School life for kids post-cancer takes a toll

by Boston Children's Hospital staff on February 15, 2010

child doing school work

by Marybeth Morris, Ed.M.

The advancement of medical science in diagnosing and treating certain pediatric cancers such as brain tumors or leukemia has led to increased survival rates for pediatric cancer patients. Due to neurocognitive deficits and physical sequelae, many child cancer survivors face significant challenges upon their return to school and throughout their academic career.

Schools often perceive that once a child’s treatment has ended, he or she will return to “baseline” and not necessarily require continued academic and emotional supports. Parents may also be uncertain about a few things.

  • The continuing educational needs of their child
  • How to ask for additional support
  • What their specific rights are in ensuring an appropriate education for their child.

It’s important for parents and teachers to be aware of the subtle, and not so subtle, signs that a child may have an emerging deficit or weakness so that identification and intervention can begin as early as possible.

The most commonly reported deficits resulting from surgery, chemotherapy and/or radiation to the brain or spinal column include:

  • Attention and executive function difficulties
  • Poor memory
  • Slowed processing speed
  • Learning disabilities

Children are particularly vulnerable during times of transition, such as that from elementary to middle school or middle to high school. Potential signs of distress include but are not limited to:

  • difficulty developing and maintaining peer relationships
  • impulsivity and poor attention, organization and planning
  • inability to independently complete assignments
  • task avoidance
  • slow pace completing homework and in-class assignments
  • poor acquisition of reading and writing skills (connecting letters to sounds, letter sequencing and spelling)
  • math difficulties (number sequences may be transposed, arithmetic signs confused, difficulties with word problems)
  • difficulty remembering information and recalling facts including previously learned information

Most parents will, from time to time, see one or more of these warning signs in their children. If, however, a parent sees several of these characteristics over an extended period of time, formalized intervention may be necessary.

Public school systems are legally obligated to evaluate a student in the areas of suspected disability if the child’s parent requests an evaluation in writing. A typical core evaluation consists of an academic and psychological assessment. A psychological assessment always indicates cognitive testing, but may also include evaluation in the areas of social and emotional functioning and attention.  School personnel must complete all evaluation measures within 30 school days of parental consent and a special education team meeting to review results must be held within 45 school days.

Watch one Children’s patient’s return to school after chemotherapy.

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