Classroom Accommodations for Children and Teens with Illnesses

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Treatments for childhood cancer, sickle cell disease, and other serious illnesses may have long-lasting side effects that can affect learning.

Sometimes children and teens may struggle in school in ways they didn’t before diagnosis or treatment. Some students may have problems focusing and paying attention.

Parents meet with young child's teacher in classroom. — Federal law provides support and services to help students with challenges learn better. These resources are called Individualized Educational Programs (IEPs) and 504 plans.

Some treatments can affect:

Memory
Learning
Focus
Attention
Processing
Organization

There are ways to help children adapt to changes. The key to getting the most out of these options is for your family, school, and hospital to work together. A school liaison can help you put this team together.

Federal law provides support and services to help students with challenges learn better. These resources are called Individualized Educational Programs (IEPs) and 504 plans.

Individualized Education Program (IEP)
What is an IEP?

An IEP is a plan for special education services. It is part of the federal law called Individuals with Disabilities Education Improvement Act (IDEA). Schools must offer IEPs if they receive federal funds.

Students can qualify for an IEP if they have both a disability and a need for help with school to deal with the disability.
Who can get an IEP?

Students can get an IEP if they:
- Have a disability
- Need help at school to deal with the disability
Disabilities may include:
- Learning
- Behavior
- Physical
- Social
- Emotional
To qualify, your child must have a disability in at least 1 of these areas.
- Autism
- Deafness
- Deaf-blindness
- Emotional problems
- Hearing impairment
- Cognitive (mental, thinking) disability
- Multiple disabilities
- Orthopedic (bone and joint) impairment (problem)
- Other health impairment (problem)
- Specific learning disability
- Speech or language impairment
- Traumatic brain injury
- Visual problems
Possible IEP services

Examples of IEP-related services include:
- Teaching or tutoring
- Counseling
  
  Rehabilitation counseling (independent living and job training)
- Occupational therapy, physical therapy, and speech/ language/ hearing support
- Parent counseling and training
- Psychological services
- School health services
- Social work services
- Transportation services
- Accommodations such as extra time for tests, reduced workload, and other accommodations as listed below:
  
  Seating at the front of the classroom
  
  Locker located near classrooms
  
  Second set of textbooks for home
  
  A “scribe” for long written work
  
  Copies of teacher’s notes
  
  Use of a study guide
  
  Extended time
  
  Tests
  
  Classroom assignments
  
  Homework
  
  Shortened or modified assignments
  
  Use of elevator
  
  Verbal testing
  
  Memory, technology, verbal, or visual aids
  
  Permission to leave class early to walk in uncrowded hallways
  
  Buddy system for visits to the school nurse’s office
  
  Permission to wear a hat at school
  
  Prompt phone contact with parent when another student in the classroom has a contagious illness
  
  Rest breaks
Your child may receive these services in different settings.
- Teachers may present lessons in a special education classroom or area.
- Your child may be pulled out of a general classroom for part of the day.
- They may receive small-group instruction in reading and math.
- They could get speech or occupational therapy.
Process for getting an IEP

Your child must go through an evaluation process for an IEP.

Contact the special education coordinator at your child’s school about getting an IEP evaluation. If the school does not have a special education coordinator, you may talk to:
- School administrators
- Counselors
- Teachers
You will be asked to sign an informed consent form to give permission for the evaluation.

If the school does not do an evaluation and you believe your child needs one, you can work with an outside psychologist. The psychologist will submit a report to the school system for review.
Getting ready for the evaluation

It’s a good idea to meet with educators before the evaluation. You can discuss the process and ask questions. Make sure to write down questions you want to ask. Take notes during the meeting.

Your child’s evaluation team could include an:
- Audiologist
- Psychologist
- Speech-language pathologist
- Social worker
- Occupational or physical therapist
- Vision specialist
- Classroom teacher
- Special education teacher
- Education diagnostician
The team may collect data through:
- Observations
- Interviews
- Tests
- Report card grades
- Classroom performance
The process may involve:
- Parents
- Teachers
- Specialists
- Students
The final report will paint a full picture of your child’s strengths and weaknesses. The IEP committee will meet and review the results and suggestions. 

If your child qualifies for an IEP, teachers will create one and review it with you. The IEP committee will meet each school year to talk about how the plan is working.

Students will have a new IEP evaluation at least every 3 years.

If your child doesn’t qualify for an IEP, you can talk with the school about other types of academic support.
504 plan
What is a 504 plan?

A 504 plan is for students with medical concerns. It provides for modifications in their classrooms to help them learn better. It is part of a federal civil rights law, Section 504 of the Rehabilitation Act of 1973. It applies to public school and other programs that get funds from the U.S. Department of Education. The qualification for a 504 plan is different from an IEP.

To be protected under Section 504, a student must be determined to: have a physical or mental impairment that substantially limits one or more major life activities; or. have a record of such an impairment; or. be regarded as having such an impairment.

The purpose of a 504 plan is to give students with learning problems the same access to instruction, activities, and school buildings as children without learning problems.

A 504 plan documents your child’s needs and may be useful in case your child requires more support in the future.

The law requires the 504 team meet at least once a year to review your child’s progress. You may request changes at any time.

For pediatric cancer survivors, creating a 504 plan with your child's school may result in additional support in the classroom.

How is a 504 plan different from an IEP?

The main difference is that a 504 plan modifies a student's education program in a general classroom setting. The classroom teacher delivers instruction.

A student with an IEP may receive services in a special or general educational setting. A special education teacher usually oversees instruction.

How may I request a 504 plan?

Ask for a meeting with the school to discuss creating a 504 plan.

Usually the school will have a Section 504 coordinator. If not, you may talk to the school administrators, counselors, or teachers.
What could my child receive with a 504 plan?

Examples of common supports include:
- Seating at the front of the classroom
- Locker located near classrooms
- Second set of textbooks for home
- A “scribe” for long written work
- Copies of teacher’s notes
- Use of a study guide
- Extended time on tests, classroom assignments, and homework
- Shortened or modified assignments
- Use of elevator
- Verbal testing
- Memory, technology, verbal, or visual aids
- Permission to leave class early to walk in uncrowded hallways
- Buddy system for visits to the school nurse’s office
- Permission to wear a hat at school
- Prompt phone contact with parent when another student in the classroom has a contagious illness
- Rest breaks

IEP or 504 plan meeting

What will happen during the meeting?

The 504 plan or IEP meeting may include:

School administrators
Counselor
School nurse
Teachers from school
Parents
Hospital school program teacher or liaison

The group will talk about the accommodations or support services your child might need in school. Members will identify the problems your child is having. And they will propose solutions.

What information should I bring to the meeting?

You know your child better than anyone.

Suggest approaches that have worked in the past.

Bring information about your child’s diagnosis and the side effects of treatment to share with educators.

What are tips for an effective IEP or 504 plan?

The IEP or 504 plan should specify the accommodations or support services your child needs.

Clear wording can get rid of confusion. For example, be specific about the memory aids your child will use.

Detail who has the job to carry out each part of the IEP or 504 Plan. Discuss all school settings that might require supports:

Each classroom your child spends time in
Outdoor recess
Physical education
Field trips

You know your child better than anyone. Be your child’s advocate in planning and monitoring your child’s progress. If you believe your child’s needs aren’t being met, ask for a meeting to discuss needed changes.

For more information, talk to your hospital’s school liaison or to a teacher or administrator at your child’s school.

Key Points

Treatment for serious childhood illnesses can affect your child’s learning.
There are ways to work with your child’s school to help your child do their best.
IEP and 504 plans can help you child learn in a setting that offers support.
Plans with clear wording can be the most effective.
If your child does not qualify for one of these plans, the school may still have options that can help.