When a child or teen is diagnosed with cancer, families and parents will face and need to cope with many problems, including the impact of a child's cancer diagnosis and treatment on regular school routines. A child's cancer diagnosis and treatment can interrupt regular school routines. Many children are able to continue their education during treatment and then will go back to school full-time at the end of treatment. See Helping Your Child Manage School During Treatment for information on keeping up with school before treatment ends.
Most children are able to return to school full-time after they complete cancer treatment. Going back to school is a priority because it can give children a sense of normalcy and is an important part of their social and academic development. Some children feel excited about returning to school, while others feel upset or anxious. These are all normal reactions. Going back to school might be a challenge or a relief. It might give your child the comforting message that they have a future and potential for a full recovery from cancer.
The transition back to school can be just as hard for parents. Parents might think school is going to be overwhelming for their child. They might worry their child will get infections, become overly tired, or be teased for being different. All of these concerns are normal. Most pediatric treatment centers know that families might need help to make sure the transition goes smoothly. Children’s hospitals may have education coordinators and teachers that make sure your child has the right support at school.
This piece will guide you through key steps in planning for the return to school after treatment ends, some common problems after returning to school, and things you can do to help.
After your child is diagnosed and long before any plans are made for them to return to school, you might have talked your child’s teachers, school principal, and school counselor about the cancer and the treatment plan. When your child is ready to go back to school,it is important to communicate early with the school and the cancer care team early. Here are some of the steps you can take before treatment ends to help get ready:
Talk to the cancer care team about when they think your child will be able to return to school after the end of treatment.
Once you have a planned return date, ask the cancer care team what resources will help plan for school re-entry. The school re-entry services might include nurses, teachers, psychologists, social workers, and child life specialists. If there is a re-reentry program, ask them what they will do to support your child's return to school. They might be involved in meetings with the school, arrange visits to the classroom, or communicate special needs to the school and teachers.
Reach out to the school principal, teacher, nurse (if there is one), and school counselor to let them know when your child might return full-time. They might have forms for you and the cancer care team to complete.
Arrange a meeting with the principal, teachers, and school nurse to make sure everyone knows what to expect. The cancer care school re-entry team members might participate and help guide this discussion, depending on the kinds of support they provide.
Some children might not be ready to return to school for full days the first week, so it could be helpful to think about how long their school day should be in the beginning. It may take them a few weeks or a month to build up their energy levels after cancer treatment. Talk to your doctor and cancer care team about these needs before you meet with the school leaders.
Meeting the teacher, principal, and school nurse (if there is one) before the child goes back to school is very important and can help everyone know what to expect. If your cancer care team offers support for retuning to school, ask if they will be at the meeting. If they will not be present, ask them to help you write a letter explaining any expected changes in the child’s routine and future plans. You’ll want to write down these things for the school’s records:
Once your child returns to school, you might find that not everything goes as planned. Going through cancer treatment was a big change. It is not unusual for your child to need more support emotionally or academically. You might find there are new physical changes that cause problems, or that the emotional adjustment is a challenge. Some treatments can also affect how children learn and think. Be sure to ask your child every week or so about any concerns they are having after returning to school. Some might need to be addressed quickly, especially if your child is feeling upset about them. Other changes due to cancer treatment may surface later. For more information, see Late Effects of Childhood Cancer Treatment.
Finding excuses to miss school could be a sign that your child is struggling with some part of going back there. If your child is tearful before and after school or every Sunday night, that might be a sign that they are having a hard time with the change. Older kids and teens might not want to go back to school because they look different, or because their long absences have changed their social standing with friends. If your child does not want to go to school, it is important to understand what is bothering them. Here are things you can do to understand the reason they are avoiding going back.
Other children may have questions for your child about cancer. It can be hard for children to know what to say in these situations. It usually helps to talk with your child before they go back to school about what to say, so they are ready if it happens.
Physical problems after cancer treatment can affect a child’s ability to get around and perform at school the way they did before their cancer diagnosis. Schools might need to accommodate a child’s physical needs after cancer treatment. Here are some examples of physical problems and ways to handle them.
If your child is having problems with fatigue or weakness
If your child is having problems with appetite, thirst, or using the bathroom
Most children adjust well to school after cancer treatment. But cancer and its treatments can cause emotional and cognitive (ability to think and reason) changes, which can affect your child at school. You can help your child by watching for problems, so they can be dealt with as soon as possible, before they become hard to manage. Some changes after treatment that affect learning can last a few months, others may last longer. Children can experience something called chemo brain that can make is hard to focus, complete tasks or remember things. Some treatments have long-term effects on learning, so it is important to get help as soon as problems with schoolwork come up.
Sometimes children who have had cancer treatment will have learning problems and need extra help. Most children who are at risk for learning problems from cancer treatment will benefit from testing, often called neuropsychology testing, to understand their individual learning needs. This kind of testing may be offered by the school psychologist or counselor at no cost to the parent or at the cancer treatment center where your child was treated. Neuropsychology testing usually covers assessments of reading, writing, math skills, memory, comprehension, attention, concentration, and fine motor skills. If your child has had radiation to the brain, you may want to ask for testing, whether you notice a problem or not.
If your child needs extra help learning, keep in mind that all children have a right to education in the least restrictive environment. This means that your child should be with other non-impaired children as much as possible. If parents have an issue with the school and the education their child is getting, they have the right to request a third party mediator to settle disagreements.
After getting all the results, the school can develop an Individual Education Plan (IEP) or a 504 plan for your child.
An Individual Education Plan (IEP) or a 504 Plan is a plan developed by both parents and teachers to meet the individual needs of a student. If your child meets all of the stringent legal requirements to qualify as a special education student, the plan is called an IEP; if not, it’s called a 504 Plan. 504 plans are often used for children who do not qualify for an IEP. 504 plans and IEPs are provided by the school at no cost to the parent and the school and cancer care team can help identify which plan is right for your child.
It can seem pretty unfair to have cancer and then to struggle to go back to school. But learning as much as you can about possible problems can help you and your child adjust faster. There are other resources that may help you.
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Brand S, Wolfe J, Samsel C. The impact of cancer and its treatment on the growth and development of a pediatric patient. Curr Pediatr Rev. 2016 Nov 15.
Childrens Oncology Group. School Support. Accessed at https://childrensoncologygroup.org/index.php/home/48-coping-with-cancer/school-support on September 18th 2017
Thompson A, Christiansen H, Elam M, et al. Academic continuity and school reentry support as a standard of care in pediatric oncology. Pediatr Blood Cancer. 2015; 62: S805-S817.
Last Revised: September 21, 2017
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