Teachers can play a pivotal role linking the child, family, and school together. While it can be difficult to gauge the child’s needs and capabilities during the different phases of treatment, support from a teacher can be instrumental in facilitating the child’s overall adjustment. When children are in middle school or high school and have multiple teachers, it is important to designate a contact person who will coordinate communication and assignments. Ideally, this will be a teacher or counselor with whom the child is especially familiar and comfortable.
Facebook, Twitter, and email also provide effective ways to share work and assignments between school, the hospital, and home. In addition, services like Skype allow the child to “sit in” during regular classes. Not only does this support academic work and send a message of continued high expectations to the child with cancer, but it also allows children to stay connected socially with their friends and classmates.
Because the prognosis for children diagnosed with many forms of cancer is so favorable, we recommend encouraging schoolwork as much as possible – depending on how the child is tolerating various treatments and related procedures. After a few days or weeks of diagnostic testing and treatment, children usually go home and receive periodic treatment as an outpatient or during brief hospital stays. During this phase of treatment, hospital schoolteachers or home tutors may be needed to provide extra help with assignments. Establishing what is a reasonable amount of work to expect a child to complete can be difficult. In general, sending assignments directly to parents is best because they know how the child is feeling day-to-day. Unfortunately, there is no single answer to the dilemma of what expectations to set regarding schoolwork for a sick child except that it requires excellent communication between teachers and parents.
Social Contact and Friendships
Some children want to have visitors from the very beginning; others are not so sure and prefer to wait until they are feeling better. It is critical that visitors with a cold, infection, or who have been exposed recently to chickenpox or the measles, understand that they cannot visit the child. If possible, siblings should also be protected from sick people, especially those with chickenpox or measles. There may also be other restrictions, such as no balloons or flowers, which will need to be clarified.
If possible, teachers might visit first, especially if students are at the primary or elementary level, so they can help prepare classmates for how the hospital looks and smells, what kind of room the child is in and how the child looks (bald? thinner? are there tubes or lines?). With the child’s permission, you may be able to take electronic photos and share them with your class.
What should classmates talk about? Most children like news of what is going on in school or the neighborhood. Hearing about activities actually helps them feel a part of what is happening rather than feeling sad that they are missing important events. On the whole, children’s visits to the hospital are far easier than adults expect. It typically takes them 5 minutes to satisfy their curiosity and then move on to the “important stuff.”
In the early days when the child may be too sick to have visitors, and in the days/weeks between visits, there are many things that the school can do to help the child feel included in the school community.
- Send get well cards and letters — at regular intervals. Cancer treatment is a marathon, not a sprint, and support is needed at all stages. We have yet to see children in the hospital who do not light up with joy when they get a card or picture from a friend or classmate. These often end up pasted to the walls of the child’s room.
- Send texts, emails or other messages.
- Send photographs or create a video diary of classroom and school activities.
- Keep inviting the child to school activities. He or she will be back.
- Send small presents that can distract the child but are not too taxing (e.g., a deck of cards, a book of mazes or Sudoku, Where’s Waldo, stickers, a teen magazine).
It is important to remind the class that not getting a thank you note or text in return does not mean the gestures are not welcome. Many times children in treatment can be too sick, too tired or too busy having treatments or tests to respond, but they really do appreciate kind gestures.
Other things teachers can do:
- Keep in regular contact with the family, and, with the family’s approval, keep other teachers and students up to date;
- Continue to call the child’s name for attendance (and have someone respond with “X is in the hospital” or “Y is at home”);
- Send information about school events to the hospital or home to keep the child and family in the loop;
- Ensure that suitable, current work assignments are sent to the family, tutors, or hospital teachers. There should be the expectation that the child will graduate with their class, although a reduced workload may be needed from time to time during treatment.