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Classroom Accommodations

  1. When children and teenagers return to school after cancer treatment, sometimes they struggle in ways they didn’t before. For instance, a student who formerly made straight A’s may start making lower grades. A teen who didn’t have behavior issues before may have problems because he struggles to maintain focus and pay attention.

    Side effects of childhood cancer and its treatments can affect children and teenagers’ memory, learning, focus, attention, processing, and organization. But there are ways to help children adapt to the changes brought by cancer.

    If your child is having significant issues, it may be appropriate to discuss the possibility of an Individualized Educational Program or IEP.

    What is an IEP?

    An IEP is a plan for special education services to meet the educational needs of a child or teenagers with a disability.  An IEP is part of a federal law, the Individuals with Disabilities Education Improvement Act (IDEA). If a school receives federal funds, educators there can consider whether a student qualifies for an IEP and make sure the student receives needed services if eligible.

    Pediatric cancer patient sits in desk with text book open in conversation with unseen teacher.

    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 is eligible for an IEP?

    Students can qualify for an IEP if they have both a disability and a need for help with school to deal with the disability. The need can be related to learning, behavior, physical, social, and emotional needs.

    Below is a list of the categories to qualify for an IEP as stated in the IDEA. Your child must have a disability in at least one (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

    What services could my child receive with an IEP?

    Examples of IEP-related services are:

    • Teaching or tutoring, such as specialized reading or math help
    • Counseling, including 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, etc.

    Depending on the nature of the services, they may be delivered in the general classroom setting known as an “inclusion classroom,” in a special education classroom or area, or in a setting where children are “pulled out” during part of the day for special instruction in areas such as reading and math or for services such as speech or occupational therapy.

    What is the process for getting an IEP?

    An evaluation is required to see if a student qualifies. Contact the special education coordinator at the school about getting an IEP evaluation for your child. If the school does not have a special education coordinator, you may talk to the school administrators, counselors, or teachers.

    If the school elects not to do an evaluation and the parents disagree, they may get testing from another source such as a psychologist in private practice or evaluation from a hospital or clinic.

    1. If the school is conducting an evaluation, it’s a good idea to meet with educators before the evaluation to discuss the process and ask questions. Make sure to write down any questions you want to ask and to take notes during the meeting. Parents must sign an informed consent to give permission for the evaluation.

      The students’ evaluation team could include an audiologist, psychologist, speech-language pathologist, social worker, occupational or physical therapist, vision specialist, regular classroom teacher, special education teacher, and an education diagnostician. The team should collect data through a variety of methods such as observations, interviews, tests, report card grades and classroom performance from a variety of sources such as parents, teachers, specialists, and the student. When completed, the report should paint a thorough picture of your child’s strengths and weaknesses.

    2. After the evaluation, the school’s IEP committee will meet and review the results and recommendations. If your child qualifies for an IEP, educators will create one. If not, you can talk with them about other types of help, including a 504.
    3. If an IEP is created, you should have an IEP meeting each school year to talk about how the plan is working. You can ask for meetings more often if you need them.
    4. Your child will have a new evaluation every 3 years, or more often if needed. This is to make sure the IEP is still needed and appropriate.

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

  2. Childhood cancer and its treatments sometimes can cause long-lasting side effects that will have an impact on your child’s school life. These issues could include difficulties with memory, focus, attention, processing, organization and multitasking.

    However, there are many ways your child’s hospital and school can help if your child struggles. The key to getting the most out of these options is for your family, school, and hospital to work together regularly. One place to begin is to discuss developing a 504 plan.

    Young pediatric cancer patients sits with classmates in cap, gown, and face mask.

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

    What is a 504 plan?

    A 504 plan allows students with medical concerns to receive accommodations and modifications in the general classroom to help them learn better. It is part of a federal civil rights law, the Rehabilitation Act of 1973. The 504 plan is named for Section 504 of this law and applies to programs and activities that receive federal financial assistance from the U.S. Department of Education, such as public schools. A 504 is designed to allow all students with learning problems the same access to instruction, school activities, and the school buildings as children without learning problems. Childhood cancer patients should qualify for 504 plans under the “other health impairments” category.

    While most schools will be very willing to make modifications to meet your child’s needs, a 504 puts these strategies in writing, and it is required that the 504 team meet at least once a year to review your child’s progress. You may request changes at any time. A 504 plan provides documentation of your child’s needs and may be useful in case your child requires additional support in the future such as an Individualized Education Plan (IEP).

    A 504 plan is different from an IEP. The main difference is that a 504 modifies a student's education program in a general classroom setting and is delivered and monitored by the classroom teacher. A student with an IEP may receive different educational services in a special or general educational setting, depending on the student's need. IEP programs are delivered and monitored by additional school support staff, such as a special education teacher.

    How may I request a 504 plan?

    You should talk to your child’s school. Usually it will have a designated Section 504 coordinator. Ask the coordinator for a meeting to discuss creating a 504 plan. If the school does not have a Section 504 coordinator, you may talk to the school administrators, counselors, or teachers. Make it known that you want to be involved in the 504 meeting.

    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 to be kept at 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

    What will happen during the meeting? What information should I bring?

    The school administrators, 504 plan coordinator, counselor, teachers, and you will determine the specific supports your child might need in school. A hospital school program teacher or liaison (sometimes a social worker or nurse) can provide valuable input as well. This can be done in a conference call if needed.

    Identify the problems your child is having and then determine solutions. Suggest approaches that have worked in the past. Bring information about your child’s cancer and the side effects of treatment to share with educators. Work with hospital school personnel to develop a list of accommodations your child will need based on medical issues, psychological test results, and any other relevant information.

    Be specific in the wording of accommodations to eliminate confusion. For example, if your child is to receive memory aids, name the exact memory aids that should be used. Make sure to document who is responsible for ensuring 504 accommodations are carried out. Discuss all school settings that might require supports – each classroom your child spends time in, outdoor recess and physical education, and 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, request a meeting to discuss needed changes.


Reviewed: June 2018