School Support for Children with Chronic Pain
by Brittany Barber, PhD, and Deirdre Logan, PhD
Many parents wonder if their child should go to school when he or she is in pain. Extensive research and clinical knowledge in this area indicate that children with chronic pain who attend school regularly have better outcomes than those who do not. Pain, academic functioning, psychological well-being and social engagement have all been known to improve when a child attends school, even if they are in pain.
The school environment is ripe with distractions, both academic and peer-related, which generally help children not to notice pain as much and cope with it better. While chronic pain can be debilitating, we have found that, with the right accommodations in place if necessary, children can succeed in school in spite of pain. Even children who have experienced long periods of school absence can gradually increase school attendance over time and resume normal academic functioning.
Some children who have chronic pain will need some temporary accommodations to help them re-enter and stay in school. Some common accommodations that we frequently work with schools to provide include:
- a gradual return to school plan for students who have missed a significant amount of instruction
- identifying a single person at school who can work directly with the student and parents to create a plan so that all staff and teachers involved will respond consistently and constructively to pain episodes
- identifying pain triggers that exist in school and helping the student determine how to avoid them or cope with them
- identifying a place for the student to go for short breaks to gain control of pain (as opposed to going home when pain intensifies)
- going to the nurse for a dose of pain medication as prescribed
- a few extra minutes to get from class to class to avoid overcrowded hallways
- extra books available to reduce weight that must be carried around school
- involving parents in school planning as much as possible, especially to reward the student for attending and participating in school despite pain
Generally, these accommodations can be provided in an informal agreement among the parents, student, teachers, and school personnel. If this is not possible, however, many students with chronic pain qualify for, and benefit from, having a formal Individualized Education Plan (IEP) or Section-504 Plan, which affords them accommodations according to national law.
Section 504 of the Rehabilitation Act is a civil rights law that prohibits discrimination against individuals with disabilities and ensures that a child with a disability, such as chronic pain, has equal access to an education. Under Section 504, a child may receive accommodations and modifications if his/her impairment substantially limits the ability to learn. Alternatively, the Individuals with Disabilities Education Act (IDEA) requires the school to provide an IEP that is designed to meet the child's unique needs and provides the child with educational benefit. For most patients with pain where a formal plan is required to obtain accommodations, a 504 plan is adequate to meet these needs. In rarer cases, a full IEP may be necessary. If a student already has an IEP in place, such as for learning disability or attention deficit problems, it is often possible to extend this plan to provide appropriate accommodations to help them succeed in school in spite of pain.
At the Pain Treatment Service, we work individually with each patient and his/her family and school to create a plan that meets the patient’s needs. We consult with schools and work in close collaboration with families toward the crucial goal of helping children with pain to remain in the school setting.