"Back to normal" means "back to school" for most children who have been treated for a brain or spinal tumor. When your child returns to school, you want him or her to be treated as normally as possible and it will take the cooperation of both the school and the health care professionals working with your child to make this happen.. To make the transition back to school an easy one the teachers and school nurse should be encouraged to prepare classmates by providing them with information about the disease and treatment and answering any questions they may have. Let the teachers and classmates know what to expect and give them an opportunity to express their concerns and feelings. It is important for teachers to communicate to other students that cancer cannot be caught and that radiation treatments do not make a child who has them "radioactive." These types of open conversations may eliminate children's curiosity and make it easier for them to accept your child back into the class and help them to accept the differences in their classmates and make them more empathetic and willing to help. Some medical centers provide an education team consisting of a child life worker and health care practitioner who can help prepare the class for your child's return, which in some cases may be helpful.
In order to make the re-entry into the scholastic environment less abrupt for your child, the students and the teachers, a slow, transitional approach to reentering school can be helpful, perhaps only having lunch, attending specific classes, or going on a field trip with the class prior to a full-time return to school. It is important to update your child's teachers and the school nurse with whatever medical information will help them help your child in school. The more knowledgeable and familiar the teachers are with how your child functions, the more the classroom environment can be adapted to your child's special needs, no matter what level of school they may be returning.
Before your child returns to school, set up a meeting with the teacher, school nurse, and principal. This meeting will give you an opportunity to discuss any special requests or concerns you might have. Suggest that the meeting also include health care professionals such as neuropsychologists familiar with brain tumor treatments, including surgery, radiation therapy, chemotherapy, and shunts and give your child's teacher a copy of Cancervive Teacher's Guide for Kids with Cancer. You might want to meet or speak with the teacher on a weekly basis to monitor your child's progress; it might also be helpful to connect with your other children's teachers as well. Remember to keep an open line of communication with your child's school. The role the teacher plays is very significant to your child's developmental adjustment and recovery. The teacher and/or school nurse must inform you of any communicable diseases, such as chickenpox, that any class member has contracted. If your child is still in treatment and has not had chickenpox, exposure to this virus can be dangerous, and you should contact your physician immediately. (Chickenpox is worrisome primarily after chemotherapy; doctors rarely worry after radiation therapy.) If informed, teachers can deal successfully with problems concerning your child's self-image and relationships with peers as they arise.
Holding a meeting prior to your child's return to school can be helpful in determining any accommodations that may be needed to meet your child's special needs. Check to see if your school has wheelchair accessibility for both the classrooms and toilet facilities, as special bathroom privileges may be needed. Your child may need playground or gym exemptions, if he or she is easily fatigued or has coordination problems. Seating arrangements in the classroom may need to be adapted if your child has suffered permanent or temporary hearing or visual impairment. You may want to discuss modifying homework assignments with the classroom teacher. If your child needs to take medications during the day, it is very important that you inform the teacher and the school's principal and nurse what the medications are for and what their side effects may be. All of these procedures, if reviewed beforehand, will make a child's return to school much smoother.
The level of parental involvement wanted by a child varies by age, gender, and individual personality. It is important to discuss returning to school with children no matter what age to be sure everyone is on the same page and children are allowed to have a voice in the involvement of their parents in their school. For older children, such as those entering high school, autonomy and a sense of independence is viewed as a necessity for many and for this reason the teacher-parent relationship is very important, because although parents may not be wanted by children in their scholastic environment, teachers have a unique view and can not only watch out for a child but do so in a way that is not considered intrusive. In this way, parents can stayed updated on their child's progress without infringing on their child's world that they are more assuredly desperate to reenter.
Joseph Fay, Executive Director of Children's Brain Tumor Foundation
