Children With Cancer and Schooling Challenges

Introduction

Significant increase in the cases of childhood cancer has characterised the past five decades. Even though the survival rate of children has improved tremendously, it is imperative to appreciate that little has been done to understand the psychological and social implications of childhood cancer. Additionally, little has been done to assist kids to cope with life after recovering from cancer (Donovan 2014). The medical advancement and increased rate of survival of children with cancer have called for society to look for ways to reintegrate the kids into school. Indeed, “there is an emergent trend that stresses the importance of incorporating the provision of comprehensive care for pediatric cancer patients that recognises the social and emotional needs of the children in addition to their clinical requirements” (Donovan 2014, p. 141).

The comprehensive treatment program seeks to enable children to go on with their academic and social life. According to Gorin and McAuliffe (2013), the education of kids who have recovered from cancer and those struggling with the health condition is a critical issue since it would help them to achieve healthy emotional and social growth. Education institutions should treat children with cancer like normal kids and allow them to engage in activities that they would do were they not suffering from the disease. This literature review will analyse the challenges that children with cancer face in their endeavour to pursue education and how to assist the kids.

Literature Review

Peers and Social Relationship

A study conducted by Fraser (2015) revealed that children with cancer find it difficult to cope with their peers when they return to school. The rationale for the study was to identify what society has done to meet the social needs of children with cancer. A qualitative study carried out on 12 families revealed that kids with cancer have unique social needs that surpass the effect of absence from school. Fraser (2015) posits that cancer treatment results in changes in the physical appearance of a patient. Consequently, when kids with cancer go back to school, their colleagues see them differently. In some instances, it becomes hard for kids with cancer to re-establish a friendship with former members who find them different.

Studies indicate that many children who have cancer are reluctant to go back to school because they fear that their friends might not accept them back. Gorin and McAuliffe (2013) support this finding by alleging that kids with cancer occasionally experience seclusion and rebuff by peers, which border the isolation that children with disabilities encounter. Lightfoot, Mukherjee and Sloper (2012, p. 61) posit, “The novelty of the child’s condition and possible shock that peers experience when a child who has had cancer returns to school can have a negative impact on how they react to that kid”. The study is helpful as it delves into changes in peer relationships and friendships, which arise after a child has cancer. It has explored ways that society can use to address the issues.

The study fails to appreciate that it is not only the physical appearance of the kid that determines how peers treat children with cancer. The research does not consider the impacts of misconceptions that children have regarding chronic diseases. Lightfoot, Mukherjee and Sloper (2012) argue that apart from physical appearance, contrary ideas regarding chronic illness may contribute to kids with cancer facing rejection from their colleagues. Most students believe that cancer is infectious, and are worried that they might contract the disease if they interact with the sick child. Fear of contamination contributes to children avoiding their peers who have cancer.

Social Inclusion

McLoone, Wakefield and Cohn (2013, p. 487) argue, “The study of the education of children with medical conditions has fallen into two opposing streams”. The first stream focuses is the medical model, and associates emotional and social challenges and education problems with the illness itself. The second stream is the social model, which associates the challenges that children with cancer experience with lack of knowledge on the part of the learning institutions and the public at large. A study by McLoone, Wakefield, and Cohn (2013), sought to determine how social inclusion helps children with cancer to return to school after being away for a long time.

The study analysed school reentry experience of kids who had just completed cancer treatment. It sought to determine the perceptions of forty-two parents whose children were undergoing cancer treatment. The researchers used semi-structured telephone interviews to gather information. The Miles and Huberman framework was used to analyse the interviews. The study identified social inclusion as a major challenge that inhibits children’s ability to reintegrate into the school system. Ethically, the study raised concerns over parents’ emphasis on the academic success of their children at the expense of overall personal development. It recommends research on the role of continued peer socialisation in the success of school reentry process.

McLoone, Wakefield, and Cohn (2013) allege that educating kids with medical conditions should follow an individual and holistic approach, which acknowledges the unique needs of every child. Their study emphasises the significance of ensuring that academic and social settings consider the needs of kids with cancer as well as those of their peers. According to McLoone, Wakefield, and Cohn (2013), educational institutions should not only offer quality education to children with cancer but also act as compensation or disruption from the ordeal that the kids have endured due to sickness. They allege that social elements and friendship, in conjunction with institutional factors, determine the success of the child’s reintegration into school.

Academic and Cognitive Impacts of Childhood Cancer

Childhood cancer does affect not only the social and psychological life of the kid but also cognitive functioning. Barrera et al. (2014) conducted a study to determine the academic and cognitive impacts of childhood cancer on kids aged below 17. The rationale for the study was to evaluate the educational and social development of survivors of childhood cancer. A total of 800 survivors were pooled together with 923 control participants. Questionnaires were used to gather information about the academic performance of the kids. The study found that most cancer survivors performed poorly in academics and repeated some grades. Ethically, the study raised a question about the significance of using cranial radiation to treat cancer patients. The radiation was found to contribute to learning challenges as well as difficulties in making friendships.

According to Barrera et al. (2014), cancer survivors encounter challenges in scholastic performance due to the late effects of their treatment. The effects “are associated with brain damage as a result of radiation and chemotherapy, which are commonly used to treat childhood cancer” (Barrera et al. 2014, p. 1754). Studies indicate that administration of cranial radiation affects the cognitive functioning of a child. Kids who undergo the treatment encounter challenges in Mathematics, English, and Science. Additionally, they have difficulties in visual-motor skills and verbal fluency. Other psychological challenges include problems with mental processing speed, attention, and intellectual deterioration.

Even though the mode of treatment of cancer can have impacts on the academic and cognitive functioning of a child, other factors such as the age of the patient also play a significant role. The study fails to consider the impact of the age of a child on cognitive functioning and academic performance. Children who undertake cancer treatment at an early age have a high risk of experiencing academic and cognitive challenges. Shiu (2014, p. 273) argues, “Developing brains are sensitive to treatment and the damage that it may cause”. Provision of educational support can go a long way towards helping children with academic and cognitive challenges. According to Shiu (2014), survivors of childhood cancer require additional tutoring to enhance their academic potential.

Teachers

Teachers play a significant role in assisting survivors of pediatric cancer to reintegrate into school. Bessell (2013) conducted a study to analyse school experience, quality of life, and psychosocial adjustments of survivors of childhood cancer. The researcher used a multimethod approach to evaluate how survivors coped with the disease and their opinion regarding psychological and educational changes as a result of cancer treatment. A total of 51 survivors aged between 8 and 17 participated in the study. Quantitative analysis showed that the survivors suffered from anxiety and challenges in psychosocial changes in the fields of intellectual and social skill and emotional balance. The study found that educators require having specific skills and knowledge to deal with cancer students. It also brought out the significance of social inclusion in enhancing students’ performance. The study did not touch on ethical issues attributed to the teacher-student relationship.

A study by Donovan (2014) supports the significance of teachers in the creation of a healthy learning environment for kids with cancer. Many survivors of pediatric cancer argue that they prefer educators who understand them and their conditions. A healthy relationship amid teachers and childhood cancer survivors entails giving the kids adequate time to complete assignments and altering teaching methods to cater to their needs. Childhood cancer survivors require a lot of educational support. Unfortunately, most educators do not have knowledge on how to assist the survivors. As a result, they become anxious and are unable to deal with children suffering from chronic diseases. In secondary schools, students deal with many teachers, thus the need to ensure that all instructors have adequate skills in how to handle cancer survivors and establish a supportive learning environment. The inability of the teachers to align instructions with the needs of individual students impedes the academic success of childhood cancer survivors.

Supporting Childhood Cancer Survivors

A’Bear (2014) conducted a study, which sought to determine methods that parents and teachers can use to assist childhood cancer survivors in continuing their education. The rationale for the study was to establish how technology may help to reduce the effects of nonattendance and enable learners to be at par with other students. The study contributed to the understanding of the role that school districts can play to ensure that kids with chronic diseases do not miss learning opportunities. It delved into the theory of inclusion. Teachers, parents, and childhood cancer survivors were among the participants in the study. The research considered confidentiality ethics. The names of the members were kept secret for privacy purpose. A’Bear (2014) used focus group interviews to collect qualitative data. The data analysis entailed a detailed examination of information gathered from each focus group. The researcher used data triangulation technique to identify major themes and eliminate possible biases. The study found that technological instruments like Skype are critical in enhancing the learning environment for children with cancer, particularly those recuperating at home. The major limitation of the study is that it relied on descriptive and ethnographic data which is prone to bias.

Thies and McAllister (2012) underline the significance of hospital schools to children with cancer. However, such a strategy can only be useful to kids who are admitted to hospitals. Children who do not spend a lot of time in hospitals may not benefit from such learning arrangements. Advancement in treatment procedures has resulted in children spending limited time in hospitals. Currently, some school districts organise for homebound programs where instructors visit learners at home. Unfortunately, the programs do not yield significant results as kids study in isolation. Suzuki and Kato (2014, p. 163) report, “patients in homebound schooling often feel unprepared to return to their community schools and report feeling lonely and isolated”.

According to Suzuki and Kato (2014), parents and teachers can use distributed learning to assist children with cancer. Suzuki and Kato (2014, p. 170) define distributed learning as “a system that responds to the unique learning needs of individual learners, and takes place outside the traditional classroom”. Literature review shows that few scholars have focused on the effectiveness of distributed learning in promoting education amid children with chronic illnesses. The learning method utilizes online technology, print-based materials, and Web 2.0 instruments to teach childhood cancer survivors who are recuperating at home. Even though distributed learning assists students to continue with their studies, it does not fulfill the socialisation needs.

Research conducted in Australia appreciates the significance of transforming the provision of educational assistance to children with cancer. The study champions the use of technology to deliver curriculum to students who are recuperating at home. The application of contemporary technology like Skype helps to establish an interactive learning environment, as the chronically ill student can connect with the classroom. Moreover, technology supports self-sufficiency and facilitates individualised learning, which is tailored to the needs of the student. A study by Thies and McAllister (2012) reinforces the findings of the significance of technology in promoting learning amid cancer students. The research underlines that synchronous technology enables the student to stay in contact with classmates. Additionally, the chronically ill learner remains active both academically and socially.

According to Thies and McAllister (2012, p. 171), “shared online whiteboarding allows students to participate in tutoring sessions with the teacher during mathematics lessons”. The strategy is more helpful than telephone conversations as instructors can elaborate on areas that the learner does not understand. Additionally, children with cancer get an opportunity to interact with their classmates, albeit virtually, and share ideas on how to handle certain mathematical questions. Lightfoot, Mukherjee and Sloper (2012) report that the use of synchronous technology to assist children with cancer to continue with their education helps the learners to establish a custom that links them to an essential nonmedical constituent of their lives. The classmates and teachers become more compassionate and understand the challenges that children with cancer endure, thus embracing them as members of the school community. Nevertheless, Thies and McAllister (2012) raise the question about the number of interruptions that arise in the course of learning because of the continuing treatment. The study recommends research to determine the role that asynchronous communication tools can play to enhance schooling amid cancer children.

Significance of Communication

Thompson et al. (2015) conducted a study to investigate the importance of communication in providing school reentry support to children with cancer. The study relied on secondary information from peer-reviewed journals bearing literature on communication and school reentry support for children with cancer. A total of 17 scholarly journals were used. The study found that communication-enabled teachers and children to understand the needs of childhood cancer survivors. Additionally, cooperation between parents and teachers enabled them to offer the necessary support to the children. The study did not touch on ethical issues that might inhibit school reentry of children with cancer. Communication between parents and teachers enable children to be at par with other students (Charlton, Pearson & Morris-Jones 2012). It allows a child to complete assignments and follow the established lesson plans. Moreover, some teachers provide academic assistance such as tutoring. It encourages a child to continue with its studies despite the health condition.

Charlton, Pearson and Morris-Jones (2012, p. 1339) argue, “Maintaining excellent communication with your child’s school will activate additional resources that may be available to help you and your child as they balance the awkward bridge between school and treatment”. Some schools provide emotional support to children with cancer. They offer counselling services to emotionally distressed kids and assure them that they will overcome their condition and go back to school. Many schools facilitate social interaction between children with cancer and other students. They help students to understand the challenges that kids with cancer have to endure and their role in helping them to reintegrate into school. It contributes to minimising rejection and guarantees a smooth return to school.

Conclusion

Children with cancer encounter numerous challenges in their effort to continue with studies. Rejection from peers is a major problem that makes it difficult for children to reintegrate into school. Apart from changes in the physical appearance of a child due to treatment, misconceptions about cancer lead to students avoiding childhood cancer survivors when they return to school. Social inclusion is paramount in helping children with cancer return to school. Education institutions should ensure that they meet the social needs of children with cancer. Childhood cancer affects the academic and cognitive functioning of a child.

The affected child has problems in understanding Mathematics, English and Science subjects. The most affected children are those who undergo cancer treatment at an early age. Teachers have a role to play in helping children with cancer return to school. They require establishing a healthy relationship with childhood cancer survivors and giving them adequate time to complete assignments. Pediatric cancer survivors prefer teachers who understand their conditions. The use of technology can help students to continue with studies as they recuperate at home. Synchronous technology can aid to establish an interactive learning environment and enable a child to stay in touch with classmates. Communication between parents and school administration can go a long way towards ensuring that a child is not left behind academically.

Reference List

A’Bear, D 2014, ‘Supporting the learning of children with chronic illness’, Canadian Journal of Action Research, vol. 15, no. 1, pp. 22-39.

Barrera, M, Shaw, A, Speechley, K, Maunsell, E & Pogany, L 2014, ‘Educational and late social effects of childhood cancer and related clinical, personal, and familial characteristics’, Cancer, vol. 104, no. 8, pp. 1751-1760.

Bessell, A 2013, ‘Children surviving cancer: psychosocial adjustment, quality of life, and school experiences’, Exceptional Children, vol. 67, no. 3, pp. 345-359.

Charlton, A, Pearson, D & Morris-Jones, P 2012, ‘Children’s return to school after treatment for solid tumors’, Social Science and Medicine, vol. 22, no. 12, pp. 1337-1346.

Donovan, O 2014, ‘Building personal and social competence through cancer-related issues’, Journal of School Health, vol. 79, no. 3, pp. 138-143.

Fraser, D 2015, ‘Strangers in their own land: friendship issues when children have cancer’, Journal of Research in Special Education Needs, vol. 3, no. 3, pp. 147-153.

Gorin, S & McAuliffe, P 2013, ‘Implications of childhood cancer survivors in the classroom and the school. Health Education, vol. 109, no. 1, pp. 25-48.

Lightfoot, J, Mukherjee, S & Sloper, P 2012, ‘Supporting pupils with special health needs in mainstream schools: policy and practice’, Children and Society, vol. 15, no. 1, pp. 57-69.

McLoone, J, Wakefield, C & Cohn, R 2013, ‘Childhood cancer survivors’ school (re)entry: Australian parents’ perceptions’, European Journal of Cancer Care, vol. 22, no. 4, pp. 484-492.

Shiu, S 2014, ‘Issues in the education of students with chronic illness’, International Journal of Disability, Development and Education, vol. 48, no. 3, pp. 269-281.

Suzuki, L & Kato, P 2014, ‘Psychosocial support for patients in pediatric oncology: the influences of parents, schools, peers, and technology’, Journal of Pediatric Oncology Nursing, vol. 20, no. 4, pp. 159-174.

Thies, K & McAllister, J 2012, ‘The health and education leadership project: a school initiative for children and adolescents with chronic health conditions’, Journal of School Health, vol. 71, no. 5, pp. 167-172.

Thompson, A, Christiansen, H, Elam, M, Hoag, J, Irwin, M, Pao, M, Voll, M, Noll, R & Kelly, K 2015, ‘Academic continuity and school reentry support as a standard of care in pediatric oncology’, Pediatric Blood & Cancer, vol. 62, no. 1, pp. 805-817.