Special education covers all the special services children may need, from gifted programs, to children with special health care needs, to children with special learning needs. Making special educational services available to children with special needs is required by Federal and State law. Some children with cancer may require a specialized education plan to meet their individual needs. Enrolling in special education services begins with an evaluation, used to create an Individualized Education Plan (IEP). An IEP may be appropriate for children who are out of school for an extended period of time due to illness.
Children who have already been receiving special education due to a learning disability, a developmental delay, or speech and/or language problems can also benefit from a new IEP that takes into account new educational needs due to the illness. An IEP may also be useful for children who have been out of a regular school schedule and are about to return; during the transition, they may require extra assistance.
Special services provided through an IEP may include: extra educational help and coordination, occupational therapy, physical therapy, speech therapy and special transportation.
An IEP typically includes the following components:
- Assessment of the child’s current level of educational performance
- Impact of the illness on learning, thinking, energy/fatigue
- Medical precautions and special needs (if any), for example: central venous access device, extra bathroom breaks, drinking water during class, snacks, limited sun exposure, modified physical education, etc.
- Statement of goals to be achieved under the IEP
- Statement of educational services that the child needs
- Date the educational services will begin
- Description of the extent to which the child will participate in regular education programs
- Justification for the type of educational placement the child will have
- List of individuals responsible for the implementation of the IEP
- Objective criteria and evaluation procedures
To obtain an IEP and establish eligibility for special education services, you will need to deliver or send a request letter to the school principal that outlines the help you believe your child needs. This help could be as simple as assistance with schoolwork, help with going back to school, or extra help in the classroom.
Once the school has reviewed the letter, it will be forwarded to the school district’s Department of Special Education. Next, an evaluation of your child’s needs will be scheduled; school districts are required by law to conduct this evaluation within a reasonable period of time. After the evaluations are completed, an IEP Meeting will be arranged including the parents/guardians, the individuals who performed the evaluation, a representative from the Dept of Special Education, the school administrator(s), teacher(s) and a hospital representative (if you request this). The meeting will determine whether your child is eligible for special services, which specific services will be needed, and will provide the input for writing and implementing the IEP. Children with cancer qualify for special education services under the category of “Other Health Impaired (OHI)”
Keep in mind that the IEP is a working document which can be revised as your child's needs change, whenever you request it.
When in-hospital schooling is necessary
In-hospital teaching can serve as a bridge between treatment and school.
When a child is in the hospital for five days or more, he or she may qualify for in-hospital teaching.
Teachers from your school district or the hospital’s school district can provide in-hospital teaching. Many children’s hospitals and the pediatric departments of medical centers also employ permanent hospital teachers.
A meeting should be scheduled including you, your child, and the hospital teacher so that your child can be enrolled in the hospital’s teaching program. The in-hospital teacher will collect information about your child’s regular school programs, and contact his or her school to coordinate with the regular schoolwork.
The hospital teacher will arrange regular teaching times that accommodate your child’s medical needs and hospital schedule. Typically, hospital teaching is limited to one hour per day, since experience has shown that focusing on schoolwork for longer than an hour can be a challenge for a child undergoing medical treatment.
Teachers may not be able to cover every subject, especially for middle and high school students; however, school credits are still earned during hospital teaching, and this can help a child feel a sense of normalcy in their lives.
If the hospital does not have a full-time teacher, the hospital social worker, child life specialist, or nurse coordinator can help you contact the local school district to arrange for a teacher to work with your child.
Is homebound instruction an option?
When your child is discharged from the hospital but unable to return to school because of health, your child’s school district must provide a teacher to come to your home to teach your child regularly. Typically, a student must be out of school for 3 to 4 weeks to qualify for a home teacher.
Larger school districts often have designated teachers that work with homebound students. These teachers specialize in teaching children with health issues. Smaller school districts may recruit a teacher from their pool of regular or substitute teachers.
Home instruction usually occurs two or three times per week, with the teacher bringing work home to the student, then teaching and reviewing the material. The teacher will also collect homework and assign new homework.
For continuity, a home teacher may sometimes continue to work with students during ongoing hospitalizations, especially if distance is not a factor.
Most districts provide about 5 hours per week of home teaching, divided up between 2 or more sessions. Be sure to keep the home teacher aware of changes in your schedule at home due to unforeseen medical appointments. Also, make sure the home teacher is provided with clear information about your child’s specific illness and treatment, so he or she can plan lessons accordingly. It may be very helpful to have the home teacher communicate directly with your child’s nurse or social worker to answer any specific questions.
Home teaching may provide less teaching time than occurs at school, but the student will be able to earn most of the credits he or she will need to stay current with regular classes.
Ernest Katz, PhD, Children's Hospital of Los Angeles
Reviewed June 2008