Child life program eases classroom transition for oncology patients

Caleb loved school, but was afraid to go back. He’d missed four months of first grade after being diagnosed with cancer, and had been through quite a bit. He’d endured a major surgery, almost died four times, and was now in a wheelchair while he worked to regain his strength.

“He was really scared about going back,” said Debbie Chapman, child life specialist for the Children’s Hospital. “But he’d been away from ‘normal’ for so long, his sense of self was disappearing.” Chapman knew that returning to the classroom would help.

Caleb’s First Day
Debbie went to school with Caleb on his first day back, to ease his transition and help his classmates understand his illness. She told the class about his ordeal, talked about the hospital, and encouraged the children to be a friend.

“They were great,” Chapman said. “They were fighting over who was going to push him down the hall (in his wheelchair).” The class also decided to assign a different helper to Caleb every day, to sit with him and turn pages in his book.

“The impact for him was tremendous,” Chapman said.

Child Life Specialist
Debbie Chapman has been helping young cancer patients re-adjust to the classroom since the Pediatric Oncology program began three years ago.

“School is the social norm for kids,” she said. “It normalizes their environment. It normalizes their illness.” In fact, the first question most kids ask after being diagnosed is, “When am I going back to school?” Chapman said.

But, like Caleb, most children are nervous about returning to the classroom after a lengthy absence. They may fear failing, being ridiculed, or having no friends.

Classmates often have fears of their own. “Kids fear the unknown,” Chapman explained.

She helps students shed their fears and gain an understanding of the child’s illness and hospital experience through a classroom presentation. Though kids may re-enter the classroom at any time of the school year, August is a particularly busy time for Chapman’s program.

“The beginning of the school year is the perfect time,” she said. “They’re all talking about what they did over the summer. The kid with cancer has a very big story to tell.”

Introducing Children to Cancer
In her presentation, Chapman explains what cancer is and uses a medical doll to show what central lines and a port-a-cath (portable catheter) look like. She talks about medical procedures and about the hospital environment including unexpected elements such as:

• the froggy garden
• therapy dogs that visit patients
• special activities in the playroom

Questions fly during the presentation:
Can we catch it? How many shots did you have to have? What is the operating room like? Did your parents cry? Are you sad?

“I’ve had kids in the classroom cry when they find out what the child has gone through,” Chapman said.

Inevitably, the most serious question of all comes up: Can he die from this? Many children know someone who has died from cancer, and they often fear the worst.

“It’s important not to lie,” Chapman said. Instead, she steers the topic in a more positive direction, explaining, “The kind of cancer Johnny has is so different from the kind your grandfather had.” She lets them know that many children survive cancer.

By the close of her presentation, the returning student has already gone a long way in readjusting to the classroom.

“Everyone wants to go sit next to the child by the end,” Chapman said.