Brain Tumors, Part 3 — Implications for school
The presence of a brain tumor may result in significant implications
for a child in school, and the management of a brain tumor 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 a brain tumor is successful at school.
The physical aspects of a brain tumor must be addressed at school. The
following accommodations and adaptations may be warranted for a child
with a brain tumor:
- Due to the possibility of fatigue, the child might need to rest during the school day. It is usually best to do this
in the nurse’s office, or in a location away from the other students
in order to not increase peers’ feelings that the child is different.
- Restroom privileges should be flexible and on an “as needed”
basis.
- Exercise may benefit the child with a brain tumor by helping to
increasing muscle strength. The child should be encouraged
to participate in all physical activities at school. From day to day,
the child may be limited in how much he/she can do or the duration of
time that he/she can participate in physical endeavors. There may be times,
due to steroids, that the child has difficulty with movement as a result
of weight gain and fluid retention. The child should be encouraged to
do as much as possible, and allowed to set his/her own limits for physical
activity.
- Balance and mobility should be evaluated by a physical therapist
and any modifications or accommodations that are indicated should be incorporated
into the student’s IEP.
Psychosocial concerns for the student may be significant.
Due to frequent absences, frequent infections, limitations on physical
activity, and possible changes in cogntive
functioning, young people
with a brain tumor 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
a brain tumor. 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.
- This is a wonderful opportunity to teach peers about supporting
a friend, how to show compassion and other essential life lessons.
- Identify strong peers to mentor the student with a brain tumor
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.
- Include 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 a brain tumor can be a significant asset. The student may need the
opportunity to discuss his/her fears about the future, keeping up in school,
socialization issues, concerns about other family members, etc.
Finally, cognitive status and academic progress must be monitored on
an on-going basis. The student
is likely to experience some degree of cognitive or learning problems
as a result of the tumor or the treatment. Usually, students with a brain
tumor qualify for special education support as students who are other
health impaired (OHI), learning disabled (LD), or developmentally delayed
(DD) under the Individuals with Disabilities Education Act (IDEA). A comprehensive
evaluation should be conducted to see if the student would qualify as
a student with one of these special education areas of need.
Doctor visits,
hospitalizations, radiation treatments and other medical requirements
may result in excessive absences for the student. This
may cause the child to feel concerned about keeping up academically. A
student with a brain tumor is likely to miss a lot of school, and will
need assistance and flexibility in completing assignments and work upon
their return to school or home. Homebound education should be utilized
ONLY if the child cannot possibly come to school. Otherwise, the child
should be encouraged to attend school as much as possible.
In order to ensure that the student continues to progress, educators
should:
- Evaluate for potential classification as other health impaired,
learning disabled, developmentally delayed or other special education
category.
- Create an IEP that allows for the possibility of on-going change
and fluctuation in ability and physical stamina.
- Identify areas of strength and help the student focus on the things
he can still do, as opposed of the functions or skills that may have been
negatively impacted by the diagnosis, surgery or treatment.
- 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.
- Notify the child’s parents and/or health care provider if
a change in behavior, personality or school performance is observed.
Part 1 — Introduction, Incidence, and Symptoms
Part 2 — Treatment, Side effects and Restrictions
Part 3 — Implications for school
For more information, please contact:
Kathy Davis, MSEd, PhD
kdavis2@kumc.edu
(913) 588-6305