Managing the Chutes & Ladders of Education Disruption
For students with a chronic health condition, school can become like a Chutes and Ladders game with many more chutes than ladders. No matter what the degree or severity of a student's medical condition, he or she will have more absences than his or her classmates. Thus there will be many challenges and setbacks trying to keep up at school.
In general, the student's health condition and medical management needs create significant obstacles to school attendance and academic and social continuity.
The school's willingness and ability to protect a student's health and education can have a significant impact on the student's social, emotional, and educational well-being. Schools that understand the needs of health impaired students know that these students require some extra thought and planning and strong school-family partnerships to coordinate their health and educational needs.
On the other hand, a teacher's inappropriate expectations and inflexible demands can cause many additional hardships, can inflict extreme distress on the students and their families, and create acute and cumulative educational disadvantages.
Recommended Reading: Missing School Time? Filling the Gaps. 1992. Ellie Goldberg, M.Ed.
B A C K G R O U N D (adapted from James Perrin, MD, Michael Weitzman, MD)
10 - 20 % of children under 17 have some type of chronic health condition (asthma, diabetes, seizure disorders, cystic fibrosis, sickle cell anemia, liver or heart defects, etc.) Less than 2% of children have a severe health impairment.
Rates of chronic illness have increased in the past twenty years.
Despite differences among specific illnesses or their severity, the issues faced by families relate to the chronicity of a condition.
And despite the differences among illnesses or their severity, students face common barriers to education and health management at school that place them at high risk of not functioning to their fullest potential.
CHALLENGES OF CHRONIC HEALTH CONDITION(S) AND DISABILITY
- Unpredictable variations in functioning (stamina and alertness).
- Swings in moods and cognitive function because of condition, fatigue and/or medication.
- Frequent and time-consuming medical evaluations, treatments.
- Altered routines (eating, sleeping, work time, recreational activities, free time).
- Fatigue
- Anxiety
- Diminished Self Esteem
- Developmental stress intensified
- Hidden Handicaps
- Out of sync with peers
- Peer acceptance/socialization skills at risk
MEDICATION
- Debilitating Side Effects
- Over dosing, Under dosing, Frequent changes in medication
DEMANDS OF MEDICAL MONITORING
- Frequent disruptions of daily activities
- Constant adjustment to changes in patterns of daily life (eating, activity levels, etc.)
- Frequent physician visits during school day
MISSED SCHOOL TIME
- Disrupted attendance
- Disrupted relationships (student-student, student-teacher)
- Missed instruction results in cumulative academic deficits
- Lack of skills development, cognitive strategies and prerequisites to make progress
- Lack of context results in not knowing what is expected, can't understand assignment objectives, doesn't understands standards for acceptable or good performance, hyper vigilance (misinterpreted as ADHD)
- Lack of communication and curricular support diminishes value of school attendance.
- Lack of meaningful evaluations.
- Unfair grading and credit penalties.
- Social inhibitions developed from loss of social relationships and contacts.
- Depression related to being left out and left behind with no hope for catching up.
- Truancy actions against student
DOMINANCE OF PROBLEM ORIENTED DISCUSSIONS
- Pessimism, Negative focus
- Impaired self esteem
- Communication problems
- Competition between academic and social needs
- Difficulty making up and keeping up with class
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