Sharpened pencils, new backpacks and notebooks; ‘Tis the season for heading back to school. Sending a child off to school for the first time can be an emotionally charged event. The typical anxiety level may be ratcheted up a notch for parents of children with cystic fibrosis. This does not need to be the case. With a little bit of help and a few simple tips, you can send your child to school confident that his or her CF needs will be met.
In August, 2007, we surveyed our members in a CF Parents Survey. Throughout this article you’ll see quotes by members of CysticFibrosis.com regarding their expectations, excitement, and apprehensions about sending their children off to school.
Larasmommy:"Mostly I’m worried about the germs and how sick she gets when she goes there."
Bbedrock:"Starting a school year is always exciting. My son loves to experience and learn new things and I hope that continues as he starts a new school year. The biggest fear is that he will contract something at school; he's entering third grade; it's never happened, but the fear is still there. "
Parents of younger children who are starting school for the first time or who are transferring to a different school, often worry about how much information to give their child’s teacher. The Cystic Fibrosis Research Inc. (CFRI) has an excellent publication, " CF in the Classroom" . This booklet outlines the basics of CF and offers guidelines for ensuring you make the most of your child’s school experience. In order to make sure the teacher understands the material you are presenting, be sure to give it to them in person. Encourage your child’s teacher to ask questions about CF and provide an opportunity to discuss it further. The CFRI has done a wonderful job of gathering the most relevant information for parents and teachers, and combined them in this informational booklet. If your child’s school has a nurse or counselor on staff, make the information available to them as well.
TonyaH:"I always meet with his teacher before the start of school to discuss the disease, supply literature, go over his meds, etc. I also make a little trip to his PE teacher to ask him/her to be aware."
Whomever you disclose your child's health information to, remind them that because this information is health-related, it is considered private. It is inappropriate for them to share or disclose the details of your child’s condition with others, including the rest of the class. As your child progresses in school, he or she may want to let others know about cystic fibrosis. Determining how and when to do that is a matter of personal preference.
The day will come when a student with CF will have to explain why he or she takes those pills at lunch time, why he or she is so skinny, or why that pesky cough never goes away.
David:"I have always told him to be honest and tell them he has cystic fibrosis and that they can’t catch it."
Depending on their age and relationship to the student, some people will ask nosey questions, and others will be genuinely interested in understanding. Many people have found the direct, non-specific or detailed approach to be the best.
Michelle43:"He made this up himself, I have CF it makes me cough and is like asthma, I have to take pills and do treatments, but I'm very lucky and healthy because my mommy keeps good care of me and I've only been to the hospital once; most CF kids go more often."
Below are some of the experiences that parents of CFers and their students have offered to explain CF to teachers and classmates.
Bbedrock:"My son's first grade year wasn't too good. The teacher admitted she felt sorry for him - no reason to; he appears and acts healthier than non-CF kids. The day before second grade started we met with everyone who was going to have anything to do with him - from the lunch aid to the phys ed teacher to the principal and went through everything CF related and the repercussions to him, emphasizing our desire to have him treated like everyone."
Consmom:"[We stay involved by] keeping in contact with the teacher, nurse and catering manager. We have an education assembly in September so he gets to show off his vest, etc. and we can explain CF to everyone."
Michelle43:"I send a "CF in the Classroom" booklet to all of his new teachers. I highlight all of the things that have to do with my son and staple a picture of Collin and phone number list where to reach me or Collin’s dr. and an invite to feel free to ask me anything and to call if he's not acting well."
Avoiding every germ is an impossible task. Getting sick is inevitable. Prevention is key, and seeking treatment at the first signs of infection is a must. Some of the basic ways to prevent illness include:
Pneumonia (every 5 years)
One of the most important things a child with CF can do to stay healthy is to minimize exposure to germs and harmful bacteria. Frequent hand hygiene, which includes washing one’s hands with soap and water, and/or using alcohol-based hand gel, is best. A good rule of thumb is if there is visible dirt on a child’s hands or the child has just used the restroom, he or she should use soap and water. After sneezing and coughing, an alcohol based gel or antibacterial wipe is sufficient.
TheDickens:"Make sure your child keeps his/her hands clean and try to keep a safe distance from children with colds and other illnesses."
Making the Grade: Keeping Up Despite Absence
Frequent absences from school are sometimes part of life with CF and can make both students and parents anxious. It is important for students to keep up with their peers in terms of coursework to the greatest extent possible. This is where an Individualized Education Plan (IEP) and the Americans with Disabilities Education Act (IDEA) serve a purpose. Another law that protects students with health impairments is Section 504 of the Rehabilitation Act of 1973, which offers modifications for students who need it.
Jane:"My kids both have a 504 plan to help with accommodations. I have found most teachers and school staff to be very helpful. I teach in the same school as my children, so I am on top of things."
It is best to have an IEP or 504 plan in place before the student becomes sick. This way, no additional time is lost trying to establish whether the student needs special accommodations.
David:"[My advice to parents is to] set up a 504 plan so that he can use the restroom when needed as well as make sure he is allowed to carry some kind of bottle with him for drinks."
Sample modifications for elementary/secondary education might include:
Student carries and takes own enzymes
Student may sit at a desk away from classmates who have colds
Snacks are permitted during class time
Child does not need to ask permission to go to the bathroom or to get a drink
Second set of textbooks for home
Section 504 also applies to colleges, graduate schools, and any other institutes of higher education that receive federal funds. Under Section 504, institutes of higher learning cannot refuse to accept students based on their disabilities. The school must provide accommodations if the student is accepted.
Depending on the school’s schedule and an individual’s stage of disease, an IEP may be required. Additionally, it ensures that the school is compliant with the IDEA, and will make reasonable accommodations for students in need. This is especially valuable for college students. Note-taking services or extended deadlines for coursework might be required in the event that the student experiences an exacerbation and cannot attend class.
A Balancing Act
Keeping up with health care in addition to a school schedule, extra curricular activities, and homework can be tiresome. It’s important that students learn effective time management skills and self discipline in order to balance the demands put upon their time and energy. Here are some strategies employed by members of CysticFibrosis.com:
JORDYSMOM:"The week before school starts, earlier bedtimes start. To ensure that things are going smoothly at school, I just communicate with him daily about how he feels, how his day went etc."
Kelli Myers:"As a former teacher, I think it is important for the parent(s) to meet with the teacher, explain the disease, and leave a typed list of instructions/helpful hints. Also, let the teacher and school nurse know of any med changes, illnesses, etc. and specify if the matter is a private matter (not to be shared with classmates, other parents, etc.)."
Michelle43:"Good communication is very important. The nurse checks Collin's temp at lunch for me if I think he may be coming down with something or I let the teacher know that we're increasing his treatments and the albuterol may make him fidget and lose concentration in class. I also mention to the gym teacher that it's so hot out that Collin has needed extra salt tabs at home; I usually see the gym teacher daily. I had one teacher’s aid who was sort of snotty and when she saw a list of Collin's meds by accident her whole attitude changed and she started asking questions, and she is much more understanding towards my son now. Sometimes education is all that's needed."
Starting school or going back to school can be an exciting while somewhat nerve-wracking experience. When parents, students, and educators work together, students with CF will benefit fully.
With the newest advances in medications and treatments for cystic fibrosis, more and more patients are able to not only graduate from high school, but go on to institutes of higher learning. The future for students with CF is growing brighter every day.