Back in the classroom after brain tumour treatment

There are many things you can do to make sure that your child has a successful experience in school. It is important to keep in touch with your child’s teacher to see how they are doing in schoolwork, but also how they are keeping up with their friendships and readjusting to school. For example, some children may show more emotions than they did before, while others may become more quiet and withdrawn. Children with brain tumours can feel very tired, and this can affect their experience in school. Let the treatment team know if there are any changes that you are concerned about, because they can help find solutions.

Returning to school

Here are some ideas that lay the groundwork for your child’s return to school.

Get a letter from your child’s treatment team

Ask the treatment team for a letter about your child’s medical condition, physical problems, and any other important information. Make copies for the school principal, your child’s teacher(s), and school nurse. If your child has had a neuropsychological assessment, copies of this may be useful. In certain cases, if your child is having balance or walking problems, a letter from a physiotherapist or occupational therapist may be helpful. A letter can also help if your child has any prescription medicines that they need to take at school.

Get in touch with school staff

Contact your child’s teacher(s) and principal before your child goes back to school. Some hospitals have a school liaison nurse or social worker to speak or meet with school staff. If not, you can set up a meeting yourself. A telephone call, teleconference, or e-mail message is also helpful if you cannot meet in person.

It may also benefit to have other experts attend. For example, you could include your child’s teacher from the year before, your child’s neuropsychologist, or a special education/resource teacher from the school board as needed.

If your child is visually impaired or is blind, it might also be helpful to include a vision itinerant teacher. Your school liaison person may help you find a vision itinerant teacher, or you may need to go to another agency, such as the Canadian National Institute for the Blind, the American Foundation for the Blind, or the Royal National Institute of the Blind in the U.K.

Likewise, if your child is deaf or hard of hearing, resources are available and accommodations can be made. Your school liaison may help you find an itinerant teacher for the deaf.

Write down any questions or points you wish to make before you make contact. Here are some ideas:

• Describe your child’s condition and treatment. Explain how it might affect school work, attendance, physical access, physical activities, and safety issues. Your child will likely need support.
• If your child is having chemotherapy, explain why chicken pox and other common childhood diseases are harmful.
• Tell them when they should notify you or call for emergency help if there is a problem. The school may have its own medical protocol where you can write down this information.
• Discuss whether your child may need an individual education plan. This is a special plan suited to your child’s ability.
• Ask them to keep in touch to let you know how your child is doing.
• Let them know if you have other children at the same school. The change in their family life may affect their school work.
• Let them know that they need to be flexible because your child’s condition may change over time.

Find out if your child will have access problems

Work with school staff to find a solution.

• Stairs: Most schools have stairs. Many schools are not wheelchair accessible. If your child is having trouble walking, they may not be able to get around at school.
• Bathroom: Most schools do not have anyone available to help your child with going to the bathroom. It is not appropriate to ask other students to take on this role, even if they are older. A teacher, school nurse, or parent could help.
• Transportation: You may need to drive your child to school. If other special arrangements for transportation need to be made, you will need to speak with the school principal.

Keep in touch

If your child can keep in contact with their classmates while they are out of school, it can help to keep their spirits up and make their return to school easier. Teachers often have great ideas about keeping in touch. Some families have found the following ideas helpful:

• A classmate visits your child in the hospital or at home to bring small assignments and news.
• The class sends letters, cards, videos, or e-mails to your child.
• Your child sends letters, cards, videos, or e-mails to their class.

Back in the classroom

Before your child returns to class, notify their teacher that they will look different than before, so that the teacher can inform and prepare his classmates. For example, the teacher can inform the children that your child will not have any hair, if this is the case. You might want to send photos of your child to the class ahead of time, or have your child make a visit to see their classmates before they officially return to school. Informing the children ahead of time can help instill sensitivity.

Getting support from classmates can also help your child. Children who feel they have more support from classmates are less likely to feel depressed and anxious.

Making sure your child can focus in class is also important. Some children with brain tumours can’t concentrate with the background noise in a classroom, and they may need personal attention. You may need to work with the teacher to find solutions, such as seating your child at the front of the classroom or structuring the classroom differently.

Children may also worry about answering questions from classmates. You can try and imagine questions your child may get and rehearse the answers. For example, if a classmate asks, "Are you going to die?" Your child could answer whatever they feel comfortable saying, such as: "I’m sick but I’m doing everything I can to get better" or "It might happen, but we’re hoping it won’t" or simply "No, I am not."

Telling your child’s classmates

Having an information session will teach your child’s classmates about the illness and can help to create a supportive environment. In this session, the classmates can learn about your child’s condition and ask any questions. First, you should ask your child what they want others to know.

If the hospital has a school liaison person, they may be able to speak to the class. Include your child if they want. Back-to-school resource kits, books, and videos are also available for these sessions.

Try and focus on concerns that classmates bring up. Get children to ask questions. Children take their cues from adults. Being straightforward, answering questions honestly, and reassuring children that they have no need to be scared can help create a supportive environment. Be careful not to give out more information than your child knows.

Finding peer support for your child

Inviting a responsible peer to support your child also sets an example for classmates. Some ideas that have helped others are:

• Having a "safe friend": Find a responsible child a few years older than yours — perhaps a neighbour or another student — to be your child’s buddy. This friend can watch out for your child, lend an ear if your child is having problems, and provide a sense of security.
• Having a peer tutor: A student in your child’s class, or in a higher grade, may take on the role of "tutor." The exact role could be discussed with the teacher. It might involve meetings once a week to talk about what was new that week, and for your child to say what they enjoyed learning and what they found difficult.

Returning to school for teenagers

For teenagers, going back to school presents different challenges than for younger students. Because your teen has a different teacher for each class, the teachers generally will not know them as well. Teenagers also tend to be more private about what they want their peers and teachers to know.

Ask your teen what he wants people to know and how it should be said.

If your teen is willing, having an information session for certain friends, classmates, or their home room class might be helpful. A hospital liaison person such as a nurse or social worker is a good choice to speak to the students and answer questions. For example, if your teen has been heavily involved in sports, then they might choose to have a session for their teammates and coaches. Another teen may just want their close friends to attend.

If you feel it might be necessary, talk to the school about arranging a general assembly that focuses on tolerance and empathy, and zero tolerance for verbal harassment or violence.

Teenagers can also benefit from joining teen support groups. As a parent, you can turn to members of the treatment team, or other experienced support networks, for ideas on helping your teenager readjust to school.

Some parents and teens have found it helpful to ask a close friend to take on the role of a helper, to provide support for your teen, listen to problems, and help deal with any school issues.

Telling other parents

It’s your decision whether you want to tell the parents of your child’s classmates about your child. You might wish to do so to get their support. On the other hand, it can also be important to keep some privacy around your child’s condition. Think about what you would like to say to maintain privacy.

You can decide what you want to say and how you say it, such as in a letter, or in parent groups. At the least, you may wish to send a letter that informs parents why they need to report if their child has chicken pox.

What does the return to school mean to you?

For some parents, their child’s return to school is another stage that leads to many strong emotions. Some areas that parents are most concerned about are:

1. Social issues: "What if my child is picked on? What if they can’t do all the school activities — will they be embarrassed or centred out?"
2. Health and safety: "What if a classmate gets chicken pox and we don’t find out? What if my child gets hurt?"
   
3. Education: "Why can’t my child remember anything anymore? Why don’t they pay attention in class?"
   

It’s natural for your protective instincts to increase, even if you have done everything possible to make sure your child’s return to school goes smoothly.

Try and balance these concerns with the fact that your child needs to have the normal childhood experience of school and socializing. They need to spend time with children their age to learn, grow, and develop.

Your ongoing communication can help prevent any accidents or infection. Making sure your child’s school knows what to do, keeping in touch with your child’s teacher, and regularly updating the school about any medical changes can help address these concerns.

While in treatment and even afterwards, schoolwork might become a challenge for some children. It may lead to feelings of sadness, disappointment, and frustration. You may need to ask yourself what you expect of your child, and whether you need to change the academic or work goals for your child. Be realistic — don’t expect too much, but don’t ignore your child’s actual abilities either. Work with your child toward their full potential.