Sickle-Cell Anemia &mdash Part 3
Implications for school
The management of sickle cell anemia at school has several facets. Educators
must consider the physical, psychosocial and cognitive/educational issues
of this diagnosis in order to ensure that the young person with sickle
cell anemia is successful at school.
The physical aspects of sickle cell anemia must be addressed at school.
Often, these students qualify for special education support as students
who are Other Health Impaired (OHI) under the Individuals with Disabilities
Education Act (IDEA). A comprehensive evaluation should be conducted to
see if the student would qualify as a student who is OHI. The following
accommodations and adaptations may be warranted for a child with sickle
cell anemia.
- Special bus transportation, picking the student up and dropping
her off at her home, is an appropriate accommodation to avoid having to
wait for the school bus in very hot or very cold weather.
- Provide rest time, if the child is lethargic at school.
- Modified physical education that addresses the limitations imposed
by this diagnosis (i.e. no strenuous physical activity, avoiding activities
that may result in blows to the body such as football, basketball, etc.).
- Proper hydration; allowing the student to have a water bottle
at his/her desk.
- Allow frequent bathroom privileges.
- Monitor closely for changes in physical status.
- Allow student to visit nurse if he/she complains of pain or other
symptoms.
Psychosocial concerns for the student with sickle cell anemia may be
significant. Due to frequent absences, pain crises and limitations on
physical activity, young people with sickle cell anemia struggle with
issues of “fitting in”. They may feel left out by their peers,
or struggle with keeping up socially as they flow in and out of school.
In order to help facilitate healthy psychological, emotional and social
adjustment, the school should consider:
- Educating peers, with the consent of the child and parents, about
sickle cell anemia. The hospital school teacher is a good resource for
offering a presentation, suggesting materials, or assisting with the education
of educators, peers or other interested community members.
- Encourage peers to stay in contact with their friend when he/she
is absent. Cards, letters and phone calls can serve to bridge the gap
when youngsters with chronic illnesses must be away from school and activities.
- Identify strong peers to mentor the student with sickle cell anemia
when he/she returns after an absence. Having someone to “fill you
in” on what you missed while hospitalized or home ill may make all
the difference in facilitating a good reentry.
- Help the student find areas of expertise and ways to excel in
the school environment. Mentoring support could be included in the IEP
to help the young person maintain or develop a strong self-concept.
- Consider social work or counseling services as part of the IEP.
Having someone at school to talk to or act as an advocate for the youngster
with sickle cell anemia can be a significant asset.
Finally, cognitive status and academic progress must be monitored on
an on-going basis for the young person with sickle cell anemia. Research
has indicated that youngsters with sickle cell anemia may be victims of
“silent strokes” (small strokes that go undetected, clinically,
but which may, over time, cause significant cognitive decline). Since
there is not a definitive, single event that indicates possible cognitive
problems, this may not be recognized. The student may, gradually, have
more and more difficulty in school, without the realization that there
may be a true, physical cause. In order to ensure that the student with
sickle cell anemia continues to progress, educators should:
- Evaluate for potential classification as other health impaired.
- Create an IEP that allows for the possibility of on-going change
and fluctuation in ability and physical stamina.
- Provide for a great deal of flexibility when the child has been
absent. Give plenty of time to complete make-up work.
- Provide tutorial assistance if the student has been absent or
if he/she is evidencing difficulty with specific learning material.
- Provide careful monitoring to determine if student has declines
in performance.
Sickle-Cell, Part 3 — Implications for school
For more information, please contact:
Kathy Davis, MSEd, PhD
kdavis2@kumc.edu
(913) 588-6305