What has changed in how administrators and teachers view “medically fragile” children?
When I was in elementary school, I didn’t run into a lot of children with medical conditions.
There was a single child in my school who had Down Syndrome, and no one was ever told of any medical issues relating to this diagnosis.
We had a special lesson about a boy in my class who was in a Spica Cast (a cast which covers the entire torso) for a few weeks during 6th grade. We were just told to be careful not to bump into him, but nothing more.
At least two students had Asthma. I was pretty familiar with Asthma since my sister was one of the two!
There was never any information shared about any conditions…..and there was nothing more significant than these 4 diagnoses in our school to our knowledge.
Fast forward now to what I have seen in-school: cerebral palsy, spina bifida, sickle cell anemia, diabetes, cancer, organ transplant recipients…..and with much of the medical care comes changes in appearance and the traumatic impact on children attending school with those children.
Think back to when you were in elementary school – what medical needs or disabilities do you remember existing in your class or in your school? What do you think has changed in how administrators and teachers view “medically fragile” children? How do you see the role of Child Life growing as a result of this change? Why do you think this change in Child Life is necessary?
In trying to reminisce about my school aged years, I have very few memories of sick, or medically fragile children in any of my classes. I do remember we had a child in the school with diabetes and that she had to manage what she ate very carefully and spent a lot of time in the nurses office. The only wheelchair I remember in the hallways is when a kid broke their leg and had to be wheeled around and I remember other kids fighting to be the one who go tot do the wheeling of that child. My sister, was diagnosed with meningitis in elementary school and missed about a month of school and was hospitalized for a couple of weeks of that. I remember her class made pictures and get well letters and the teacher came to visit and brought them. Once she was better, she went back to school and had no further complications so her class just moved on like any other typical day. Things have certainly changes over the last decades. Now , we see many kids in schools with life threatening allergies, asthma, childhood cancers, autism and many other chronic debilitating illnesses.
Parents , educators and communities must establish policies and procedures which will help to assist students with special needs ( Doka, 2014). Communications between schools, families, and even physicians is at an all time high in order to manage medically fragile and developmentally disabled children in our districts and to maintain typical school activities that encompass everyone. Schools work to encourage sick children to attend and work to educate their peers with accurate information rather than fear or rumor. It is important to maintain as many normal routines as possible when a child is ill or disabled as stress and anxiety increase with lack of normal activity ( Doka, 2014 ). It is important children feel connected to their classroom, peers and teachers as that helps them “not to feel different. ” A key component is preparing the classroom for that medically fragile child to feel comfortable, the more aware other students are of what is happening the less likely they are to feel threatened or scared (Doka,2014).
Child Life specialists can help to reintegrate the child into classrooms . They develop and implement plans with the child, families, teachers and other students. Those plans include education about illness or preventative measures and also use open ended questions In the classroom to help guide conversations around illness (Hammond,2018 ). The child life specialist can help minimize stress and anxiety for the teacher as well when welcoming a sick child back into the classroom . Ensuring teachers understand what the child and the whole class needs while being respectful of a child’s privacy and not oversharing are hallmarks of what a child life specialist can bring to a classroom (Hammond, 2018 ). Child life is the first line defense to help ease transitions from hospital back to classroom. They can use these experiences to evaluate and see what they would do differently to ensure success fro medically fragile families and their typical developing peers.
Doka, Kenneth, J. (2014) Children Mourning, Mourning Children , New York, New York : Taylor and Francis
Hammond, B. (2018) Death, Dying and Grief in Pediatric Acute Care ; Lesson 4
Growing up I do not recall knowing or seeing any children with medical conditions in my elementary school. However, it is very possible that at this age I did not acknowledge any medical conditions if a child had one. It is common to be oblivious to certain things like that at that age. I may have been told when I was younger a child in my classroom had a medical condition, but I am sure at that age it went in one ear and right out the other ear. In middle school I do remember seeing kids with different medical conditions. I did not know any of them personally, but they would stay in the exceptional student education room at school.
I am currently a substitute for the elementary schools around me. I noticed in one of my kindergarden classes the other day that there were two children with medical conditions. I was surprised both of them were not placed in an ESE classroom, however both of their conditions were psychological and they looked just like any other child in the classroom. It may have been because they have minor psychological conditions or other reasons I was unaware of. One of the two children is extremely touchy. He likes to touch many of the kids and it bothers most of the children in the classroom. He usually sits in a special seat and plays with toys similar to stress balls. Although he is just one child with a minor psychological condition, he did take up a lot of my time throughout the day. I had to constantly be on him about keeping his hands to himself, which made me pause what I was doing and focus all of my attention on him. He did leave the classroom towards the end of the day to go meet with a teacher. Although lesson 4 suggests that many schools do not have medical professionals that are needed for every child’s medical condition, I am impressed with the schools I have been working in around me. Everything could always use improvement, but for what little resources we have in the small area I live in, the ESE rooms do an excellent job trying to make everything easy on their kids.
It is important that the children who are in normal classrooms with minor disabilities feel comfortable in there and don’t feel any different from the children around them. I think it is great that the school I taught at had two children with medical disabilities in the typical kindergarden class. During certain times throughout the day things got challenging with them, but it was not impossible.
Placing a Child Life Specialist in the school system would leave a positive impact on the children. By incorporating one in the schools, the children who need to be getting therapy can receive it throughout the day which can help give them a break in the classroom. This can also give the teachers a break as well. A change needs to occur in the school system to help educate the parents and help them find resources outside the school to help their children.
Berger, K.S., (2016) The Developing Person Through Childhood & Adolescence, 10E, Worth Publishing, New York, NY
Thompson, R.H., (2009) The Handbook of Child Life: A Guide for Pediatric Psychosocial Care, Charles C Thomas Publishing, New York, NY