Going back to school after being hospitalized and/or recuperating at home for cancer treatment is both an exciting and anxious time for children and parents. To learn more about school re-entry, Cancer.Net discussed this process with Karen Fasciano, PsyD.

Q: What are the first steps parents can take once the doctor says it is okay to go back to school?

A: Ask the doctor about any physical limitations your child may have, especially fatigue (tiredness), the ability to concentrate on schoolwork, and how fully the child can participate in physical activities. Talk about these possible challenges with your child so he or she is clear about what to expect. Before school re-entry, a medical professional on the child's treatment team should talk with the school nurse about your child's medical considerations.

At school, the parent may want to have a meeting with the child's teacher, school nurse, and principal to discuss how the team can best support the child. One option for parents is to initiate a formal educational plan called a 504 plan (part of the 1973 Rehabilitation Act), or an individual educational plan (IEP), which ensures that children with medical illness receive appropriate accommodations.

Finally, it is important to ask your child about worries he or she has going back to school and talk about these with your child.

Q: What are some ways parents can work with teachers, counselors, and others at the school to make this transition easier?

A: Identifying a point person at the school to be the main communicator between school officials and parents can be very helpful with the transition. This person can help develop a system of appropriate, regular communications.

Families and school personnel may consider a school re-entry program, which is a formal program offered at many major cancer centers. Cancer centers may be able to send a nurse to speak with the child's classmates to help ease the transition. Generally, the nurse provides some basic, age-appropriate information about cancer, and the classmates have an opportunity to ask questions of the nurse. Some children with cancer want to be part of this presentation, while others do not.

On a practical note, once the child returns to school, it may be helpful to identify a quiet place for the child to comfortably rest during the day if needed.

Q: What are the differences between preparing a younger child and an older child to go back to school?

Elementary school children need assistance and specific guidance from school professionals, such as how to answer their classmates' questions. Younger children are often relieved to know that they can choose simple answers, such as "Thanks for asking, but it's hard at talk about at school. Playing with me would be nice though.", "I don't know the answer to that.", or "Can you ask the teacher that question?" Elementary school children may also want a nurse or teacher to address the fact that cancer is not contagious and that there is nothing anyone did to cause it.

Adolescents may want help identifying their support team, including one person who they can seek out for respite or support during the day. However, many adolescents don't want to be different from their peers and are generally uncomfortable with any attention that singles them out. As with younger children, it may be helpful for adolescents to get some coaching from a parent or counselor about how to answer questions about their illness in a way that is comfortable for them. Some adolescents find it easier to simply not discuss their cancer at school, while others come up with "one liners" in response to common questions or comments.

No matter what the age, children all have their own individual coping styles. Identifying these will help to prepare the child in a way that feels most comfortable to him or her.

Q: What are some signs that your child may not be coping well at school, either with the schoolwork or the social aspect? What are some ways to handle this situation?

A: Refusing to go to school may indicate that the child is struggling with some aspect of the school experience. If the child can describe why he or she does not want to go to school, the parent may want to meet with the school team and see if there are strategies for encouraging the child to come to school. For example, the team may want to discuss implementing shorter days for the child, accommodating the curriculum, structuring social support, or developing a plan that combines time at school and tutoring at home.

It is important to find ways for your child to participate in school, since school allows your child to socially interact with kids his or her own age and find a regular routine.

Dr. Fasciano is a clinical psychologist at the Dana Farber Cancer Institute who specializes in school issues for children when a family member is faced with a cancer diagnosis.

Additional Resources

Lance Armstrong Foundation: School Re-entry for Children and Adolescents

American Cancer Society: Children Diagnosed with Cancer – Returning to School

CureSearch: Education Services for Children with Cancer

More Information

Cancer in Children

Cancer in Teenagers: Cancer and School

Childhood Cancer Survivorship

Last Updated: August 13, 2007