the situation already or it's possible that the sibling will inform their peers once in school, there should be a conversation among school staff and the family regarding what is acceptable to share if questions arise from peers or the parents of those peers. In order to ensure that the school environment is comfortable for everyone, this topic must be addressed among staff and the family, as well as peers and the parents of those peers if needed.
Resources for School Personnel
Children's Books About Cancer.
Taking Cancer to School by Cynthia Henry and Kim Gosselin
When a Kid Like Me Fights Cancer by Catherine Stier (talks about what to expect and "not fighting along")
The Famous Hat by Kate Gaynor (a hair loss book)
Amazing Annabelle by Dyan Fox (talks about her journey- having surgery and receiving “medicine”)
Mr. C Plays Hide and Seek by Eva Grayzel (talks about cancer from the cellular level in a child-friendly, easy-to-understand way)
Organizations with Helpful Websites
Pediatric Brain Tumor Foundation/Imaginary Friend Society (has a ton of information not just for children with brain tumors and the Imaginary Friend Society is their children's website that has great videos about all kinds of things, everything from radiation to just being angry)
Alex's Lemonade Stand (another good source of a wide range of information and has links to other resources)
Monkey in my Chair is a program to help young students feel involved in the classroom even when they can't be physically present
Nicole has been a Child Life Specialist for almost 4 years, majority of which was spent working in radiation oncology. Since leaving that position, I have taken on a number of new projects, but I continue to have a heart for children with cancer and their families.
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Chekryn, J., Deegan, M., & Reid, J. (1987). Impact on teachers when a child with cancer returns to school. Childrens Health Care, 15(3):161-176.
Prevatt, F., Heffer, R., & Lowe, P. (2000). A review of school reintegration programs for children with cancer. Journal of School Psychology, 38(5): 447-467.