Educational Issues after Childhood Cancer


Some children who were treated for childhood cancer have a harder time learning in school than their peers. During treatment, being absent and having low energy levels can hinder progress in school. So can certain treatments that affect memory and learning ability. Although your cancer treatment has ended, learning problems can persist or emerge. The good news is that not all survivors have trouble in school and those who do can get extra help.

Am I at Risk?

Many factors can raise your risk for learning problems in school, including having been absent a lot or for a long time during treatment and having learning problems before you were diagnosed with cancer.

Some kinds of cancer and treatment can increase your risk, as well.

Treatment 

Certain chemotherapy drugs, surgery that involved the brain, radiation to the head or whole body, and treatment to the brain, spinal cord, or both can make you more likely to have learning problems. So can having had treatment that resulted in physical disability, lower energy levels, or worse hearing or vision.

Cancer Type 

Some cancers are more likely than others to need treatment that could affect learning and memory. These include:

But treatments for these cancers vary, so not everyone who had these cancers has a higher risk.

What Learning Problems Might Occur?

Survivors with learning problems often have difficulty with these areas:

  • Handwriting
  • Spelling and vocabulary
  • Math
  • Concentration, attention span, and memory
  • Ability to finish tasks on time or to do assignments with many steps
  • Planning and organizing
  • Problem solving
  • Social skills

Should I Be Tested for Learning Problems?

If you are at risk for learning problems, or if you are already having trouble in school, you should undergo special testing by a child psychologist when you begin long-term follow-up. The testing will measure your IQ, school-based skills, and how you process and organize information. Even if the results are normal, testing should be repeated if problems at school emerge and when academic challenges are more likely to occur, such as when starting a new school or planning to go to college.

What Can I Do If I Have Learning Problems?

If you are having trouble in school, you can request special services to help you. Most often you first need to have a meeting with your school to create a specialized educational plan. The plan will outline strategies that can help lessen any learning problems you have.

Examples of strategies include these:

  • Sitting near the front of the classroom
  • Minimizing the amount of written work required in classes
  • Using digitally-recorded textbooks and lectures
  • Using a computer keyboard instead of handwriting
  • Using a calculator for math
  • Modifying test requirements, such as getting extra time or having an oral rather than written exam
  • Getting a classroom aide
  • Getting extra help with math, spelling, reading, and organizational skills
  • Using an elevator
  • Having extra time for transition between classes
  • Having an extra set of textbooks at home

What Laws Protect the Rights of Students Who Have Had Cancer Treatment?

In the U.S., three laws protect the rights of students with educational problems related to cancer treatment. These laws are:

The Rehabilitation Act of 1973 – Section 504 

All childhood cancer survivors in the U.S. are able to receive accommodations under this law. These could be to the curriculum (such as being able to use a calculator and have extra time for assignments or tests) or to the environment (such as having seating near the front of the classroom and getting extra time between classes).

The Individuals with Disabilities Education Act (IDEA) 

To qualify for special education services under this act, you must meet qualifications under at least one disability outlined in the law. The disabilities that most often apply to students who had cancer treatment are "specific learning disability," "traumatic brain injury," or "other health impairment."

To access services, parents must first ask that students be evaluated for an Individualized Education Plan, or IEP. If the student qualifies for services, a plan is developed to meet his or her educational needs.

Services available under the law include tutoring, specialized classroom placements (such as a resource room), psychological services, adaptive physical education, transportation services, and physical, occupational, and speech/language therapy. All services and accommodations needed by the student should be specified in the IEP.

The IEP should be reviewed and updated every year to make sure that it still meets the student’s education needs.

The Americans with Disabilities Act 

This law protects people with disabilities against discrimination in employment, transportation, communication, government, and public accommodations. It guarantees equal access to public spaces, events, and opportunities. It might be particularly helpful for students seeking higher education or work.

Where Can I Find More Information?

You can find more information about disabilities in children from the National Information Center for Children and Youth with Disabilities at www.nichcy.org.

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