School Intervention and Re-Entry Program
When a child is undergoing treatment for cancer or a blood disorder, it’s important for that child to return to school as soon as he or she is medically cleared.
Often, schoolwork can be a welcome distraction from treatment or painful procedures, and returning to school offers these additional benefits for children and their families:
- a sense of normalcy
- a "back-to-routine life"
- a sense of purpose and achievement
- a time to transform fear to hope for the future
- time to socialize with peers
Our Program
Our School Intervention and Re-Entry Team is made up of physicians, nurses, child life specialists and educational liaisons who work with school personnel including teachers, school nurses, counselors, social workers, psychologists and other staff members in a joint effort to ease the child's return to the classroom. All services are free to our patients.
Stony Brook's School Intervention and Re-Entry Program is nationally and internationally recognized. It serves as a model for other institutions, with team members presenting at national conferences frequently, as well as serving on boards of nationwide professional organizations.
Our program offers many services to all student patients, depending on the individual need. Our team may:
- Give presentations to school faculty regarding the patient's illness and treatment
- Provide classroom presentation to the patient's peers
- Liaison between hospital and school
- Arrange for home instruction
- Advocate for appropriate educational services
- Attend 504 and CSE/IEP meetings
- Provide medical documentation to schools
- Facilitate neuropsychological evaluations and/or other educational testing services
- Hold ongoing phone consultation regarding school issues, placement, curriculum, accommodations, and other educational services
- Host the annual "Educating the Educators" conference for school and healthcare professionals
- Offer professional development in-services to school staff
- Provide special school presentations when needed (for example, bereavement or coping with a staff member with illness)
FAQs from Parents
As the parent of a child with cancer or a blood disorder you probably have questions about your child’s return to school. Below are answers to some of the questions we get asked the most.
Your child can return to school as soon as the medical staff determines it is safe to do so. The doctor will consider your child's type, frequency and duration of therapy. A child may return to school as soon as he/she is physically and emotionally ready.
Treatment for cancer and blood disorders is difficult enough on the child, both physically and emotionally. Having them return to school will give them a sense of normalcy. A decision to use home instruction is made by the family, medical team, and school on a case by case basis. Having your child stay home does not necessarily offer complete protection from infection. The child will also greatly benefit by being in classes with their peers.
Physical activity is healthy and as long as the child feels up to it, gym class is fine. Exercise is always important. It is crucial that the child be restricted as little as possible. For children with central lines and mediports, we recommend that direct contact to the chest be avoided. The medical team will evaluate each child on an individual basis and suggest accommodations that best suit your child's diagnosis, treatment and needs.
It is a big concern for children without antibody protection who are undergoing treatment for cancer. The school needs to notify you about an outbreak as soon as possible so an injection (VZIG) can be given to help the child fight the infection. Ask the teacher to send a letter notifying parents that an immunocompromised child is in the class. The letter can request parents to notify the school nurse about infections as soon as possible.
Yes, without naming specific illnesses (viruses and bacterial infections). Good communication between the family, school and treatment team will enable appropriate interventions to be made.
The School Re-entry Team can review medication administration and make arrangements with the school nurse.
Yes. Exceptions can be made to school policy, however the entire staff MUST be made aware of this exception. Discuss with the teacher, principal and school nurse the necessity of covering your child's head. It is important to protect the head from heat loss and sun exposure.
The best approach is to have the School Re-entry Team contact your child's school up front before problems develop. However, we can meet with the school personnel at any time. The team will discuss the side effects of therapy and how learning may be impacted. Recommendations will be made to best evaluate your child.
Research indicates that children receiving certain types of therapy may be at increased risk for developing learning difficulties. Additionally, some blood disorders put children at increased risk for learning problems. Please discuss this with your medical and School Re-Entry Team.
Your child may have certain rights under the Individuals with Disabilities Education Act and/or section 504 of the Rehabilitation Act. Children diagnosed with cancer may be eligible for help under the "other health impaired category." Contact the School Re-Entry Team to learn more about these laws and available educational services in your district.
It is important to remember that when treating a child with cancer or a blood disorder, the whole family is affected. Siblings may feel left out or act out for attention. They may be concerned about their brother's/sister's return to school and related issues (teasing). They may have their own academic struggles due to familial stress or the parents' decreased ability to assist the well child with schoolwork. It may benefit the sibling to seek support from school counselors.
Ask your child if they have any specific concerns. Teach them to practice simple answers (My hair fell out because of my medicine; it will grow back). Remind them to ignore teasing and walk away. Ask the teacher about a buddy system, to pair the child with a "safe" person. This can be any individual the child can trust and go to if something happens.
Tips for Teachers
Help A Child Return To School After Being Diagnosed With Cancer
- Maintain active contact with the student (phone calls/letters/recorded messages)
- Provide classroom opportunities for students to understand their classmate's illness and treatment
- Arrange for the school reentry team to make a classroom presentation (if possible)
- Send classroom/school cards/greetings to the student
- Include the student in classroom activities
- Keep other classmates updated with the child's progress, when appropriate
- Provide opportunities for the child to participate or contribute to classroom projects
- Allow older students and adolescents to determine "what" and "how much" information can be shared with classmates
- Assist and communicate with the student's tutor
- Provide distance learning via computer/video camera, when available
- Invite the School Intervention and Re-Entry Team's for a Faculty Presentation and/or Classroom Presentation
- Review the Student's Individualized Educational Plan, "I.E.P.", if applicable
- Discuss comprehensive evaluation with the child's parents if warranted. (Children with cancer are covered under the Individuals with Disabilities Education Act and/or 504 of the
Rehabilitation Act "other health impairment") - Communicate with student/staff/parents/health care team
- Prepare classmates for the student's return (changes in appearance: weight gain or loss, scars, casts, wheelchairs etc.) via the School Intervention and Re-Entry's Team
Classroom Presentation - Maintain contact with Parents (daily logs, phone calls, progress reports)
- Determine which educational accommodations would be appropriate (e.g. extended test time, extended completion time, fewer assignments, separate testing area)
- Determine what classroom accommodations would be appropriate (e.g. preferential seating, access to hydrations and snacks, second set of books)
- Implement modifications, be sure not to single the student out, do not place unnecessary restrictions
- Offer innovative learning strategies (e.g. audio recordings to assist with reading)
- Provide adequate time to transfer from class to class (elevator pass, 5 minute hall pass, or book/backpack buddy if necessary)
- Anticipate poor handwriting due to medications that cause neuropathy (deficits in both sensory and motor function)
- Help organize the student's notebook, keep log of daily assignments
- Use the "buddy system" to review assignments
- Allow the student to wear hats, bandannas, hairpieces (waive the no cap policy)
- Offer the student a quiet place to rest, if needed
- If necessary, modify physical education class
Information for School Nurses
Important guidelines to follow when a child in your school has cancer or a blood disorder:
- Identify and establish open communication with the School Intervention and Re-Entry/Medical team
- Request information regarding the child's diagnosis and treatment
- Inquire about side effects the child is experiencing
- Ask about changes in the child's body image (Will the child wear a hat, have a cast, require crutches or a wheelchair)
- Inquire about the child's central line type and location
- Identify any necessary activity restrictions or modifications
- Inquire about medication administration and obtain prescriptions/orders, if necessary to administer during the school day
- Report infectious outbreaks to the family/medical team (e.g. chicken pox, measles pertussis)
- Send a letter to parents of classmates requesting notification of contagious illnesses because of the presence of an immunocompromised child in the class
- Hold a meeting with the child and family prior to the child's return
- Keep updated with child's progress
- Notify the family/medical team for fevers, pallor, bleeding, vomiting and any other unusual signs and symptoms
